Wrap up the school year on a high note with NESCA’s Executive Function Coaching and Functional Occupational Therapy! We offer support in EF, Real-life Skills, Parent/Caregiver Coaching, and OT.

Time is running out to schedule a Transition Assessment before the school year ends—gain valuable insights to guide the IEP process.

Ready to learn more or book a service? Fill out our Intake Form today!

Tag

NESCA

50
Girl with Down Syndrome in a job training

Pre-Employment Transition Services (Pre-ETS)

By | NESCA Notes 2024

Girl with Down Syndrome in a job trainingBy: Kelley Challen, Ed.M., CAS
Director of Transition Services, NESCA

Did you know that vocational rehabilitation (VR) agencies are required to provide services to students with disabilities in order to prepare them for future employment?

The Workforce Innovation and Opportunity Act (WIOA), enacted in 2014, mandates Pre-Employment Transition Services (Pre-ETS), which may be provided through VR agencies, contracted community partners, or even schools.

And importantly, Pre-ETS services are available to all students with disabilities, not just those on IEPs.

There are five key components of Pre-ETS:

  1. Job Exploration Counseling: Helps students understand various career options and what is required for different jobs.
  2. Work-Based Learning Experiences: Provides opportunities for students to gain practical, hands-on work experience through internships, job shadowing, or apprenticeships.
  3. Counseling on Post-Secondary Education: Assists students in exploring post-secondary education options, such as college or vocational training, and understanding the necessary steps to achieve their educational goals.
  4. Workplace Readiness Training: Focuses on developing essential skills needed for employment, such as communication, problem-solving, and social skills.
  5. Instruction in Self-Advocacy: Teaches students how to advocate for themselves, including understanding their rights and responsibilities, and how to request accommodations in the workplace or educational settings.

Pre-ETS benefits students in several ways:

  • Enhances students’ understanding of career and education options
  • Provides exposure to real-world work environments
  • Develops essential soft skills required for employment
  • Helps promote confidence and independence
  • Supports a smoother transition from school to adulthood

By participating in Pre-ETS, students with disabilities can better prepare for their future, ensuring they have the skills and knowledge needed to achieve their career and life goals.

If you want more information about Pre-ETS in any state, you can try some of the following steps:

  1. Visit your state VR web site: https://rsa.ed.gov/about/states
  2. Google it! Use key terms like “Pre-Employment Transition Services [state name]”
  3. See if your state department of education or special education agency has information about Pre-ETS on their web site
  4. Ask your local school district

The U.S. Department of Education’s Office of Special Education and Rehabilitative Services recently published guidance with additional information about Vocational Rehabilitation, Pre-ETS, and Transition Services. To download a copy of the guidance, visit: Coordinating-Transition-Services-and-Postsecondary-Access.pdf

 

About the Author
Kelley Challen, Ed.M., CAS, is an expert transition specialist and national speaker with over 20 years of experience supporting youth andKelley Challen headshot young adults with diverse developmental and learning abilities. Since 2013, she has served as Director of Transition Services at NESCA, offering individualized transition assessments, planning, consultation, coaching, and program development. She specializes in working with students with complex profiles who may not engage with traditional testing tools or programs. Ms. Challen holds a BA in Psychology and a Minor in Hispanic Studies from The College of William and Mary, along with a Master’s and Certificate of Advanced Graduate Study in Risk and Prevention Counseling from the Harvard Graduate School of Education. She is a member of CEC, DCDT, and COPAA, believing it’s vital for all IEP participants to have accurate information about transition planning. Ms. Challen has also been actively involved in the MA DESE IEP Improvement Project, mentored candidates in UMass Boston’s Transition Leadership Program, and co-authored a chapter in Technology Tools for Students with Autism.

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

NESCA is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; the greater Burlington, Vermont region; and Brooklyn, NY (coaching services only) serving clients from infancy through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

6
Rebecca Dautoff headshot and quote

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

By | NESCA Notes 2024

Rebecca Dautoff headshot and quoteBy: Jane Hauser
Director of Marketing & Outreach, NESCA

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

What brought you to NESCA and why?

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

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

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

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

 

About the Author

Dr. Rebecca Dautoff provides comprehensive neuropsychological and psychological (projective) evaluation services for children, adolescents,Headshot of Rebecca Dautoff, Psy.D. and young adults who have complex presentations with a wide range of concerns, including attention deficit disorders, psychiatric disorders, intellectual disabilities, and autism spectrum disorders (ASD). She also values collaboration with families and outside providers to facilitate supports and services that are tailored to each child’s specific needs.

 

If you are interested in booking an appointment for an evaluation with Dr. Dautoff or another NESCA neuropsychologist/clinician, please fill out and submit our online intake form. 

 

NESCA is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; the greater Burlington, Vermont region; and Brooklyn, New York (coaching services only) serving clients from infancy through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

6
Leah Weinberg headshot and quote

NESCA Adds Pediatric Neuropsychologist Leah Weinberg, Ph.D. to its Team

By | NESCA Notes 2024

Leah Weinberg headshot and quoteBy: Jane Hauser
Director of Marketing & Outreach, NESCA

NESCA is pleased to welcome Dr. Leah Weinberg to its team of expert neuropsychologists. Learn more about her professional experiences and what she hopes to bring to NESCA and the families it serves. 

Tell us about your career path and what made you get into neuropsychology.

My path to neuropsychology was not a direct one. My initial field of interest was in school psychology, a discipline that focuses on the mental health, behavioral, and academic needs of students within the school setting. The program I went to at Fordham University had a focus on testing, but also offered very strong consultation and counseling components. That’s how I got into psychology, broadly speaking. I did my internship at and worked as a school psychologist in a large private school for different age groups. During that time, I worked in early childhood, elementary, and in high school grades. As a school psychologist, I engaged in psychoeducational assessment, provided direct therapeutic support to students, and collaborated closely with educators, parents, and administrators to promote positive student outcomes.

And as a side job during and after graduate school, I dipped my toes into some teaching – assistant teaching, regular classroom instruction, some special education settings, and school counseling, primarily with middle to high schoolers. From there, I got into neuropsychology, which brought together my love of testing and helping children/students – and by extension, their families – by helping to figure out what is going on and how to direct them to the appropriate intervention(s).

I was a post-doctoral fellow at a group practice in the greater Boston area and stayed with them as a pediatric neuropsychologist for a total of 10 years.

What are your areas of expertise in evaluating students?

