NESCA’s Londonderry, NH location has immediate availability for neuropsychological evaluations. Our NH clinicians specialize in the following evaluations: Neuropsychological; Autism; and Emotional and Psychological, as well as Academic Achievement and Learning Disability Testing. Our NH clinicians also conduct evaluations for students who are at boarding schools, and two of our NH clinicians have PsyPACT authorization, allowing them to conduct evaluations out-of-state.

Visit www.nesca-newton.com/intake for more information or to book an evaluation.

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Neuropsychological Evaluation Archives - NESCA

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Unbiased Does Not Mean Uninformed

By | NESCA Notes 2025

By Angela Currie, Ph.D.

NH Clinical and Operational Director; Pediatric Neuropsychologist; PSYPACT-authorized

Families often come to NESCA after a long journey through previous evaluations, diagnoses, and educational plans, sometimes feeling frustrated or misunderstood. When seeking a new neuropsychological evaluation, it is common for parents to hope for a “clean slate.” Understandably, some request that we not review prior reports, IEPs, or teacher input, worrying that this information will bias our perspective or simply repeat what’s been said before.

This desire for objectivity is completely valid. If you disagreed with a previous diagnosis or felt that earlier testing missed the mark, it’s natural to want the new evaluator to approach your child or teen without any preconceived notions. However, it is important to understand that unbiased does not mean uninformed¸ and, in fact, review of previous documents and school input is a critical component of a fresh perspective and comprehensive evaluation.

Why Background Information Matters

A comprehensive neuropsychological evaluation is much more than a set of test scores – it is a synthesis of data, history, observation, and context. Reviewing previous reports, IEPs, and teacher feedback is not about accepting others’ conclusions at face value. Rather, it allows the evaluator to:

  • Understand the full picture: Seeing how strengths and challenges evolve over time helps identify patterns, progress, and trajectories, rather than isolated moments in time.
  • Spot gaps and inconsistencies: Previous testing may have missed key areas of possible concern or used measures that just scratch the surface. Knowing what was done helps the evaluator focus on what still needs to be explored.
  • Avoid unnecessary repetition: There are many measures that should not be repeated within a given timeframe, so it is important to know what to avoid. Knowing recent scores also allows the evaluator to avoid unnecessary redundancy and dig deeper into other skills.
  • Clarify and explain differences: If a previous diagnosis or past recommendations are not supported, the evaluator can integrate previous information into a bigger picture explanation for why a shift in perspective is supported.
  • Address discrepancies in presentation across settings: Often times disagreements between families and schools can result from the fact that children and teens may present differently across settings. Integrating teacher input is critical for determining if concerns are consistent across settings or if the client is working hard to compensate and “look good.”
  • Support IEP development and special education due process: Evaluations that lack integration of school records and input are much more likely to be rejected by the IEP team, as they do not provide a complete picture of the child’s functioning. They are also more likely to be viewed as lacking in credibility should the family proceed with special education due process.

Building Trust Through Transparency

Our role as neuropsychologists is to provide an assessment that is both thorough and fair. We approach each client with fresh eyes, critically evaluating all available information. Reviewing past reports allows us to be confident in our conclusions and build on what is already known. This allows for greater clarity and better advocacy for the client’s unique needs. By blending past information with new observations and data, we can provide the most accurate, insightful, and actionable recommendations possible.

If you have questions about how background information is used in our evaluations, please reach out. At NESCA, we believe that true objectivity comes from being informed and that every client deserves an evaluation that tells their whole story.

 

About the Author

Dr. Currie specializes in evaluating children, teens, and young adults with complex profiles, working to tease apart the various factors lending to their challenges, such as underlying learning, attentional, social, or emotional difficulties. She particularly enjoys working with the seemingly “unmotivated” child, as well as children who have “flown under the radar” for years due to their desire to succeed. She also evaluates adults for concerns regarding ASD and ADHD.

 

To book an evaluation with Dr. Currie or one of our many other expert neuropsychologists, complete NESCA’s online intake form. Indicate whether you are seeking an “evaluation” or “consultation” and your preferred clinician in the referral line.

