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Transition Planning: Let’s Talk about Graduation Dates for Students on IEPs

By | NESCA Notes 2018

 

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

On March 26, the Massachusetts Department of Elementary and Secondary Education (DESE) sent out an important administrative advisory regarding transition services and graduating with a high school diploma (Administrative Advisory SPED 2018-2: Secondary Transition Services and Graduation with a High School Diploma). This much-needed advisory clarifies when and how students with IEP’s should be issued a high school diploma and also touches on best practices for planning both student graduation and appropriate secondary transition services.

As a transition specialist who is often contracted by schools and families, it is not uncommon to be asked to help determine whether a student is ready to graduate. The challenge in answering this particular question is that there is no universal set of skills or level of knowledge that deems a student on an IEP “ready” to graduate. In fact, students on IEP’s, just as with mainstream students, graduate all the time without being ready for many adult activities (e.g. apartment hunting, changing jobs, applying for a bank loan, comparing health insurance plans).

The truth is, there are a number of skills that we need for “adulting,” but do not need in order to graduate with a high school diploma. As this important advisory points out, the special education process is not simply about completing local graduation requirements. It is also about transition planning and services that uniquely equip a student for reaching their goals after leaving public education. Therefore, we need to rethink the question, “Is my child/student ready to graduate?” And instead, the critical question to ask when a student approaches the end of 12th grade is, “Has the child/student received a free and appropriate public education (FAPE)?”

As I discussed in a previous blog (Transition Planning: The Missing Link Between Special Education and Successful Adulthood), FAPE as guaranteed by the Individuals with Disabilities Education Act of 2004 (IDEA 2004) includes transition planning and services. Under IDEA 2004, a federal law, transition planning must start by the time a student turns 16. Here in Massachusetts, we have even stronger regulations, and secondary transition services may begin “no later than the age of 14.” This means that the IEP has to be carefully constructed to help students build skills “in a stepwise and cumulative manner” toward completing their high school program while also making progress toward their desired post-secondary learning, working, and independent living activities including community engagement.

The foundation for this process is an individualized and coordinated transition assessment process that carefully evaluates a student’s needs, strengths, preferences, and interests beginning before the age of 14. Just as with all IEP goals and services, assessment informs the team’s discussion and decision-making; it helps the team to know how to plan for the long-term, prioritize for the coming school year, and to track progress.

In each annual meeting for a transition-aged student, the IEP team needs to explicitly discuss whether the student is progressing towards their measurable postsecondary goals and whether the educational program and related transition services are calibrated in such a way that the student will continue to make progress. Anticipated graduation date (listed on the top of the Transition Planning Form and recorded in the Additional Information section of the IEP) is a critical part of this discussion each year. When a student, parent, teacher, or other team member is uncertain about a student’s ability to complete local requirements and receive appropriate transition services “on time,” this needs to be discussed directly.

If there is confusion or disagreement about the graduation date, additional assessment may be needed to clarify the student’s needs. However, if the team starts the transition planning process when a student is 14, and carefully plans out the instruction, community experiences, and employment related activities necessary for progressing toward the student’s post-high school goals, and closely tracks the student’s progress, then students, parents and educators will rarely need to ask whether the student is “ready to graduate.” Instead, they will know if the student has received FAPE because the student’s IEP has included well-calculated transition services and there will be clear measures of the student’s progress with annual goals and transition-related services indicating whether this particular student requires support beyond the traditional 12 years of education.

I am grateful for the recent administrative advisory from DESE and have found each of their advisories on the topic of transition to be tremendously helpful in supporting a shared understanding of the transition planning process among families, schools, and the professionals supporting them. At NESCA, we have seen great progress in the delivery of individualized transition services across the state of Massachusetts since the Massachusetts Legislature approved the amendment to the Massachusetts special education statute in 2008 to require transition planning services “beginning age 14 or sooner” and DESE put out Technical Assistance Advisory SPED 2009-1: Transition Planning to Begin at Age 14. With the recent advisory, I am certain that we will continue to see more teams embrace the transition planning process early. Students, families, and districts will experience less confusion and distress as a student approaches the end of 12th grade, because there will be a clear plan for exiting or continuing special education based on effective transition planning and a collaborative and communicative team process.