As far as ages go, I like to work with individuals from age six through the college years or into young adulthood. Regarding the profiles of students I evaluate, I have experience in a little bit of everything, but largely focus on children with executive function and attention deficits. I also evaluate for learning disabilities, including reading, math, and writing challenges, nonverbal learning disability, as well as children with concerns of various types of anxiety, depression, or mood issues. I also see a lot of children with emotional regulation issues, presenting as emotional outbursts, behavioral outbursts, meltdowns, or ADHD-type symptoms.

It’s really interesting to me to determine the cause of the various forms of regulation challenges. It may stem from being born prematurely or could also be related to a disorder or disability. The behaviors that children with regulation challenges exhibit may look similar from one child to another, but no two children are the same. The root cause is unique within each child or individual.

I really enjoy working with these kids and helping their parents or caregivers understand what’s going on with them. It’s often mind-blowing to see their parents or caregivers finally understand that there is a reason behind the difficult behaviors and that they have a chance to support them. You can watch them start to connect the dots or see things start to make more sense to them. It’s like pulling the veil off of something that looks and feels very complex, but through evaluation, we are giving them a path to go down to support the child and mitigate the challenges. This is why I love my job. I can provide clarity to parents and other providers. And with that clarity, we can empower them to seek appropriate and tailored care and support for their child.

What were you looking for in choosing to join the NESCA team?

I was hoping for a more supportive and collaborative environment and with a strong peer group. I wanted to be in a setting surrounded by colleagues who love their jobs as much as I do and who can work well together and independently.

I am hoping to nurture the relationships I have with the families I work with and also with my colleagues. From what I’ve experienced, NESCA is a supportive environment that will assist me in doing my job through its collaborative, enriching peer group, and that benefits the families we serve and strengthens our skills as neuropsychologists. I love learning from the different perspectives, experiences, and insights into schools, providers, and interventions we recommend.

What do you tell parents or caregivers who are hesitant to have their child evaluated?

Often, parents are setting out trying to find answers for their child’s struggles, maybe for the first time. Very frequently, they are unsure of the process and what it all means. They are worried about their child getting a label, what the implications of having a label will be  and for how long their child will carry this. They are scared of what they don’t know. Those who have been seeking answers for quite some time may be skeptical that a neuropsychological evaluation won’t deliver the answers they are desperate for.

Parents and caregivers exploring whether to get a neuropsychological evaluation carry a lot of fear, and rightfully so. In my role, I try to put myself in their shoes. They feel as if they are putting their child under a microscope and are unsure and afraid of what we will find. I keep their journey or experiences, which are often frustrating and tumultuous, in mind and educate them about the different ways in which a neuropsychological evaluation can be beneficial. For example, beyond assisting the family in understanding their child’s strengths and weaknesses in a thorough fashion, a diagnostic label may just be the key to giving their child (and them) some relief from their struggles. With a diagnostic label, they may finally access the services needed to help their child realize their full potential as a student, friend, or community member. Our goal is always to make things better for the child.

What have you been seeing in children, teens, and young adults since Covid hit?

I am seeing more emotionally driven scenarios, stemming from the increase in anxiety. I am also seeing kids with more of a mood component to their profiles. In addition, we are seeing an increase in learning disabilities alongside that mood piece. In many cases, it is more difficult to distinguish what exactly is the root cause of the challenges, whether each issue they have exists independently of or is part of another disorder, or which of the issues they are experiencing is at the forefront of the challenges. We also are seeing younger students taking much more time to learn to develop their academic skills, such as reading. Since Covid, there have been more cases involving questions about gender identity

We are also seeing a large population of students who are struggling with those important developmental and educational transitions, such as with the jump from elementary school to middle school and middle school to high school. The time that should have been dedicated to preparing students for these types of milestones was wildly disrupted. These students were left struggling to navigate so much on their own – things like how to work with multiple teachers, how to get around in a new environment and with a different schedule than they were used to. Their transitional preparation was essentially bypassed and children were required to carry out their education in developmentally unsuitable ways that they were not prepared for.

Finally, schools scaled down the level of work so much during Covid, which made it more challenging for the students when they came back to school. Since being back in the school setting, their demands were raised back up. It’s been difficult  for students and families to rebound, especially if there is some kind of identified need or challenge with the student. We’re still very much dealing with the ramifications of these shifts.

 

About the Author

Dr. Leah Weinberg specializes in the assessment of school-aged children and adolescents with a wide range of concerns including development disorders, such as Autism spectrum disorder, learning disabilities (e.g. dyslexia, dysgraphia), language-based learning difficulties, Attention Deficit Hyperactivity Disorder (ADHD), Nonverbal Learning Disability (NVLD), and executive functioning disorders (e.g. slow processing speed). She also has experience in working with individuals with psychiatric difficulties, such as anxiety, mood disorders (e.g. depression), and behavioral disorders. Dr. Weinberg has expertise in working with children with complex profiles or multiple areas of strength and weakness that cannot be encapsulated by a single diagnosis. Dr. Weinberg is passionate about helping families better understand their child’s neuropsychological profile and the impact it may be having on their behavior or functioning in order to best support them in all areas of their life.

 

If you are interested in booking an appointment for an evaluation with Dr. Weinberg or another NESCA neuropsychologist/clinician, please fill out and submit our online intake form. 

 

NESCA is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; the greater Burlington, Vermont region; and Brooklyn, New York (coaching services only) serving clients from infancy through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

12
Sean O'Brien headshot and quote

Introducing Pediatric Neuropsychologist Sean Hyde O’Brien, Psy.D., ABPdN

By | NESCA Notes 2024

Sean O'Brien headshot and quoteBy: Jane Hauser
Director of Marketing & Outreach, NESCA

NESCA is excited to welcome Sean Hyde O’Brien, Psy.D., ABPdN, to our team, conducting evaluations in the Newton, Massachusetts office! My interview with Dr. O’Brien offers an opportunity for readers to get to know him, his professional background, experiences and expertise, and his approach to working with children, adolescents, and young adults as a pediatric neuropsychologist.

You covered a broad swath of academic, emotional, and developmental challenges in your career as a pediatric neuropsychologist. Tell us more about that.

I think I’m a good generalist as far as pediatric neuropsychology goes, covering a lot of the high-incidence disorders, like ADHD, autism spectrum disorder, and learning disorders, but there are a couple groups that I really like working with.

What are the groups of children or students you find the most interesting?