 

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

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Image of a Neuropsychological Evaluation Report with the question, What's Next? There is also a quote from Dr. Maggie Rodriguez

Navigating Life After a Neuropsychological Evaluation: What Comes Next?

By | NESCA Notes 2025

Image of a Neuropsychological Evaluation Report with the question, What's Next? There is also a quote from Dr. Maggie RodriguezBy: Maggie Rodriguez, Psy.D.
Pediatric Neuropsychologist, NESCA

Going through the process of getting a neuropsychological evaluation can be a big investment of time, energy, and money.  Once it’s completed, you should have some important information about your child and a detailed report. But now what? What do you do with this information and who do you share it with?

As a parent who has been through the neuropsychological evaluation process with two of my children, I know firsthand how overwhelming it can feel to move from diagnosis to action. The report you receive is often extensive and should be filled with valuable insights and recommendations. But translating those findings into real-world support for your child is the next crucial step. Here are some thoughts and practical tips on what to do next:

1) School: The Starting Point for Support

For many families, the primary motivation for seeking a neuropsychological evaluation is to better understand their child’s learning profile and needs in the school setting. The report can be a powerful tool in advocating for appropriate accommodations, interventions, and support.

  • Share the report with your child’s teacher, special education coordinator, and/or school psychologist. If you don’t know where to start, reach out to the school to ask who your contact person should be.
  • Use the findings to inform IEP (Individualized Education Program) or 504 Plan meetings. NESCA neuropsychologists are available to present the findings directly to your child’s team at meetings and can be a valuable resource in this regard.
  • Ask for specific classroom strategies or modifications based on the recommendations. You may want to consider collaborating with an educational advocate as well.

2) Treatment Providers: Building a Collaborative Team

Your child may already be working with therapists, counselors, psychiatrists, or other healthcare professionals. Alternatively, you may be working on setting up treatment. Sharing the neuropsychological report with providers can help them tailor their interventions and monitor progress more effectively.

  • Consider providing copies or summaries of the report to your child’s treatment team.
  • Discuss how the findings might impact therapy goals, medication management, or behavioral strategies.
  • Ask for their input on how best to support your child at home and in other settings.

3) Family: Creating Understanding and Empathy

Sometimes, the people closest to us—grandparents, step parents, siblings—may not fully understand the challenges your child faces. Sharing relevant parts of the neuropsychological evaluation can foster empathy and support within your family.

  • Choose what information is most helpful for family members to know.
  • Have open conversations about your child’s strengths and challenges.
  • Ask for support in implementing strategies at home, such as routines or communication techniques.

4) Care Providers: Ensuring Consistency Across Settings

If your child regularly spends time with nannies, babysitters, or other caregivers, it may be important that they understand your child’s needs and the best ways to support them.

  • Consider sharing key takeaways and practical recommendations from the report that will help caregivers respond effectively.
  • Provide written instructions or checklists if needed.
  • Maintain open communication about what works and what doesn’t.

A Few Final Thoughts

Receiving a neuropsychological evaluation report can be both a relief and a challenge. It offers clarity, but also raises new questions about how to move forward. Here are some tips to help you navigate the next steps:

  • Take time to review and digest the report. Don’t hesitate to ask the neuropsychologist for clarification or a follow-up meeting.
  • Organize the information. Consider making a summary sheet of key findings and recommendations for easy reference.
  • Empower your child. Depending on their age and understanding, talk to your child about their strengths and areas for growth in a positive, supportive way.
  • Remember that you are not alone. There are many resources and communities available for parents navigating similar journeys.

Ultimately, the goal of a neuropsychological evaluation is to help your child thrive. By sharing the findings thoughtfully with the right people, you can build a team of support around your child and help them reach their fullest potential.

 

 

About the Author

Maggie Rodriguez, Psy.D., provides comprehensive evaluation services for children, adolescents, and young adults with often complex presentations. She particularly enjoys working with individuals who have concerns about attention and executive functioning, language-based learning disorders, and those with overlapping cognitive and social/emotional difficulties.