Transition Resources and Advisories from MA Department of Elementary and Secondary Education 
· MA DESE Secondary Transition Page – http://www.doe.mass.edu/sped/secondary-transition/default.html
· Administrative Advisory SPED 2018-2:Secondary Transition Services and Graduation with a High School Diploma – http://www.doe.mass.edu/sped/advisories/2018-2.html
· Technical Assistance Advisory SPED 2017-1: Characteristics of High Quality Secondary Transition Services – http://www.doe.mass.edu/sped/advisories/2017-1ta.pdf
· Technical Assistance Advisory SPED 2016-2: Promoting Student Self-Determination to Improve Student Outcomes – http://www.doe.mass.edu/sped/advisories/2016-2ta.pdf
· Technical Assistance Advisory SPED 2014-4: Transition Assessment in the Secondary Transition Planning Process – http://www.doe.mass.edu/sped/advisories/2014-4ta.html
· Technical Assistance Advisory SPED 2013-1: Postsecondary Goals and Annual IEP Goals in the Transition Planning Process – http://www.doe.mass.edu/sped/advisories/13_1ta.html
· Technical Assistance Advisory SPED 2009-1: Transition Planning to Begin at Age 14 – http://www.doe.mass.edu/sped/advisories/09_1ta.html

While this blog includes some specific content that applies only to families of students in IEPs in Massachusetts, the requirement of transition services for students on IEPs is a federal mandate. For families living in New Hampshire, guidance from the New Hampshire Department of Education can be found athttps://www.education.nh.gov/instruction/special_ed/sec_trans.htm. The NH DOE has additionally helped develop a website with resources for increasing the college and career readiness of NH Students that can be found at https://nextsteps-nh.org.

 

If you are interested in working with a transition specialist at NESCA for consultation, planning, or evaluation, please complete our online intake form: https://nesca-newton.com/intake-form/.

 

About the Author:

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

 

 

 

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

 

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The Role of Pediatric Occupational Therapy

By | NESCA Notes 2018

By: Sophie Bellenis, OTD, OTR/L
Occupational Therapist; Community-Based Skills Coach

In order to fully understand the role that occupational therapy can play in pediatric health and wellbeing, it is first important to understand the term “occupation.”  The World Federation of Occupational Therapy (WFOT) defines occupations as, “the everyday activities that people do as individuals, in families, and in communities that occupy time and bring meaning and purpose to life.”  As we know, these activities look different at every age, and our routines, habits, and responsibilities are continually growing and changing.

During childhood, the development of these skills moves more quickly than any other period of life. For example, a two-year old little girl, Katie, is learning to put on her shirt independently, kick a ball, and sort by color.  Within ten short years, Katie may be getting herself ready for the bus, writing a three-paragraph essay, and learning to play the saxophone.  The transition to adolescence comes with even more new experiences and expectations.

So where does occupational therapy come in?

Occupational therapy focuses on the child, the activity at hand, and the environment around them.  By considering all of these factors, OTs work to determine the correct modifications, adaptations, and strategies that may be necessary for success.

What is the goal?

Due to the fact that occupations are incredibly personalized, the goal of OT is often to simply increase independence and participation in valued activities.  One child may be working on learning to independently tie his shoes, while another may need help developing a morning routine to consistently follow.  These goals are only worth focusing on and problem-solving if they are important to the child and his or her family.

How do we get there?

Consider the child’s strengths and limitations. These may include physical, emotional, cognitive, sensory abilities, and much more.  A child’s particular interests, level of motivation, and understanding of themselves all play a role in their ability to engage in the things that are important to them.

Consider the environment. The environment in which a child lives and grows is physical, spiritual, social, and cultural. It is this individuality that makes it nearly impossible for an environment to be a “good fit for all users.”  Occupational therapists often work to modify the environment, or help individuals understand the role that the environment plays.

Consider the activity itself. The list of childhood occupations is seemingly never-ending.  From brushing your teeth, getting dressed, and doing chores, to maintaining friendships, navigating the digital world, and learning to take the bus, these skills all require numerous steps and different abilities.  These activities often must be broken down into small steps to determine how to help a child be successful.

My work at NESCA

At NESCA, I am currently working as a community-based skills coach, using occupational therapy to create experiential learning opportunities, and develop functional living skills.  I love having the ability to work with tweens, teens, and young adults in their own environment to collaborate on creating lasting strategies for participation and independence.

Dr. Bellenis works with a small caseload of clients aged 12-26 who have recently participated in neuropsychological evaluation and/or transition assessment at NESCA. If you have questions about working with Dr. Bellenis for Community-Based Skills Coaching, please email Kelley Challen, Director of Transition Services, at kchallen@nesca-newton.com.