I really like kids that are on the high functioning end of the autism spectrum, so I did one of my post-doctoral years at McLean at the Center for Neurointegrative Services, which is a DOE-approved special education school for kids who used to have what was called Asperger’s Disorder, which is now part of the ASD diagnosis. I got to spend a lot of time honing my assessment skills, but also spending quality time getting to know this group of students. They have a special place in my heart.

Another area I enjoy is working with children who came from other countries and may have moved because of war, famine, or simply for better opportunities for their families. They often come to this new country, perhaps not with the best English skills, and a lot of complex developmental and psychiatric challenges. Teasing all of those components apart and helping them acclimate to a new school, culture, and world has been interesting to me.

It takes a lot of thinking on your feet from an assessment standpoint to work with this population. For example, when you evaluate a child who speaks Russian and has only been learning English for six months, you’re not going to be able to do your standard battery of tests to figure out what their cognitive functioning is like. You have to think creatively and find ways to work slightly outside the domain of standard evaluation procedures. I’ve learned so much being with them, watching, and observing them in different settings, and, of course, getting the information from multiple sources, like teachers and parents. Those kids along with those who come from other countries through adoption are the most challenging, but also probably the most rewarding to me.

My wife and I were both adopted, so I come from a family of people who know and are part of the adoption community. I did a lot of research and clinical work involving international adoption. I love working with children who are coming from China, India, Korea, or domestically and their adoptive parents who are trying to figure out how to best support them with the range of strengths and weaknesses that they might have. These are also some of the kids who stick out to me.

Why did you come to NESCA?

I was looking for a change. I’ve been a partner in a private practice that we built from scratch for about 15 years, handling all of the many aspects of running a small business and evaluating students. I felt that the operational and clinical duties became too time-consuming to have a healthy work-life balance. I decided that it was time for a recalibration that would allow me to continue to evaluate children, but not have to stress over all of the other time-consuming operational details.

Throughout my career, I’ve had many NESCA reports come across my desk. They were very well done, and the practice has an incredible reputation. I met with NESCA’s founder and I knew it was the right place. She values the same things that I value – collegiality, warmth, and child-centric care. I was looking for a place where I could do good work and do it in a way that feels good at the end of the day. I found that in NESCA.

What do you feel you can contribute to NESCA families and staff?

The feedback I received over the years is that my ability to connect with children makes me an ally to them, especially those who may be a little resistant to the process. Some kids come in and are scared or angry that they have to be there for an evaluation. I always find a way to let them know this is in their best interest. I will explain what an evaluation will do for them in the end and that I want to work with them to figure out their “operating system” to make life work better for them. Families feel that I’m warm, approachable, and just a nice guy. I make sure that the individuals I evaluate don’t see me as Dr. O’Brien – I’m just Sean, and I’m a “learning detective,” of sorts, who helps figure out what’s going on with them.

I’ve had a number of students who I’ve seen three or so times over the course of the past 15 years. They may have come to me as a struggling six- or seven-year-old and are now in college. It’s the long-term relationships and knowing that the work I did, or that we did together, changed their developmental trajectory and helped them start to feel better about themselves as a learner and/or a person. That’s the piece that keeps me loving the work that I do and feeling young, fresh, and energized. I couldn’t ask for a better job.

What are your thoughts on the field of neuropsychology overall?

We’re a field that is a mixture of art and science. We are students of the brain; not experts, and we are all still learning about how the brain works. That is continuously being questioned, refuted, and remodeled. Since I first started studying neuroanatomy, we have come so far and yet we still know so little.

We can’t become rigid or complacent in the evaluation of children, adolescents, or adults, because that will be the biggest disservice we can give to our clients. We have to always be learning and evolving. Using antiquated models, not being open to new tests or new ways of thinking about things will not help anyone. I have the feeling I will learn a lot of new, creative, proven approaches while I am at NESCA, and that is very exciting to me.

I don’t think you get that kind of ongoing learning and exposure to innovative ways of doing things in many places. Often, neuropsychologists have to go outside of their practices to get that kind of knowledge from colleagues. Having that built in here at NESCA is something I am excited about.

 

About the AuthorHeadshot of Sean Hyde O'Brien

Dr. Sean Hyde O’Brien has been providing comprehensive neuropsychological evaluations in the Greater Boston area since 2006. He specializes in the assessment of children and adolescents who present with a wide range of developmental conditions, such as  Attention-Deficit/Hyperactivity Disorder, Specific Learning Disorder (reading, writing, math), Intellectual Disability, and Autism Spectrum Disorder; as well as children whose cognitive functioning has been impacted by medical, psychiatric, and genetic conditions. He also has extensive experience working with children who were adopted both domestically and internationally.

To book a consultation with Dr. O’Brien or one of our many other expert neuropsychologists or other clinicians, complete NESCA’s online intake form.

NESCA is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; the greater Burlington, Vermont region; and Brooklyn, New York (coaching services only) serving clients from infancy through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

50
Someone moving freely, symbolizing transition

Five Good Reasons to Choose NESCA for Transition Assessment and Services

By | NESCA Notes 2024

Someone moving freely, symbolizing transitionBy: Kelley Challen, Ed.M., CAS
Director of Transition Services, NESCA