Prior to joining NESCA, Dr. Rodriguez worked in private practice, where she completed assessments with high-functioning students presenting with complex cognitive profiles whose areas of weakness may have gone previously undiagnosed. Dr. Rodriguez’s experience also includes pre- and post-doctoral training in the Learning Disability Clinic at Boston Children’s Hospital and the Neurodevelopmental Center at MassGeneral for Children/North Shore Medical Center. Dr. Rodriguez has spent significant time working with students in academic settings, including k-12 public and charter school systems and private academic programs, such as the Threshold Program at Lesley University.

Dr. Rodriguez earned her Psy.D. from William James College in 2012, where her coursework and practicum training focused on clinical work with children and adolescents and on assessment. Her doctoral thesis centered on cultural issues related to evaluation.

Dr. Rodriguez lives north of Boston with her husband and three young children.  She enjoys spending time outdoors hiking and bike riding with her family, practicing yoga, and reading.

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

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

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Image of a procedures manual and a quote from Dr. Angela Currie

Reflecting on Excellence: How NESCA’s Updated Procedures Manual Sets the Standard for Neuropsychology

By | NESCA Notes 2025

Image of a procedures manual and a quote from Dr. Angela CurrieBy Angela Currie, Ph.D.

NH Clinical and Operational Director; Pediatric Neuropsychologist; PSYPACT-authorized

As we undertake our annual update to NESCA’s comprehensive procedures manual, it’s a moment to reflect on what truly sets our practice apart. The level of structure and support can vary widely in private neuropsychological practices. However, at NESCA, we have intentionally built a model that prioritizes a high degree of structure, explicit expectations, and robust support for our neuropsychologists. We believe this approach ensures the highest quality of care for our clients and the greatest professional growth for our clinicians. Our neuropsychology procedure manual is not just a set of rules; it is a living document that embodies our commitment to excellence.

A Culture of Structure and Accountability

Few neuropsychology practices can claim to have an employee procedures manual as comprehensive, and as regularly updated, as NESCA’s. Our manual is reviewed and revised annually to reflect the latest best practices, regulatory changes, and the evolving needs of our clients and staff. This level of procedural clarity is a hallmark of our commitment to excellence.

From the moment a referral is received, every step – intake documentation, insurance, file management, scoring protocols, feedback, and report writing – is governed by clear, detailed procedures. Our clinicians are never left to guess what is expected, as there are explicit expectations and timelines for every stage of the evaluation and reporting process. These standards are tracked and reinforced by clinical directors.

Unmatched Oversight and Training

At NESCA, oversight is about ensuring quality and fostering growth. New staff are onboarded with in-person training and have direct access to clinical directors for case consultation and procedural questions. We not only have real-time clinical support, but we also have a strong administrative team that can troubleshoot anything from an IT issue to ordering supplies. Thanks to the roles clearly defined in the manual, there is never a question about who to go to when these needs arise.

Although many practices see frequent psychometrician turnover, NESCA has had a consistent, strong team of psychometricians who are committed to excellence in scoring. The procedures manual outlines standardized procedures for scoring, data management, and file security, and clinicians are responsible for cross-checking all data. Although rare, errors are addressed through direct feedback, and there is a clear chain of communication for resolving issues that arise. This system of checks and balances helps ensure the accuracy and integrity of our clinical data, allowing clinicians and clients to feel confident in their findings.

A Commitment to Professional Development

NESCA’s oversight goes hand-in-hand with our commitment to professional development. Not only do we provide regular staff training, our procedures manual includes guidance on matters such as efficient report writing, guidance for legal hearings, insurance requirements, and the latest assessment technologies. We emphasize ongoing education, with recommendations for tracking CEU workshops and maintaining up-to-date curriculum vitae (CVs).

Why This Matters

Neuropsychology is complex, and the stakes are high. Clients come to us seeking answers and guidance for some of life’s greatest challenges. By providing a highly structured, supportive environment, NESCA ensures our clinicians deliver the highest standard of care – consistently, efficiently, and ethically. NESCA emphasizes strong systems and a culture of continuous improvement. This benefits our staff, our clients, our referring partners, and the field as a whole. NESCA leads the way by valuing structure, mentorship, and excellence. We don’t just set the bar – we raise it every year.

