Tag

neurodevelopmental disorders

Oct 21
4

The Path to Eligibility

By | NESCA Notes 2019

By: Reva Tankle, Ph.D.
Pediatric Neuropsychologist

A child’s pediatrician is often the first professional who hears a parent’s concern that their child is struggling in school. It is comforting to know that The American Academic of Pediatrics has recently provided guidelines to pediatricians that outline the important role they can play when a child is struggling in school. The guidelines refer to pediatricians’ involvement in prevention (e.g. avoiding brain injuries, good nutrition, etc.), early recognition, diagnosis, treatment, advocacy/monitoring and referral. Regarding referral, pediatricians are asked to consider involvement of a number of subspecialties, including neuropsychologists, child psychologists, speech and language pathologists and others.

In my prior work as a Special Needs Advocate and now as a pediatric neuropsychologist, I understand how the referral to a neuropsychologist for a comprehensive evaluation can assist a parent in the Special Education eligibility process, but it is still too often an unknown for many others. To be eligible for Special Education services, a child must meet three basic criteria (1) present with a qualifying disability; (2) demonstrate a lack of effective progress in the general education setting; and (3) require specialized instruction or related services (e.g. Speech Therapy, Occupational Therapy, Psychological Services, etc.). The determination of eligibility is made by the school team that includes the parents. The school will conduct its own assessments which may provide the information needed to make a determination of eligibility. A private neuropsychological evaluation provided by the parents can also help to inform the process, by providing a diagnosis(es) as well as a deeper and more integrated look at the child’s cognitive, academic and social/emotional profile.

School evaluators do not typically provide what are considered medical diagnoses, such as ADHD, Autism Spectrum Disorders or Dyslexia. A neuropsychologist can make such a diagnosis, and a comprehensive neuropsychological evaluation should also provide an understanding of how the disability is impacting the child’s academic, social and/or emotional development. The neuropsychologist can then relate the diagnosis to the appropriate educational disability category for the school’s consideration. A neuropsychological evaluation can also assist in determining if a child is making effective progress within the general education setting. Data obtained through standardized testing, teacher reports and observation of the student in the school setting can provide information needed to determine if the child is making progress commensurate with their potential. Finally, delineation of specific skill deficits identified in an evaluation can provide information necessary for selecting appropriate specialized methodologies or the related services the child requires to make progress.

We often hear the phrase, “It takes a village.” It certainly “takes a village” of professionals to provide the coordinated and comprehensive care that a child who is struggling in school requires. With pediatricians providing the first line of support and referrals for parents, the outside professionals, including neuropsychologists, can work with the pediatrician and in conjunction with the school staff to provide the struggling student the range of services needed to foster their academic, social and emotional development.

 

About the Author

Combining her experience and training in both pediatric neuropsychology and educational advocacy, Dr. Reva Tankle has particular expertise in working with families who are navigating the IEP process. Having participated in numerous team meetings over the years, Dr. Tankle is especially knowledgeable about the many ways that schools can support and accommodate students with special learning needs, information that she clearly communicates in her evaluation reports and in team meetings, if needed. She also has a great deal of experience in articulating the reasons that a student may need a program outside of the public school.

Dr. Tankle evaluates students with ADHD, learning disabilities, high functioning autism spectrum disorders, and neurological conditions, as well as children with complex profiles that are not easily captured by a single diagnostic category.

 

To schedule an appointment with Dr. Reva Tankle in Plainville, MA, or any of our expert neuropsychologists, please complete our online intake form. 

 

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

 

Jul 29
2

Back to School 101: How to Support your Child

By | NESCA Notes 2019

By: Reva Tankle, Ph.D.
Pediatric Neuropsychologist

 

When should I start transitioning back to the “school routine?”

The summer break should be a time for kids to have fun playing with their friends and family and enjoying new adventures and experiences. As the new school year looms, however, parents start to think about how to transition from the flexible downtime of summer to the more structured and rigid schedule of the school year. As such, they often wonder when to start the process of getting back to the school routine. Of course, it will be different for each child but, for most children, a slow transition is the best plan. Things to consider are:

  • Probably the most important routine to get back into is the bedtime and morning schedule. Parents should consider a slow transition starting 1–2 weeks before the first day of school. Move the bedtime by 10–15 minutes earlier every few days; inching closer to the school night bedtime. By the time it is the night before the 1st day of school, your child should be back to their regular bedtime. After allowing for an adequate number of hours of sleep, parents might consider waking their child up earlier in the morning, again, inching closer to the wake-up time on school days.
  • During the summer months, some children’s access to screen time might increase. Parents should consider reducing screen time during the day and especially in the evening; closer to their family’s rules for access to screens during the school year. Since many children have summertime reading to do, this might be a good time to get your kids off the screens and focused on completing their summer reading.
  • Regardless of your best intentions to transition smoothly to the school year routine, the beginning of school can be challenging for many children. Giving children, especially younger children, adequate time after school for play and ensuring the right amount of sleep will help children make the transition from summer to school.

What can I do to help this year’s teachers, specialists and therapists get to know my child as well as what’s in their IEP or 504 Plan?