 

About the Author:

Dr. Sophie Bellenis is a Licensed Occupational Therapist in Massachusetts, specializing in pediatrics and occupational therapy in the developing world. Dr. Bellenisjoined NESCA in the fall of 2017 to offer community-based skills coaching services as well as social skills coaching as part of NESCA’s transition team. Dr. Bellenis graduated from the MGH Institute of Health Professions with a Doctorate in Occupational Therapy, with a focus on pediatrics and international program evaluation. She is a member of the American Occupational Therapy Association, as well as the World Federation of Occupational Therapists. In addition to her work at NESCA, Dr. Bellenis works as a school-based occupational therapist for the city of Salem Public Schools and believes that individual sensory needs, and visual motor skills must be taken into account to create comprehensive educational programming.

 

 

 

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

 

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Pre-Employment Transition Services – What Are They and Who Is Eligible?

By | NESCA Notes 2018

 

Business professional in a black suit extending a hand for a handshake.
What are MRC Pre-Employment Transition Services (Pre-ETS)?
How Could They Help Your Child on an IEP?

By: NESCA Transition Specialist

On July 22, 2014, the Workforce Innovation and Opportunity Act (WIOA) was signed into national law. The goal of the act is to help job seekers, including vulnerable populations such as individuals with disabilities, to access education, training, and support services enabling them to be successful in finding and sustaining employment.

In response to this act, Massachusetts developed a comprehensive workforce development plan involving a number of programs and partners including The Vocational Rehabilitation Program which spans across Massachusetts Rehabilitation Commission (MRC) and Massachusetts Commission for the Blind (MCB). One important aspect of this plan is that MRC must spend at least 15% of its Title I budget on pre-employment transition services (Pre-ETS) for students ages 16 to 22 with disabilities.
Whereas students historically did not begin involvement with MRC Vocational Rehabilitation (VR) services until the age of 18 or until exiting high school, many students on IEPs are now eligible for support at the age of 16 while enrolled in high school. Given that paid employment in high school is a predictor of both college success and adult employment, the opportunity to engage with MRC VR services in high school is an exciting opportunity!
Each Vocational Rehabilitation (VR) Office has contracted with local providers in order to offer services benefiting students in the following areas: Job Exploration Counseling; Workplace Readiness Training, Work-Based Learning Experiences; Counseling on Enrollment in Transition or Postsecondary Educational Programs; and Self-Advocacy/Mentoring Instruction. Often these services include activities like interest assessment, worksite tours, “soft skills” training, travel training, and paid internships.
Also, every public high school has an MRC liaison who often has office hours within the school. These liaisons are able to offer many direct services within the school setting including providing group education and attending IEP meetings when appropriate.
Transition services as part of an IEP process are designed to support students developing skills and making progress towards their postsecondary employment goals. However, educators may not be as familiar with employment trends and entry-level work skills as vocational rehabilitation specialists. The opportunity for a student to work with MRC VR counselor in conjunction with their IEP team creates a wonderful opportunity to make progress toward high school completion requirements while simultaneously preparing to become an employable adult.
To learn more about MRC and Pre-Employment Transition Services, please visit the following links:
Students with visual impairments may additionally be interested in Pre-ETS services through Mass Commission for the Blind (MCB) VR services:

 

4

Increasing Reading Success: Early Identification of Reading Challenges

By | NESCA Notes 2017

 

By:  Alissa Talamo, Ph.D.
Pediatric Neuropsychologist

I recently attended the International Dyslexia Association Conference in Atlanta, GA (dyslexiaida.org). Among the conference attendees were researchers, teachers, speech-language pathologists, psychologists, and parents of children with dyslexia. One recurring key point was the importance of early identification of reading difficulties, as early provision of appropriate interventions and services leads to better outcomes.

It is important to remember that unlike seeing, hearing, and eating, reading is not something humans do naturally. Reading must be learned and it is not easy (Maryanne Wolf, Proust and the Squid).

As a parent, your early observations are important as there are many developmental indicators that may signal a risk for reading difficulties such as:

  • Experiencing repeated early ear infections
  • History of speech delay and/or pronunciation problems
  • Slow vocabulary growth, frequent difficulty finding the right word, use of less specific words such as “the thing,” “the stuff,” or “that place.”
  • Your child struggles to recognize words that start with the same sound (e.g., cat and car) or end with the same sound (rhyming).
  • Difficulty learning letter and number symbols when in preschool
  • Family history of reading problems

During first grade, you can watch for these warning signs as you listen to your child read aloud:

  • Does not know the sounds associated with all of the letters
  • Skips words in a sentence and does not stop to self-correct
  • Cannot remember words; sounds out the same word every time it occurs on the page
  • Frequently guesses at unknown words rather than sounding them out
  • If you ask your first grader to read aloud to you and he/she is reluctant and avoidant

Remember: 

Early identification of reading issues is extremely important for outcome. If children who have dyslexia receive effective phonological awareness and phonics training in Kindergarten and 1st grade, they will have significantly fewer problems learning to read at grade level than children who are not identified or helped until 3rd grade.