And on that note, I better get back to updating that manual – after all, the bar isn’t going to raise itself.

 

About the Author

Dr. Currie specializes in evaluating children, teens, and young adults with complex profiles, working to tease apart the various factors lending to their challenges, such as underlying learning, attentional, social, or emotional difficulties. She particularly enjoys working with the seemingly “unmotivated” child, as well as children who have “flown under the radar” for years due to their desire to succeed. She also evaluates adults for concerns regarding ASD and ADHD.

 

To book an evaluation with Dr. Currie or one of our many other expert neuropsychologists, complete NESCA’s online intake form. Indicate whether you are seeking an “evaluation” or “consultation” and your preferred clinician in the referral line.

 

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

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Image of a student struggling to write and a quote from Alissa Talamo, Ph.D.

Why Does My Child Struggle With Writing?

By | NESCA Notes 2025

Image of a student struggling to write and a quote from Alissa Talamo, Ph.D.By: Alissa Talamo, PhD
Pediatric Neuropsychologist, NESCA

A concern I often hear from parents is that their child is bright, creative, and articulate—able to express ideas clearly in conversation—but gets “stuck” when asked to put those same thoughts into written form. Instead of demonstrating the full extent of their knowledge, these children often write just enough to complete the assignment, leaving teachers and parents wondering what’s holding them back.

Difficulties with written expression can arise for a variety of reasons. For some children, an expressive language disorder makes it challenging to find the right words and organize their thoughts on paper. Others may have fine motor difficulties, making the physical act of writing laborious and frustrating. Children who struggle with spelling often limit themselves to simple words, even if their spoken vocabulary is much richer. These challenges are relatively straightforward to identify, but there are many children who don’t fit these patterns—children who seem to have all the necessary skills yet still find writing to be an uphill battle.

In these cases, neuropsychological testing often confirms what parents already suspect: the child is intelligent, insightful, and capable of high-level thinking, but something is interfering with their ability to express themselves in writing. One of the most common underlying issues is difficulty with executive functioning. Executive functioning is a set of mental skills that includes planning, organization, time management, working memory, attention control, task initiation, self-monitoring, impulse control, emotional regulation, cognitive flexibility, goal setting, and problem-solving. Writing is a uniquely demanding task because it requires the simultaneous use of many of these skills. To write effectively, a student must generate ideas, organize those ideas, keep track of them in working memory, and attend to mechanics like spelling, punctuation, and grammar—all at the same time. It’s no wonder that writing can feel overwhelming!

The good news is that once a child’s specific areas of weakness are identified, there are many strategies and supports available to help them improve their writing skills. Executive functioning tutoring can be especially beneficial, teaching students how to use graphic organizers (such as compare/contrast charts, part/whole relationships, or cause/effect diagrams) and writing templates to structure their thoughts. Tutors can also help students develop strategies for catching mistakes that result from inattention to detail, such as errors in grammar, spelling, or capitalization. In addition, tailored recommendations can be made for in-class support, allowing the student to build their writing skills in a supportive environment.

Why Neuropsychological Testing Can Make a Difference

If your child is struggling with writing, neuropsychological testing can be an invaluable tool. This comprehensive assessment goes beyond surface-level observations to identify specific strengths and weaknesses in cognitive, language, motor, emotional, and executive functioning skills. By pinpointing the root causes of writing difficulties, neuropsychological testing provides a roadmap for targeted interventions and accommodations. With the right supports in place, children can overcome barriers to written expression, gain confidence in their abilities, and more fully demonstrate their knowledge and creativity—both in school and beyond.

 

About the Author

Alissa Talamo headshotWith 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 daughter.

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

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

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Visuals of a covid and pregnancy test not the same as the visual with a child being tested; quote from Dr. Ann Helmus

Test Results Are Not The Answer

By | NESCA Notes 2025

Visuals of a covid and pregnancy test not the same as the visual with a child being tested; quote from Dr. Ann HelmusBy Ann Helmus, Ph.D.
Founder & Director, NESCA

A few days ago, a routine blood test showed high cholesterol. My doctor was concerned and suggested I start on a life-long medication.