If you child is in elementary school, your child will likely have one or at most two new teachers. It is a good idea to make sure the teachers are prepared to meet your child’s educational needs from the first day of school. But it is also important to recognize that it will take time for the teacher to get to know your child, and you want to make sure that you don’t overload the teachers with more information than they can handle. They will read the IEP, but that can be very overwhelming. To help them get started, you can send an email on the teachers’ first day back at school. Keep it short. Write a few sentences describing your child’s strengths and weaknesses. And then write the 2 or 3 things in the classroom that you think will be most important for your child to be successful in the upcoming year. I can’t stress enough how important it is to be short and to the point in this note. If you keep it focused on the most important information, it is more likely that the teachers will remember what you have shared.

If your child is in middle or high school, you could use a similar approach and write a short note about your child. You may choose to send it to all their content teachers or specifically to their Special Education teacher/liaison.

Finally, if your child is on a 504 Plan, it is definitely worthwhile to send a note to all your child’s teachers that informs them of the 504 Plan, listing the accommodations that are in your child’s 504 Plan. If, however, it is a very long list, you might consider writing the most important accommodations and request that they refer to the official 504 Plan for the comprehensive list. If you have a scanned copy, you could attach it to the email and make it easier for them to have access to it.

My child is anxious – how can I help my child feel more at ease?

Many children feel anxious at the start of a school year. They worry about having a new teacher and being with new classmates. To ease your child’s worries about the first day of school, here are some suggestions:

  • Often teachers start working in the school a few days before the students arrive. Call the teacher and arrange for your child to visit the classroom and have a brief 1:1 meet and greet with the child. If the classroom is set up, the teacher might be able to show your child where their desk will be. Consider taking pictures of the room, desk, locker/cubby and other locations in the school where your child may frequent throughout the school day. As the first day approaches, you can remind your child about how nice the teacher was and possibly, where their desk is, reviewing the photos, if taken. Taking away some of the “unknowns” should reduce your child’s anxiety.
  • Find out from other parents which children from last years’ class are in your child’s new class. Arrange playdates toward the end of summer so you child has some familiar faces to look for.
  • Make sure your child has a “go-to” person in the school with whom they feel comfortable. If they had a counselor the prior year, make sure that person is available to them and remind your child they can go see them if needed.
  • Most importantly, be positive and optimistic about the upcoming year. If you are calm and expect the best, your child will pick up on that and approach the new year with a positive attitude.

New School?

If your child is moving to a new school, many of the suggestions listed above will be helpful in your child’s transition to that school. Most importantly, the opportunity to tour the school and meet teachers should ease their concerns. If they are a middle or high school student, it might be helpful for them to know where their locker is and to “practice” going to their different classrooms. Again, revisit pictures, if  taken during the school visit/meet and greet. The more familiar they are with the environment, the better!

My child doesn’t have an IEP or 504, but I have concerns. What do I do?

If, as the school year begins, you have concerns from the previous year, you should be prepared to act quickly to ensure that your child doesn’t fall further behind. Within the first few days of school, you should send your child’s primary teacher a brief note that outlines your concerns. For example, you might write: “My son didn’t meet the end of the year benchmark in reading last year. I am concerned about his reading development. I would like more information from you about his reading level after you do your beginning of the year benchmark assessment.” It will be important for you to follow up with the teacher within 3–4 weeks and get the information you requested. If you remain concerned because of academic, behavioral or emotional issues you are seeing at home, you should not hesitate to request a Special Education evaluation for your child. Make your request in writing to either the Special Education coordinator at your school or the main Special Education office (find out from your school where to send it or, to be sure, send it to both).

It is critical that you don’t let too much time go by at the beginning of the year to make your request for an evaluation. The school is obligated to evaluate at your request so, don’t be dissuaded from the evaluation if you have concerns about your child’s development and their ability to make progress in school.

I wish you and your family a positive and happy return to school this year!

 

 

Reva Tankle, Ph.D.
Pediatric Neuropsychologist

Combining her experience and training in both pediatric neuropsychology and educational advocacy, Dr. Reva Tankle has particular expertise in working with families who are navigating the IEP process. Having participated in numerous team meetings over the years, Dr. Tankle is especially knowledgeable about the many ways that schools can support and accommodate students with special learning needs, information that she clearly communicates in her evaluation reports and in team meetings, if needed. She also has a great deal of experience in articulating the reasons that a student may need a program outside of the public school.

Dr. Tankle evaluates students with ADHD, learning disabilities, high functioning autism spectrum disorders, and neurological conditions, as well as children with complex profiles that are not easily captured by a single diagnostic category.

 

To schedule an appointment with Dr. Reva Tankle in Plainville, MA, or any of our expert neuropsychologists, please complete our online intake form. 

 

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

 

Nov 19
2

Interview with Reva Tankle, NESCA Pediatric Neuropsychologist

By | NESCA Notes 2018

 

 

By:
Ashlee Cooper
NESCA Marketing and Outreach Coordinator

 

What made you become interested in being a neuropsychologist?