What should I do if I suspect my child has challenges with reading?
If you suspect your child is struggling to learn to read, have your child receive an independent comprehensive evaluation so that you understand your child’s areas of cognitive and learning strengths and weaknesses. This evaluation should also include specific, tailored recommendations to address your child’s learning difficulties.

To learn more about evaluations and testing services with Dr. Talamo and other clinicians at NESCA, you may find the following links helpful:

What if I am not sure whether my child needs a neuropsychological evaluation?

When determining whether an initial neuropsychological evaluation or updated neuropsychological evaluation is needed, parents often choose to start with a consultation. A neuropsychological consultation begins with a review of the child’s academic records (e.g., report card, progress reports, prior evaluation reports), followed by a parent meeting, during which concerns and questions are discussed about the child’s profile and potential needs. Based on that consultation, the neuropsychologist can offer diagnostic hypotheses and suggestions for next steps, which might include a comprehensive neuropsychological evaluation, work with a transition specialist, or initiation of therapy or tutoring. While a more comprehensive understanding of the child would be gleaned through a full assessment, a consultation is a good place to start when parents need additional help with decision making about first steps.

Sources used for this blog:

 

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.

She has given a number of presentations, most recently on “How to Recognize a Struggling Reader,” “Supporting Students with Working Memory Limitations,” (with Bonnie Singer, Ph.D., CCC-SLP of Architects for Learning ), and “Executive Function in Elementary and Middle School Students.”

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.

Her professional memberships include MAGE (Massachusetts Association for Gifted Education), IDA (International Dyslexia Association), MABIDA (the Massachusetts division of IDA) and MNS (the Massachusetts Neuropsychological Society).

She is the mother of one teenage girl.

 

 

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

 

 

 

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

 

4

Emerging Psychosis: When to worry about your teen’s thinking

By | NESCA Notes 2017

 

By:  Stephanie Monaghan-Blout, Psy.D.
Pediatric Neuropsychologist

Emerging Psychosis: When to Worry about Your Teen’s Thinking

Teenagers are famous for incidents of bad judgment and poorly considered decisions; it is one of the rites of passage for parents and children to have had at least one “What were you thinking?” discussion before the teen leaves the family nest for college or employment. These events are often memorable, however, because they tend to be outliers, occurring simultaneously with instances of relatively accurate appraisals of situations and relatively adequate problem-solving as they navigate the expectations of school, family, friends, and community.

Some parents must confront a separate set of ongoing concerns about their child’s thinking that effect their assessment of the world and themselves. In this article, I will talk about the nature of psychosis, describe the changes leading up to an episode of psychosis and outline emerging models of treatment which aim to prevent the first acute episode or at least delay onset of the episode as much as possible. These findings emphasize the critical importance of early identification and treatment of symptoms to prevent or reduce future impairment.

The Nature of Psychosis
Psychosis refers to a condition in which a person has lost contact with reality and is unable to distinguish what is real and what is not. Psychotic symptoms include what are called “positive” (what is present) and “negative” (what is absent) symptoms.

  • Positive symptoms include: abnormalities of thinking in both content as well as form; the former refers to distortions of reality such as hallucinations or delusions, and the latter refers to disorganization of thinking and bizarre behavior.
  • Negative symptoms refer to the reduction of emotional response (“blunted” or incongruous affect), apathy and loss of motivation, social withdrawal, impaired attention, reduced speech and movement, loss of enjoyment in life (“anhedonia”).

Researchers have also identified subtle cognitive impairments that include:

  • Deficits in processing speed
  • Executive function
  • Sustained attention/vigilance
  • Working memory
  • Verbal learning and memory
  • Reasoning and problem solving
  • Verbal comprehension
  • Social cognition

The impact of these issues can result in severe functional deficits across a range of domains such as work, school, and relationships.

Psychosis is now thought to be a neurodevelopmental disorder, meaning that it is thought to be related to abnormalities in brain development that become apparent as the brain matures in adolescence. Psychosis is thus a condition that emerges gradually as the underlying dysfunction comes to the fore. It is also thought to be a neurodegenerative disorder, meaning that the disease causes physical changes to the brain that results in impaired functioning. These changes include, on average, slightly larger lateral ventricle and slightly less cerebral gray matter for people at the first psychotic break compared to controls. From a behavioral perspective, researchers have found that the longer people live with an untreated psychosis, the more likely they are to experience functional impairments, have a poor response to psychiatric medications, and experience a poor quality of life. These alarming findings have prompted researchers and clinicians to research the period of time before the first psychotic break, referred to as the prodromal period, where symptoms start to emerge, in an effort to discover a way to divert or slow this process.