But here’s what was missing from that recommendation:

Six weeks earlier, I had Covid. When I tested negative, I launched into a grueling stretch of all-day meetings, international travel, public speaking, and disrupted sleep. I never fully recovered.

At the time of my blood test, I was still in a post-viral fatigue phase, which is known to increase cholesterol. All other medical tests showed normal results. Instead of looking at the pattern of test results, my doctor focused on the one abnormal value, which likely reflects my lack of adequate recovery from Covid and travel stress, not an underlying problem with cholesterol.

This experience illustrates an important principle in neuropsychological evaluation: An individual test result rarely speaks for itself. It must be interpreted in the context of other results, history, and clinical observation.

There is no test for ADHD or for ASD or for LD or any of the other conditions that we see. There are only data points to be connected. There is no single test result that can explain: why a child is struggling, what the underlying issue is, or the type(s) of support that will help them thrive.

Those answers come from interpretation that involves:

  • Deep developmental history-taking
  • Pattern analysis across multiple measures
  • Direct clinical observation
  • Integration of cognitive, emotional, academic, and behavioral data
  • And years of diagnostic experience

A neuropsychological evaluation is not like a Covid test, the results of which can be easily interpreted by a layperson. Neuropsychological testing results need to be carefully analyzed and interpreted by a highly trained professional relying on their experience and clinical judgement to determine the meaning of the results, and, most importantly, what they mean for treatment.

When interpretation is shallow, children are likely to be improperly diagnosed, which leads to:

  • Wrong educational placements
  • Inappropriate medications
  • Mismatched interventions
  • Years of frustration for a child who was misunderstood

A high-quality evaluation does not simply label. It provides a proper explanation that leads to meaningful intervention. We don’t treat numbers. We don’t treat checklists. We don’t treat isolated test results. We treat human beings.

 

About the Author

NESCA Founder and Director Ann Helmus, Ph.D., is a licensed clinical neuropsychologist who has beenAnn Helmus headshot practicing neuropsychology for 35 years and has been director of NESCA’s Neuropsychology practice for nearly three decades, continuously training and mentoring  neuropsychologists to meet the highest professional standards.

To book a neuropsychological evaluation at NESCA, complete NESCA’s online intake form. 

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

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school student frustrated over the work

Navigating the Post-Honeymoon Phase: Signs Your Child May Need Support This School Year

By | NESCA Notes 2025

school student frustrated over the workBy Miranda Milana, Psy.D.
Pediatric Neuropsychologist

With the start of the school year well underway, we are beginning to see students and teachers settling into their classroom routines. Along with this increase in familiarity and comfortability, parents often start to see bits and pieces of challenges arise around this time of year that may have gone unnoticed during the initial “honeymoon period.” You may be wondering what challenges you should be looking out for and when those challenges warrant an evaluation to determine further supports and services. Let’s take some time to explore what to keep an eye on, and when it might be time to reach out to schedule an evaluation to dive a bit deeper into what is going on.

Academics

No matter their age, if you ever feel your child is inundated and overwhelmed with schoolwork, it is a great idea to reach out to their teachers; ask how long homework should be taking and whether it should feel like review vs. new material. If homework starts to consistently become a battle, it might be worth taking a closer look into why. It could be because it’s a new and appropriately challenging course. It could also be because there are underlying language-based learning disabilities, a nonverbal learning disability, executive function challenges, or increasing symptoms of anxiety or depression. Some specific things to watch for:

  • Frequent tears during homework that appear to be getting worse instead of better
  • Not appearing to “get it” even after review and repetition
  • Difficulty studying/holding information in memory
  • Dysfluent reading or not understanding what they’ve read
  • Challenges understanding math concepts or memorizing math facts
  • Difficulty applying and generalizing concepts
  • Opposition to handwriting tasks or when asked to compose a writing assignment
  • Poor penmanship that is illegible and/or immature for age
  • Not meeting benchmarks on assessments