  1. Expert Clinicians with Specialized Training
    Our team of transition specialists brings decades of experience supporting teens and young adults with a wide range of needs, from mild to complex. As Director of Transition Services, I have closely trained and supervised each of our specialists. Together, we have multidisciplinary expertise spanning guidance counseling, school psychology, special education, occupational therapy, and vocational rehabilitation counseling. This breadth of knowledge allows us to deeply understand each student’s needs as they relate to postsecondary living, learning, training, and working. Additionally, our team collaborates with NESCA’s neuropsychologists and other expert clinicians, ensuring every assessment is thorough, individualized, and aligned with best practices.
  2. Comprehensive, Individualized Approach
    We believe transition planning should be as unique as each student we serve. Assessment at NESCA always begins with a thorough intake and record review to build a complete picture of the student’s known abilities and areas of need—and an understanding of what must be uncovered through the evaluation process. We combine formal and informal tools, functional evaluations, and input from students, families, schools, and other providers. We also offer situational assessments in school, home, and community environments. This comprehensive approach ensures we uncover meaningful goals and develop actionable strategies to support postsecondary success.
  3. Clear, Comprehensive Recommendations
    Transition assessments lay the foundation for effective transition planning and IEP services. NESCA’s evaluations clearly identify measurable postsecondary goals in the required areas of living, learning and/or training, and employment. We take the time to uncover students’ strengths, preferences, and interests while providing tailored recommendations for the instruction, services, community experiences, and progress monitoring needed to progress toward their goals. Our expertise extends to essential areas, such as planning for age of majority, course of study, and graduation timelines, and we always fully adhere to special education guidelines as independent evaluators.
  4. A Culture of Collaboration and Support
    Collaboration is at the heart of NESCA’s approach. Our clinicians meet regularly to share insights and strategies, ensuring every evaluation reflects our collective expertise. We also maintain strong connections with schools, agencies, and community resources, providing families with actionable plans and ongoing guidance. Transition planning requires teamwork, and we want to be active members of our students’ teams. We’re here to support schools and families, whether through team meetings, follow-up evaluations, ongoing coaching, or consultations at key points in a student’s journey.
  5. Empowering Youth, Families, and Schools
    At NESCA, we prioritize the student’s voice. We empower students to foster self-determination, independence, and confidence as they prepare for the future. We also recognize the critical roles of families and educators in the process, ensuring their perspectives are included and valued. NESCA’s transition assessments provide not just a roadmap but the tools, understanding, and collaboration needed to move forward with purpose.

 

About the Author
Kelley Challen, Ed.M., CAS, is an expert transition specialist and national speaker with over 20 years of experience supporting youth andKelley Challen headshot young adults with diverse developmental and learning abilities. Since 2013, she has served as Director of Transition Services at NESCA, offering individualized transition assessments, planning, consultation, coaching, and program development. She specializes in working with students with complex profiles who may not engage with traditional testing tools or programs. Ms. Challen holds a BA in Psychology and a Minor in Hispanic Studies from The College of William and Mary, along with a Master’s and Certificate of Advanced Graduate Study in Risk and Prevention Counseling from the Harvard Graduate School of Education. She is a member of CEC, DCDT, and COPAA, believing it’s vital for all IEP participants to have accurate information about transition planning. Ms. Challen has also been actively involved in the MA DESE IEP Improvement Project, mentored candidates in UMass Boston’s Transition Leadership Program, and co-authored a chapter in Technology Tools for Students with Autism.

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

NESCA is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; the greater Burlington, Vermont region; and Brooklyn, NY (coaching services only) serving clients from infancy through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

13
Sarah LaFerriere headshot and quote

NESCA Welcomes Sarah LaFerriere as a Transition Specialist

By | NESCA Notes 2024

Sarah LaFerriere headshot and quoteBy: Jane Hauser
Director of Marketing & Outreach, NESCA

Transition Specialist and Special Educator Sarah LaFerriere, M.Ed., joined NESCA during the summer. We’d like to take the opportunity to formally introduce her and fill you in on her inspiration for getting into Special Education and eventually Transition Services as well as her previous professional experiences, and how she supports families and students here at NESCA.

What led you to special education in general and then to transition services?

From early in elementary school, I remember having peers with disabilities who were often not being included. I would go out of my way at recess or lunch and play or sit with them so they would not feel so alone or different. My teachers would tell my parents that I was very nurturing and inclusive.

I was also personally motivated by one of my brother’s friends, who was severely autistic. My brother invited him to his 9th or 10th birthday party, where they played with temporary tattoos among other things. I was a teenager at that time. While there were many areas that were a struggle for my brother’s friend, he somehow figured out how to disable their home alarm system, left his house, and walked to our yard and waited there for a tattoo because he had so much fun with them at the party. His parents were beside themselves, calling the police to report him missing. I remember thinking that I would love to know how his brain works. It was fascinating that he had so much difficulty carrying out functional activities and was simultaneously so determined to get another tattoo, he disabled an alarm system at the age of nine.

I took that interest and just ran with it, volunteering in the life skills room in high school, and because I loved that so much, I became a skills trainer, PCA, and worked for The Arc (now LifeWorks), then held a position at one of the MACI programs at Bridgewater State. That’s where I began my love for working with transition-aged youth.

After I graduated college, I got my master’s through the EXCEL program at Bridgewater State University. As graduate assistant in that program, I taught high school and loved it. I really enjoyed working with older students, helping them navigate the community during their transition to adulthood. That brought me to my work in transition and eventually to NESCA as a transition specialist.

Who do you work with at NESCA?

So far, I’ve been seeing a wide range of students. My specialty area is working with students with more severe challenges. I really enjoy working with autistic students and those with intellectual disabilities, working with them on building life skills. At NESCA, I have had the chance to work with college-bound students who are living with anxiety, ADHD or other mental health concerns.

How would you describe your approach to working with students who are more severely impacted by their disabilities?

I try to connect with them as much as possible and develop a relationship with them based on their interests. Many students with disabilities have very specific interests. I use those interests as a way to make the initial connection with them. Once they see that I have a sincere interest in them and their interests, they tend to feel more comfortable and open up with me. People often tell me that it’s clear that I make strong connections with my students. In my opinion, we would not be able to accomplish nearly as much as we do without that relational approach. It’s hard for students to understand their full potential if the providers they work with can’t make a connection with them.

How do you define self-determination, and why is it such an important part of the transition process?

Self-determination is the ability to advocate for yourself, make decisions, and really learn about yourself – your likes, what you want, or what you don’t want. Self-determination is just so important for students of all ages, but especially for high schoolers and transition-aged youth, because there are so many important decisions and changes coming up for them. Self-determination is actually at the very heart of the transition process.

Self-determination is a big theme in the new Massachusetts IEP format. Why is this change so significant for students on IEPs?

Hopefully, the new IEP format here in Massachusetts will help more students become involved in their IEP process, which is now driven by the vision students have for themselves in all aspects of life after high school. It will hopefully guide schools to support students in building self-determination and independence skills, teaching them how to  speak up, advocate, and participate in their own education. I truly hope the new format translates into schools putting a heavier emphasis on helping students successfully be part of the IEP process.

If we build these skills earlier on so students can be part of and contribute to IEP, once they leave school, they will be able to use those skills in life, whether that’s at a job or in the community. Hopefully, they will learn to generalize those self-advocacy skills to help them get what they need or want as they move into adulthood.

Another goal with the new Massachusetts IEP is to involve students in the IEP process at a younger age. Why do you think that is a priority?