The Prodromal Period

The prodromal period is a time when “subclinical”, or milder symptoms of psychosis begin to appear. This period can vary in length from a few weeks to a few years. During this period, the adolescent or young adult may experience mild disturbances in perception, cognition, language, motor function, willpower, initiative, level of energy, and stress tolerance. These are differentiated from frank psychosis by lower levels of intensity, frequency or duration. The teen may complain of nonspecific clinical symptoms such as depression, anxiety, social isolation, and/or difficulties with school. They then may start to occasionally experience positive symptoms that are brief in duration and moderate in intensity. These events may become more serious over time, although they don’t happen often, last for only a few minutes to hours, and the person still retains some insight as to the unusual nature of the phenomena. However, this situation changes as the person comes closer to the initial psychotic break, signaled by the emergence of unusual thoughts, perceptual abnormalities, and disordered speech.

Risk and Resource

Who is most likely to move from the prodromal period to frank psychosis? Factors most predictive of this transition include people with a family history of psychosis and a recent deterioration of functioning, a history of substance abuse, and higher levels of unusual thoughts and social impairments. Other mediating factors include poor functioning, lengthy time period of symptoms, elevated levels of depression or other comorbid conditions, and reduced attention.

What factors appear to ameliorate risk of descending into psychosis? Risk/protective factors include higher premorbid cognitive skills and social skills and lack of a history of substance abuse.

How and When to Intervene

The information provided here about emerging psychosis underlines the critical importance of early intervention to address the serious and pervasive impact on functioning. Professionals who treat people at risk of psychosis are now beginning to use a clinical staging of treatment, meaning treatments should be tailored to the client’s needs, starting with safer and simpler interventions for the prodromal stages and increasingly intensive and aggressive treatment for people who are already contending with psychosis. This requires starting with what appears to be most problematic at the time for the person. For some people, this means treating the comorbid psychiatric conditions. For those who are experiencing difficulties with attention/executive function or reporting elevated levels of unusual symptoms, it may mean starting the person on an atypical antipsychotic. The use of targeted psychosocial interventions such as cognitive behavioral therapy, social skills training, and family therapy have all been found to be associated with reduced or delayed transition to first episode psychosis.

Where to Go for Help

Living in the Boston area, we are fortunate to have a wealth of resources in our hospitals and training sites that are engaged in cutting edge research and intervention to address the needs of young people who are contending with emerging psychosis. These include Beth Israel-Deaconess Hospital’s Center for Early Detection and Response to Risk (CEDAR) and the Prevention and Recovery in Early Psychosis (PREP) jointly run by the Beth Israel-Deaconess and Massachusetts Mental Health Center. Also, Cambridge Health Alliance offers the Recovery in Shared Experiences (RISE) program for the treatment of first episodes of psychosis.

Neuropsychological testing, augmented by psychological testing can be a useful tool to learn more about cognitive and emotional functioning. However, this is best undertaken as part of a comprehensive program of intervention.

 

Articles used for this blog:

  • Larson, M, Walker, E, and Compton, M (2010) Early Signs, diagnosis, and therapeutics of the prodromal phase of schizophrenia and related psychotic disorders, Expert Review of Neurotherapy. Aug. 10 (8), 1347-1359. https://www.nimh.nih.gov/health/topics/schizophrenia/raise/what-is-psychosis.shtml
  • NPR Your Health Podcast (2014) Halting Schizophrenia Before It Starts
  • Miller, Brian Negative Symptoms in Schizophrenia; The Importance of Identification and Treatment, Psychiatric Times, March 2017

 

 

About the Author:

Monaghan-BloutFormerly an adolescent and family therapist, Dr. Stephanie Monaghan-Blout is a senior clinician who joined NESCA at its inception in 2007. Dr. Monaghan-Blout specializes in the assessment of clients with complex learning and emotional issues. She is proficient in the administration of psychological (projective) tests, as well as in neuropsychological testing. Her responsibilities at NESCA also include acting as Clinical Coordinator, overseeing psycho-educational and therapeutic services. She has a particular interest in working with adopted children and their families, as well as those impacted by traumatic experiences.

 

 

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

 

 

 

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

 

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