Social Skills

At this point in the school year, children are typically starting to be interested in other peers within their classrooms. For younger kids, they are likely to feel more comfortable interacting with other children in their play. Common social concerns can include:

  • Not remembering any names or faces of kids in their class
  • Preferring to play alone; hesitant to join in with a group
  • Appearing unaware of social cues or how to initiate conversation with others
  • Rigidity in play – always wanting to play their own game by their own specific rules
  • Frequent peer conflicts and feeling rejected or left out

Emotional Functioning

A new school year often elicits feelings of anxiety in kids no matter how outgoing and social they may be! When might it be a sign that there is something more?

  • Continued and persistent resistance to going to school
  • Frequent somatic complaints with no apparent cause (e.g., headaches, stomachaches)
  • Change in sleeping patterns – not being able to fall asleep at night or waking up frequently
  • Difficulty with regulating their emotions/frequent tantrums
  • Changes in appetite
  • Negative statements about themselves
  • Increase in irritability
  • Withdrawal from others or previously preferred activities
  • Always wanting to know what is happening next and struggling with changes in routine (i.e., Does a substitute teacher derail their whole day? If a friend is out sick, is there a perseveration on where they are? Do you wait to tell them about changes in plans so they don’t worry in advance?)

Attention/Focus

Have you ever found yourself feeling restless and distracted when sitting through a work meeting? Kids are no different! Sitting still and paying attention for extended periods of time can be really tough – especially after being on summer break! Here are a few things to keep an eye on:

  • Frequently fidgeting in their seat or needing a fidget item to increase concentration
  • Difficulty with multi-step directions
  • Not remembering information presented during lectures
  • Acting impulsively
  • Easily distracted/daydreaming
  • Acting as if running by a motor
  • Blurting out thoughts, interrupting conversations
  • Teacher feedback that they are interrupting other students or not able to sit quietly and attend to class discussions

As always, you know your child best! If you feel like this year is off to a rocky start, or you’re starting to have questions regarding their functioning, do not hesitate to reach out and schedule an evaluation. A comprehensive neuropsychological evaluation is designed to look at ALL aspects of a child to determine what is getting in their way of reaching their potential. We are always here to help!

 

About the Author

Dr. Miranda Milana provides comprehensive evaluation services for children, adolescents, and young adults with a wide range of concerns, includingMiranda Milana Headshot attention deficit disorders, communication disorders, intellectual disabilities, and learning disabilities. She particularly enjoys working with children and their families who have concerns regarding an autism spectrum disorder. Dr. Milana has received specialized training on the administration of the Autism Diagnostic Observation Schedule (ADOS).

Dr. Milana places great emphasis on adapting her approach to a child’s developmental level and providing a testing environment that is approachable and comfortable for them. She also values collaboration with families and outside providers to facilitate supports and services that are tailored to a child’s specific needs.

Before joining NESCA, Dr. Milana completed a two-year postdoctoral fellowship at Boston Children’s Hospital in the Developmental Medicine department, where she received extensive training in the administration of psychological and neuropsychological testing. She has also received assessment training from Beacon Assessment Center and The Brenner Center. Dr. Milana graduated with her B.A. from the University of New England and went on to receive her doctorate from William James College (WJC). She was a part of the Children and Families of Adversity and Resilience (CFAR) program while at WJC. Her doctoral training also included therapeutic services across a variety of settings, including an elementary school, the Family Health Center of Worcester and at Roger Williams University.

Dr. Milana grew up in Maine and enjoys trips back home to see her family throughout the year. She currently resides in Wrentham, Massachusetts, with her husband and two golden retrievers. She also enjoys spending time with family and friends, reading, and cheering on the Patriots, Bruins, Red Sox, and Celtics.​

To book an appointment with Dr. Miranda Milana or another expert NESCA neuropsychologist, please complete our Intake Form today. 