Someone put it to me this way, and I think it paints an accurate picture. Think about parents or caregivers planning a party for a child down to every last detail. All the plans have been made; all the invites went out…everything is booked. But then, they don’t actually invite the child to their own party. That’s what we have been doing with students and their IEPs. We make the plans, we invite the providers and teachers, but we don’t ever invite the student to their own IEP meeting. This whole process, this whole document, this whole program is all for them, and our students have no idea of what took place in the meeting and why.

It’s really important for students of all ages to know their strengths and challenges, and have the opportunity to express their own voice throughout the process. Involving students at a younger age shows them how we are all working towards what they are hoping to achieve.

You have worked in a variety of settings from public and private schools to camps and different agencies. How do your past experiences benefit NESCA families?

 When I think about all of the people sitting around the table in an IEP meeting, I think I’ve been in almost every one of the spots, with the exception of being a school administrator. I’ve been the teacher, the skills provider, in the paraprofessional role, and in the specialist role. While my own child doesn’t have a disability, just being a parent, I now see things more clearly from the parent point of view as well.

I feel like all my past experiences have led me to this position where I can provide realistic and attainable goals and recommendations to support students throughout the transition process. I know what can be accomplished by teachers and specialists in schools and what may be more of an unrealistic expectation for them to carry out. I understand how swamped they all are and how understaffed schools may be. That knowledge allows me to get creative and develop recommendations that allow students to reach their transition goals by teachers, providers, and parents putting those pieces in place. I can now think from the perspectives of all those roles. It’s not that we are expecting less from teachers or others, but I am able to identify who may actually be a better fit to work on skills with the student. Perhaps some instruction could be accomplished through a skills teacher in the home setting or a specialist at the school other than a teacher, for example.

You recently received a certification to help teach parents, caregivers, and providers to educate students with special needs about topics related to sex. Tell us more about that.

Yes! I’m really excited to work in this area. It’s so important. I now have the opportunity to go into schools and teach administrators or special educators how to teach their students about topics related to their bodies and sex. All too often, students in special education just don’t get taught about sexual safety and what’s going on with their bodies, and they are often some of the most vulnerable people out there. There is also a large percentage of special needs students who are part of the LGBTQ+ community, and it’s so important for parents and care providers to have the language and the knowledge to talk about some of these uncomfortable topics at their child’s level of understanding, whether that’s based on age or ability. I think a lot of families and schools really need support in this area.

Students also have a right to know and understand what’s going on in their bodies and how that may be adding to a lot of their behaviors. When I first became a special educator, I worked with students who exhibited sexualized behaviors, and I was not prepared for that. If a trained special educator was not prepared, parents, who likely have very little training on this topic, may feel like they are at a loss in supporting their kids. We all know kids don’t come with instruction manuals!

If I have the chance to educate students in a way that helps to prevent them from abuse and teaches them how to speak up and advocate for themselves if something inappropriate is going on, I am all for it.

What were you looking for when you came to NESCA and what do you feel like you’ve experienced in the past few months that you’ve been here?

I didn’t expect to learn so much from the people who work here. I knew there was an emphasis on life-long learning here, but I’m amazed at what I have learned and been exposed to in a short amount of time.

I love our weekly Case Conferences where clinicians present some of the more complex cases to gain insight and the perspectives of our colleagues. I get to learn about so many people and different approaches. I have had a lot of exposure to the mental health side of the students we work with and better understanding the connections between mental health and autism, intellectual disabilities, and more severe disabilities. I love learning more about the language, techniques or creative approaches to use with students who are experiencing anxiety or depression.

I enjoy being in a multidisciplinary setting where I can strengthen my knowledge in transition services, while also learning from the neuropsychologists, counselors, and others outside of the transition team.

In any given week, I may be writing reports, attending conferences or observing students in various settings, even at a zoo. I underestimated the new experiences and great connections that I’ve been able to make since coming to NESCA. It’s just been a really great experience.

 

About the AuthorHeadshot of Sarah LaFerriere, M.Ed.

Sarah LaFerriere, M.Ed., is a transition specialist and special educator who has nearly a decade of experience working with transition aged students in public schools, college, and home-based settings. She provides transition assessment, consultation, and coaching services to a wide range of clients, and specializes in supporting students with autism, intellectual disabilities, developmental disabilities, mental health conditions, and medical conditions.

To book a consultation with Sarah LaFerriere or one of our many other expert transition specialists, neuropsychologists, or other clinicians, complete NESCA’s online intake form.

NESCA is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; the greater Burlington, Vermont region; and Brooklyn, New York (coaching services only) serving clients from infancy through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

3
Map of Massachusetts with Plainville identified on the map and a quote from Dr. Erin Gibbons

Why Choose Plainville?

By | NESCA Notes 2024

Map of Massachusetts with Plainville identified on the map and a quote from Dr. Erin GibbonsBy: Erin Gibbons, Ph.D.
Pediatric Neuropsychologist, NESCA

NESCA opened in 2007 in beautiful Newton, Massachusetts, which is a central location for many residents of the state, who are coming from different directions. Over the last 17 years, we have expanded both in Massachusetts and beyond to Londonderry, NH, Plainville, MA, and Hingham, MA (our newest location).

Our amazing intake coordinators frequently tell me that when they are talking with new clients on the phone and explain that their evaluation will take place in NESCA’s Plainville location, they commonly hear, “Where is that?!”

So, I am here to extol the many benefits of coming to NESCA in Plainville!

  • We are conveniently located off I-495 and Route 95. Since Plainville is in the suburban metropolitan areas of both Boston and Providence, there is very little traffic getting to the office. We also have ample free parking.
  • Miranda Milana, Psy.D. and I both work in Plainville. Between us, we evaluate clients ranging from 12 months to 30+ years of age. We both have extensive experience testing clients who have historically struggled to participate in traditional testing; for example, clients who are nonverbal, behaviorally dysregulated, or medically complex.
  • We receive frequent referrals for challenging diagnostic questions related to autism spectrum disorders (ASD), mood disorders, or intellectual disabilities and are comfortable taking on these often-complicated cases.
  • Both Dr. Milana and I evaluate toddlers for autism spectrum disorders in our ASD Diagnostic Clinic in Plainville. Our goal in the clinic is to help provide early detection of autism in children under three-years-old, when interventions are most effective.
  • Our fantastic occupational therapist, Jessica Hanna, MS, OTR/L works in the Plainville office. She is available for both OT evaluations and treatment. She also allows our testing clients to use the sensory gym during their breaks in their evaluation.
  • While your child is engaging in testing sessions during their evaluation, there are several stores, such as Target, that are only a 5-minute drive from our office. If you are looking to get some self-care in during their testing, you can even catch a 60-minute yoga or barre class in the plaza next door.
  • Finally, Patriot Place is a 10-minute drive from NESCA’s office in Plainville. If your child is a football or soccer fan, a visit to Gillette Stadium/Patriot Place is a great way to reward them for their hard work during the evaluation!