I first became interested in neuropsychology when I was in graduate school.  I was pursuing a Masters Degree in Developmental Psychology and I worked on a research project looking at brain organization in children with autism.  This sparked my interest in how the brain works and how differences in brain organization relate to different neurodevelopmental disorders. My doctoral research focused on differences in how right and left-handers processed information.  I had planned to make a career within the research field of neuropsychology and my first job was in the Neurology department of a medical school. However, after a short time, I found this to be rather unsatisfying as I did not feel that the work, I was doing was having any direct impact on individuals’ lives.  It was at that time that I took a job in Boston at a rehabilitation center working with adults with traumatic brain injury. I found working with the patients and their families to be very meaningful and satisfying.

What brought you to NESCA?

After working for many years in the field of adult brain injury, I found myself having to navigate the special education world. My family and I were assisted by a wonderful Special Education advocate and from that experience I found my next “calling.”  I did the advocate training through the Federation for Children with Special Needs and over the next 7 years, I had the opportunity to work with hundreds of families and help guide them through the process. I was fortunate to meet Dr. Ann Helmus, Director of NESCA, and she invited me to join NESCA; first, to expand my training as a neuropsychologist and then as a staff clinician.  I have been able to bring my experience of working with many wonderful families and dedicated school personnel and connect it to a deep understanding of the neuropsychological underpinnings of the learning and emotional challenges our children face.

Do you have a specialty? What do you specialize in?

I evaluate students age 6 years to young adulthood.  I see a wide range of children and young adults including those with language-based learning disabilities, attentional issues, brain injury, and other neurodevelopmental disorders.  I often do school observations and attend Team meetings. I provide recommendations that are individualized for that student and relevant for both school and home-based interventions.

What do you like about your job?

First and foremost, I love spending time with and evaluating children.  One very bright child asked me “Is this boring for you?” I told him “No, I am always thinking about what the child is doing and trying to figure out what else I need to do to best understand his or her thinking and learning.  And that is not boring.” And I try hard to have “fun” and make it an enjoyable experience for the child. No one is going to be a pediatric neuropsychologist and not find kids fun to be with. I also like my job because I can have an impact on the life of that child, their family and their school.  When we work effectively as a Team, we can really make the life of that child so much better and make their school experience more positive.

Why should parents bring their child to NESCA for evaluation?

The evaluations we provide at NESCA are individualized and comprehensive so that we can answer the referral questions being asked by either the family or the school district.  We have no time constraints; so, if a child needs a third or even a fourth session to get through the necessary testing, the clinician is encouraged to do so. This allows us to fully evaluate the child and develop a deep understanding of the cognitive, learning and/or emotional factors that are making school and life in general, hard for this child.

I would also like to point out that NESCA clinicians are provided with extended opportunities for continuing education and consultation with colleagues.  The NESCA clinicians meet several times a month for continuing education seminars provided at NESCA to further both clinical knowledge and information about resources in the community.  In addition, NESCA clinicians gather weekly for a “Case Conference” where colleagues can consult with each other to ensure that our evaluations and recommendations include the broad-based expertise of our many clinicians.

What advice do you have for parents who are not sure if a neuropsychological evaluation is needed for their child?

When I teach at the Parent Consultant Training course for the Federation for Children with Special Needs, I tell them that an evaluation should be recommended when parents have concerns about their child’s development, particularly cognitive or academic.  Parents might start out with a school evaluation, but, a more comprehensive neuropsychological assessment should be considered if the school evaluation does not provide a deep enough understanding of the child’s learning needs or if the child is not making meaningful progress.  There are great benefits to intervening early when a child is struggling. A neuropsychological evaluation can provide a better understanding of the child’s learning profile and offer recommendations for the interventions that can avoid longer-term negative consequences on learning and emotional well-being.

NESCA has opened up a 3rd location in Plainville, Massachusetts which is where you will be primarily seeing clients. Can you tell us more about your decision to work in Plainville?

Well, I have to admit that moving to Plainville will result in a significantly shorter commute for me.  I have loved being a part of the daily excitement in the Newton office but, I have struggled with the commute.  I am excited to extend this easier commute to families on the South Shore, MetroWest and even Central MA who will find it easier to get to our new office.  I don’t want to make our Newton colleagues jealous, but even parking will be easier.

 

Reva Tankle, Ph.D.
Pediatric Neuropsychologist

Combining her experience and training in both pediatric neuropsychology and educational advocacy, Dr. Reva Tankle has particular expertise in working with families who are navigating the IEP process. Having participated in numerous team meetings over the years, Dr. Tankle is especially knowledgeable about the many ways that schools can support and accommodate students with special learning needs, information that she clearly communicates in her evaluation reports and in team meetings, if needed. She also has a great deal of experience in articulating the reasons that a student may need a program outside of the public school.

Dr. Tankle evaluates students with ADHD, learning disabilities, high functioning autism spectrum disorders, and neurological conditions, as well as children with complex profiles that are not easily captured by a single diagnostic category.

 

NESCA’s new satellite office, opening December 1st,  is located at 60 Man Mar Drive, Suite 8, Plainville, MA 02762.  To schedule an appointment with Dr. Reva Tankle in Plainville, please complete our online intake form. 

 

 

 

 

 

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