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 Coral Gables/Miami, Florida, serving clients from infancy through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

 

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Dr. Luisa Hernandez Medellin evaluating a child

NESCA’s Heading South to Care for Children and Empower Families

By | NESCA Notes 2025

Dr. Luisa Hernandez Medellin evaluating a childBy Jane Hauser
Director of Marketing & Outreach, NESCA

Dr. Luisa Hernandez Medellin Discusses NESCA’s Miami Launch

NESCA recently opened its latest pediatric neuropsychology office in Coral Gables/Miami, Florida, headed up by Dr. Luisa Hernandez Medellin. I had the opportunity to speak with Dr. Luisa Hernandez Medellin to get to know more about her background, the current evaluation landscape in South Florida, Latin America, and the Caribbean, and to hear from her what unmet needs NESCA addresses in bringing its expertise to that region.

Tell us about your background and how you chose to become a pediatric neuropsychologist.
I was born and raised in Mexico City in a family that valued service and helping others. As a teen, I considered becoming a missionary nun because I wanted to travel to deliver services and support to children in need. During those years, I spent time in Cuba, Nicaragua, Guatemala, and Costa Rica, where I witnessed numerous disparities in the way people lived. That experience shaped my commitment to serving children and families.

When I returned to Mexico, I explored different careers, including teaching and medicine, as my father was a doctor, and eventually landed in psychology almost by chance—but it felt like home as soon as I discovered it. Later, when I moved to Miami, I completed my bachelor’s degree and entered a doctoral program in child psychology. During my training, I discovered neuropsychology, and it was a perfect fit: a way to combine psychology with the medical world, caring for both the mind and the body of an individual.

I trained at Jackson Memorial Hospital, where I fell in love with pediatric neuropsychology, working with children with neurodevelopmental disorders in both inpatient and outpatient settings. That experience set the foundation for my career. Since then, I’ve worked in hospitals, private practice, and now with NESCA, where I get to provide high-quality evaluations in a compassionate way that will help children and their families have a path to move forward on.

What is your philosophy when working with children and families?
I treat every child as I would my own. I’m a mother of three, all neurodivergent in different ways, so I understand how hard it can be to navigate the challenges of having children with disabilities while also loving them so deeply. My role is to get to know each child who comes in for an evaluation—what makes them unique, what’s important to them—and to help uncover what’s happening so they can flourish.

How do you feel neuropsychological evaluations benefit individuals and families?
Evaluations give us a deeper, objective understanding of a child’s strengths and challenges. Parents often come to me worried that they’ve done something wrong that caused their child’s struggles. I reassure them that no one is at fault. The goal is not to find problems or identify something or someone to blame; rather, it’s to identify the root cause of a child’s challenges while also highlighting each child’s strengths. It’s about finding the “lights AND the shadows.” For example, if a child struggles in math but loves music, we lean into music as a source of joy and growth for the child while knowing how to  properly provide support in areas like math, that may be more stressful.

How do you approach parents or caregivers who are resistant to the evaluation process or the possibility of their child receiving a diagnosis from it?
In Miami, many families are hesitant about their child receiving a diagnosis(es). I take the time during the intake process to listen to their concerns and gently plant seeds about the types of issues we may be seeing. That way, parents aren’t shocked during the feedback session where they learn the findings from the evaluation, which may include one or more diagnosis(es). It helps them process the information and reduces their fears. I emphasize that neurodivergence isn’t caused by parenting choices or styles, screen time, or the Covid experience. It’s just how a child is wired. My focus is on supporting families and children and building hope with new information from the evaluation.

How did you connect with NESCA, and what excites you about bringing NESCA to Miami?
While considering a move to Boston, I met NESCA’s founder and director, Dr. Ann Helmus, and our conversation felt like meeting a kindred spirit. She reminded me of my attending supervisor from Jackson Memorial Hospital in that they both expect very high quality evaluations, really care about their patients, and truly value the quality of the training provided to their trainees. That’s not always the way with providers, so that was very important to me.

She shared that NESCA was planning to open a Miami office, which felt like the perfect match. Now, I get to help NESCA bring its 30 years of expertise to our region, while I’m also contributing my own 20 years of experience right here in Miami. Together, we’re offering high-quality, culturally-sensitive evaluations in both Spanish and English.