We invite you to learn more about the services we offer at NESCA in Plainville, MA, who we serve, and the many benefits of our convenient location. If you have any questions about our Plainville location, please let us know. We are happy to discuss the options for evaluations in Plainville.

 

About the Author

Since 2011, Dr. Gibbons has been a trusted expert at NESCA where she evaluates children presenting with a range of attentional, learning,Erin Gibbons headshot and developmental disabilities. She has a particular interest in children with autism spectrum disorders, intellectual disabilities, and those with complex medical histories. In addition, she evaluates adults who have concerns about whether they meet criteria for an ASD or ADHD diagnosis.

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

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

8
Headshot of Alison Burns and a quote by her

Introducing Alison Burns, Ph.D., NESCA Pediatric Neuropsychologist

By | NESCA Notes 2024

Headshot of Alison Burns and a quote by herBy: Jane Hauser
Director of Marketing & Outreach, NESCA

I had the chance to interview Dr. Alison Burns, a pediatric neuropsychologist who joined NESCA earlier this year. I learned a lot about Dr. Burns, both personally and professionally in my interview. I invite you to learn more about her, her approach to pediatric neuropsychological evaluation, and her expertise in ADHD and concussion, among other domains.  

You returned to the workforce this year after having children. How was your experience returning to work, and how was NESCA instrumental in doing so?

When I had my second and final child, I wanted to take a more extended parental leave to really soak up that precious early childhood time before returning to the workforce. Throughout my time out of the workforce, I completed continuing education classes and remained involved with a research project from my time at Children’s National in Washington DC. Because of the excellent supports at NESCA, it was a smooth transition back to work! I had the support of Dr. Moira Creedon, who served as a mentor for the first six months. In addition to the larger collaborative group of colleagues, I had someone I could go to with any specific questions I had.

Why did NESCA feel like the best fit for you?

I knew that I wanted to join a group practice because I wanted the ability to consult and collaborate with colleagues, particularly when working with more complex patients. It was important to me to join a team that is multidisciplinary as the unique perspectives that other disciplines at NESCA offer allow me to think more holistically about a patient’s profile and needs. NESCA has a culture of professional development and encourages clinicians to continue to learn through continuing education which fit with my core belief in the importance of staying up to speed with new evidence-based research.

I was also looking for a practice that understood family balance, because even though I am working, I am still the primary caregiver for our children, particularly during those morning and afterschool shifts. I knew I would need some flexibility, and everyone I met at NESCA really understood what it’s like to be a working mom and the load that comes with that role. At NESCA, I can make my work schedule fit my family’s needs.

What types of issues do you enjoy figuring out and unraveling for families?

My favorite population of kids to work with is those who have or are showing signs of ADHD. I trained at Children’s National with Gerard Gioia, Ph.D., who is an expert in the field of executive functioning. It was a big focus of my training, and I had the opportunity to evaluate many kids with ADHD throughout my post-doctoral training. It’s a very important population to assess because often times children are diagnosed with ADHD based on a symptom checklist alone. However, there are many other things that cause symptoms of ADHD such as anxiety/depression, learning disorders, or language difficulties just to name a few. This overlap in symptoms can lead to a misdiagnosis which is problematic as interventions for these disorders are wildly different. It’s important to tease apart these symptoms through a comprehensive evaluation so children receive the correct interventions and supports.

You’ve talked about the importance of behavioral observation during evaluations? What makes that so important?

Test scores, or data, can only tell me so much. Really watching a child and understanding how and why they performed a certain way adds critical information that fine tunes my understanding of a child’s neuropsychological profile. While it is important to consider a person’s history and current symptoms from clinical interviews, questionnaire data from a variety of sources, and direct testing scores, I think behavioral observations allow us to “look under the hood” so to speak. Seeing how a child works and thinks often provides me with excellent insight that helps me develop very targeted and specific recommendations for that individual.

You were previously part of a hospital-based multidisciplinary team. Can you explain how your experience with that team helps you in your work at NESCA?

I completed my internship and postdoctoral fellowship at Children’s National and had the opportunity to be a member of two multidisciplinary medical specialties (i.e., epilepsy and hematology/oncology). So far at NESCA, I’ve had the opportunity to work with one child who is post-chemotherapy, and it was rewarding to be able to support that patient with an understanding of the neuropsychological risks that chemotherapy can pose. It’s such a wonderful, unique population to work with. The resilience of child cancer survivors is just remarkable.

In addition, I worked with a range of medical providers across my other training opportunities, including therapists, psychiatrists, speech and language therapists, occupational therapists, physical therapists, behavioral health specialists, and primary care physicians. This experience taught me the importance of working with all providers who may be associated with a given patient in order to provide the most integrated care.

My training in a children’s hospital also taught me how important it is to rule out any medical explanations for the challenges we may see in the individuals we evaluate. For example, while I was a post-doc, I was evaluating a child who came to our ADHD clinic for a general ADHD evaluation. I noticed some things that had me concerned about the possibility of absence seizures. After further testing, it was determined that this child was actually experiencing absence seizures and not ADHD. Thankfully, we were able to refer them to the epilepsy team to get the correct treatment.

How did you gain expertise in evaluating students with concussions and supporting those who have lingering effects from concussion?

That specialty came out of my internship and post-doctoral fellowship at Children’s National. I was fortunate to have been able to work with some of the leading experts in the field of concussion, both clinically and in research pursuits. I am part of a “sports family,” so it was a natural fit for me. It’s also a booming area of research that was so interesting to me. During my fellowship, I saw patients who had suffered a concussion recently (often around a week after injury), following them serially through to the point of recovery. I provided them with guidance about how to safely return to school and physical activities, adapting the plan each week as their recovery progressed. Some children took much longer to recover from their concussion and had ongoing struggles and negative impacts long after the injury. In doing a full neuropsychological evaluation with these kids, we were able to consider the full scope of their needs and whether they needed a 504 plan or IEP in place.

It’s become an increasingly important population to think about because it’s not just kids who play sports that get concussions. It could be anything from a child who falls on ice or runs into playground equipment. It is not uncommon to learn that a patient being seen for an evaluation has a history of concussion at some point in their childhood. Having this training and expertise helps to tease apart what may be related to concussion and what is most likely unrelated to concussion.

 

About the Author

Dr. Burns conducts comprehensive evaluations of school-aged children, adolescents, and young adults with a variety of developmental, learning, and emotional difficulties. She has expertise in the evaluation of individuals following a concussion/mild traumatic brain injury and particularly enjoys working with individuals with attention (ADHD) and executive functioning (EF) difficulties. Dr. Burns is passionate about helping individuals and their families better understand their areas of strength and weakness and provides tailored treatment recommendations based upon that unique profile to make the evaluation most helpful for each client.

 

To book a consultation with Dr. Burns or one of our many other expert neuropsychologists, complete NESCA’s online intake form.

NESCA is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; the greater Burlington, Vermont region; and Brooklyn, New York (coaching services only) serving clients from infancy through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

16
Image of a sign saying, "You Belong Here."

Is Inclusion Enough?

By | NESCA Notes 2024

Image of a sign saying, "You Belong Here."By Dot Lucci, M.Ed., CAGS
Director of Consultation and Psychoeducational Services, NESCA

In the United States, we have federal and state laws that support individuals with disabilities: The ADA, IDEA, Section 504 of the 1973 Rehabilitation, Chapter 766, Chapter 688, and more. Each of these laws supports the inclusion of individuals with disabilities at school, in employment, and in the community by mandating wheelchair ramps/automatic doors, mainstreaming children with special needs into general education classrooms, assistive technology for an individual at a workplace, and more. We have made many strides in including people with disabilities; yet there is still a long way to go.

In education circles, the word inclusion has effectively replaced the term mainstream. By definition, inclusion means placing students with disabilities in regular or “mainstream” settings along with their “non-disabled” peers, focusing on the “physical integration” of children with disabilities rather than, what was more common at the time – placing them into separate, segregated or “self-contained” settings with other “disabled peers.”

Inclusion embodies a shift from just physical inclusion/integration to a broader definition that promotes equal access and support for all children, creating an environment that promotes the success of every student regardless of ability (Karlsudd, 2017). Inclusion, at its best should offer universally designed environments/curricula, specialized supports, services, accommodations, modifications, and differentiation in instruction, and more, as all students – whether identified as “special needs” or typical – are unique in their learning profiles.

Education lecturer and researcher Gregor Maxwell, 2018, describes in a published article, three perspectives on inclusion. They are:

  • The Compensation Perspective is like the deficit model or medical model which emphasizes a child’s impairment or limitation as the reason for exclusion. It focuses on Identifying the limitation/deficit and remediating it through individualized accommodations and supports that enable the student to be included.
  • The Critical Perspective is comparable to the Social Model of Disability in that it identifies the problem within the broader context of the environment, and the focus is on changing policies, structures, and attitudes about disability and inclusion.
  • The Dilemma Perspective is a critique of the Compensation and Critical Perspectives. It emphasizes that meaningful participation is central to inclusion, and that inclusive practices need to recognize and celebrate the diversity of all children regardless of whether they have a disability or not. Participation is defined as the involvement in life situations with family, same-aged peers, and other community members, and is distinct from inclusion, according to the International Classification of Function, Disability, and Health (ICF) of the World Health Organization.

While individuals with disabilities are being included and participating in schools, in employment settings, and in the community, there still seems to be the lingering question of, “Is inclusion and participation enough?” Do individuals with disabilities feel valued and honored for who they are? Are their strengths being recognized (ideally, the new Massachusetts IEP form should help with this)? Do they feel like they are “one of the gang,” like they belong/fit it and have friends? Having worked in many public schools, I think many students with disabilities are participating in inclusion activities but don’t feel like they belong nor are valued for who they are.

Erik Carter, professor of Special Education at Vanderbilt University, has studied inclusion and belonging for many years. He concludes, “Where we once pursued integration, we now talk about promoting inclusion. But my sense is that both terms fall short of what really matters most. People want to be more than merely integrated or included. They want to experience true belonging.” In more recent years, schools have been focusing on social and emotional learning (SEL), yet many students with and without disabilities still feel isolated and like they don’t fit in/belong. Belonging, feeling valued for who one is and being recognized for one’s strengths, is more significant than inclusion. It is at the very core of who we are as humans; it is a basic need. Let’s help our special needs students feel that they belong. Let’s hope that as the new MA IEP, with its focus on student strengths and participation, will be afford us the opportunity to focus on what truly matters…a sense of belonging for all of our students.

For more information and helpful handouts about Erik Carter’s approach, visit: Progress Center Reflecting on our Practice: Ten Ways Schools Can Foster Belonging Among Students With and Without Disabilities https://promotingprogress.org/sites/default/files/2022-02/Fostering_Belonging_Handout.pdf

 

Resources

Erik Carter https://www.erikwcarter.com

Karlsudd, P. (2017) The Search for Successful Inclusion. DCID, 28(1), 142-160.

Maxwell, G.R. Granlund, M. & Augustine, L. (2018) Inclusion through participation: Understanding participation in the international classification of functioning, disability, and health as a methodological research tool for investigating inclusion. Frontiers in Education, (3), Article 41, 1- 16.

 

About the Author

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

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

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

NESCA is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; the greater Burlington, Vermont region; and Brooklyn, NY, serving clients from infancy through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

 

7
Picture of a teen with a disability at work getting assistance

How Occupational Therapists Can Support Neurodivergent Teens and Young Adults with Self-Regulation in the Workplace

By | NESCA Notes 2024

Picture of a teen with a disability at work getting assistanceBy: Lyndsay Wood, OTD, OTR/L
NESCA Executive Function and Real-life Skills Program Manager

Self-regulation is a critical skill for anyone entering the workplace, but for neurodivergent teens and young adults, it can be particularly challenging. These individuals may face overstimulation, burnout, emotional dysregulation, and many other unexpected challenges in the work setting. Occupational therapy (OT) can play a pivotal role in helping these young adults develop the tools they need to thrive in a work environment.

What is Self-Regulation, and Why is it Important?

Self-regulation refers to the ability to manage your emotions and state of arousal in order to meet the demands of your environment. In the workplace, self-regulation is essential for staying calm under pressure, responding appropriately to feedback, and managing the various sensory and social demands of the job.

For neurodivergent teens and young adults, challenges may arise when dealing with unexpected changes, new work tasks, over or under stimulation of the sensory system, or complex interpersonal workplace dynamics. Learning to regulate within the context of these challenges can make the difference between a successful work experience and one that leads to frustration, anxiety, burnout, or job termination. Below is a list of three different ways occupational therapists can support teens and young adults with self-regulation in the workplace.

Developing a Personalized Self-Regulation Plan

One of the most effective ways to support workplace success is through the development of a self-regulation plan. This plan is individualized to each person and can serve as a guide for both the individual and their supervisors or co-workers. Here is a breakdown of essential items to include within the plan.

  1. Strengths

Before diving into potential challenges, it’s important to highlight strengths. What skills does the individual already possess that can help them succeed in the workplace? For example, a teen with an autism spectrum disorder (ASD) might have exceptional attention to detail, while a young adult with Attention-Deficit/Hyperactivity Disorder (ADHD) may excel in creative problem-solving. Identifying these strengths helps boost confidence and serves as a foundation for skill building.

  1. Triggers

Triggers are external or internal factors that can lead to dysregulation. These can include:

  • Sensory triggers: Bright lights, loud noises, hot rooms, specific textures, etc.
  • Emotional triggers: Criticism, frustration, misunderstandings
  • Cognitive triggers: Task-switching, or multi-tasking demands, large quantities of information being given verbally

A key part of OT intervention is helping the individual recognize their personal triggers, because understanding triggers can help prevent or minimize dysregulation.

  1. Develop Preventive Strategies

Once triggers are identified, the next step is to create strategies to prevent dysregulation before it happens. These strategies might include:

  • Environmental modifications: Wearing noise-canceling headphones, keeping fidgets at your desk, requesting a desk near a window for natural light, adjusting the workload to prevent overwhelm, or bringing a therapy animal to work
  • Routine adjustments: Incorporating short, frequent breaks during the workday, using visual schedules and reminders to manage tasks more efficiently, or requesting that work tasks be provided in writing
  • Emotional prep: Practicing self-talk or role-playing scenarios that may be challenging, engaging in daily mindfulness activities, spending time doing an activity that improves your mood prior to a work shift
  • Medication: Ensuring essential medications are taken daily at a consistent time

By establishing preventive strategies, individuals can feel more in control and reduce the likelihood of becoming overwhelmed.

  1. Create In-the-Moment Strategies

Even with preventive measures in place, there will be moments when the individual feels dysregulated. Developing in-the-moment strategies is critical to managing these situations effectively. Some in-the-moment strategies include:

  • Breathing techniques: Deep breathing exercises to help calm the nervous system and lower anxiety in stressful situations
  • Distraction: Watch a funny or calming video on your phone for a couple of minutes to help your brain reset
  • Physical movement: Taking a short walk or doing some discreet stretching at the desk can help release built-up tension
  • Taking a break: Request or take a 5-minute break from your work tasks to reset

These strategies should be easy to access and implement in the workplace, allowing the individual to regain control without disrupting their workflow.

Building a Toolbox of Sensory Strategies

Sensory regulation is a key part of self-regulation, particularly for neurodivergent individuals. Occupational therapists can help teens and young adults build a sensory toolbox that includes items or activities to help them self-soothe and regulate their sensory systems. Examples of sensory tools might include:

  • Fidget tools for tactile input
  • Aromatherapy oils or scented items to calm or refocus
  • Weighted blankets, heavy work, or pets on the lap (if the work environment allows) for proprioceptive input
  • Noise-canceling headphones or earplugs to manage auditory input

The goal is for the individual to have access to sensory supports that can be used in non-disruptive way while at work. These tools can be critical in maintaining focus and emotional regulation during the workday.

Building Self-Advocacy Skills

An essential part of successful self-regulation in the workplace is the ability to advocate for one’s own needs. Many teens and young adults have a difficult time with this skill, but occupational therapists can help individuals build the skills and confidence they need to successfully advocate for themselves in the workplace. Self-advocacy involves:

  • Knowing one’s needs: The individual should have a clear understanding of their strengths, challenges, and what accommodations are most beneficial. It is extremely beneficial to create a document that the individual can access and update throughout their lifetime that details all of this information.
  • Communicating needs: Learning how to express these needs clearly and assertively to supervisors or co-workers is crucial. This may involve requesting a quieter workspace or asking for a sensory break during particularly stressful tasks. Role-play is often a helpful tool to practice these communication skills.
  • Setting boundaries: Advocating for one’s needs also includes setting personal boundaries to avoid burnout. This could mean learning to say “no” to additional tasks when overwhelmed or asking for extra time to complete certain projects.

Occupational therapy can support the development of these communication skills through role-playing, practicing real-life scenarios, and building confidence in expressing needs.

Conclusion

Occupational therapy can play a crucial role in supporting neurodivergent individuals with self-regulation in the workplace through the development of an emotional regulation plan, the building of a sensory toolbox, and the development of self-advocacy skills. With these tools in place, individuals are empowered to manage their emotions, arousal, and sensory needs, leading to greater success and fulfillment in their professional lives.

 

About Lyndsay Wood, OTD, OTR/L

Lyndsay Wood, OTD, OTR/L, Vermont-based Executive Function and Real-life Skills Program Manager, is an occupational therapist who focuses on helping students and young adults with disabilities to build meaningful skills in order to reach their goals. She has spent the majority of her career working in a private school for students with ASD. She has also spent some time working in an inpatient mental health setting. Lyndsay uses occupation-based interventions and strategies to develop life skills, executive functioning, and emotional regulation. While completely her doctoral degree at MGH Institute of Health Professions, Lyndsay worked with the Boston Center for Independent Living to evaluate transition age services. She uses the results from her research to deliver services in a way that is most beneficial for clients. Specifically, she focuses on hands-on, occupation-based learning that is tailored the client’s goals and interests.

Dr. Wood accepts Vermont- and Massachusetts-based transition and occupational therapy assessments. Her in-home and community-based coaching services are available in the greater Burlington, Vermont area. Dr. Wood can accept virtual coaching clients from both Massachusetts and Vermont.

 

To book coaching and transition services at NESCA, complete NESCA’s online intake form. 

 

NESCA is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; the greater Burlington, Vermont region; and Brooklyn, New York (coaching services only) serving clients from infancy through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

Skip to content