Why does Miami need a practice like NESCA?
The system here in South Florida often creates delays in the identification of developmental, emotional, or learning disabilities. Pediatricians sometimes use a “wait and see” approach; bilingualism is sometimes mistaken for a speech delay when it’s really a sign of autism; and schools often face huge, lengthy backlogs for testing students.

It can be tricky to find the right resource or professional to help identify challenges early on. Neurologists tend to be trained in the brain as “hardware,” whereas we examine the brain’s operating system and how it functions when there is a brain injury, a developmental disorder, or other issue. More often, they look to scans and imaging for answers, where we look at the child’s wellbeing and growth, especially when there is a more complex presentation that may lead to several diagnoses, like ADHD, autism, and anxiety, all co-occurring. And due to productivity pressures in large Miami hospitals, they are only able to see patients for 15 minutes or so and often via telehealth.

And again, with our medical system not being optimized, there is a lot of overwhelm among pediatricians who are forced to operate in a factory-like system. Many people here in South Florida don’t actually have a dedicated pediatrician who knows them and their families. It’s more of a walk-in urgent care system, and that means there is no follow-up in six months or even a year to see how a child is progressing or not. No one is tracking them and is dedicated to their developmental well-being. This is another reason for the frequent delays in diagnosis here.

Because of all of these issues, too often, families don’t receive timely or comprehensive evaluations, and diagnoses and services are delayed. NESCA offers an alternative: in-depth, individualized assessments that consider the whole child—what their lives look like and how they do in school, at home, and in the community. NESCA coming to Miami is filling a very large gap in getting families the answers they are looking for and getting children the support they need to thrive.

What do you evaluate at NESCA in Coral Gables?
I focus primarily in pediatric neurodevelopmental disorders, ADHD, Autism Spectrum Disorders, and learning disabilities, providing evaluations and highly tailored recommendations for interventions. I have also been training practicum students in the Miami area, which we will continue to do as part of the NESCA practice in Coral Gables. There are currently only two sites in Miami where doctoral-level students can train at a practicum level in pediatric neuropsychology, and one of them is now NESCA.

What are your plans for working with schools and international families?
International families and private schools are actively seeking support for their students. Many families from Latin America and the Caribbean face limited resources in their home countries. They come to NESCA for specialized, highly personalized evaluations and recommendations on how to support their child or student at home or in school, in their country. NESCA in Miami will provide these families with the guidance and expertise they need—tailored to their cultural context and delivered with compassion.

Any final thoughts?
NESCA offers families in South Florida, Latin America, and the Caribbean the best of both worlds. We’re bringing NESCA’s legacy of excellence from 30 years of practice in New England, along with my decades of experience living and practicing in Miami, to serve families in this diverse, multicultural community. My goal is simple: to help every child be understood, supported, and given the guidance and tools necessary to thrive.

Headshot of NESCA Pediatric Neuropsychologist Dr. Luisa Hernandez MedellinAbout the Author

As a bilingual pediatric neuropsychologist, Dr. Hernandez Medellin conducts comprehensive and culturally sensitive neurodevelopmental and neuropsychological assessments, comprehensive diagnostic evaluations, and effective care plans, providing appropriate recommendations for the client’s school, home, and the community. She specializes in the identification and assessment of neurodevelopmental disorders such as Autism Spectrum Disorders, ADHD, developmental and learning disorders, and their co-occurrence with anxiety and mood disorders. She also works with children and young adults with acquired brain injuries, epilepsy, brain tumors, strokes, general medical conditions, and genetic disorders affecting the nervous system. She is a native Spanish-speaker, passionate about serving the eclectic and vibrant South Florida community, as well as international patients looking for high-quality and compassionate care.

To book evaluation services at NESCA in Coral Gables, Florida, complete NESCA’s online intake form. 

To book a neuropsychological evaluation or other services at NESCA’s New England offices, complete NESCA’s online intake form. 

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

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Engineered for Excellence

By | NESCA Notes 2025

Image of NESCA clinicians conferring with each other and a quote from Dr. Ann HelmusBy Ann Helmus, Ph.D.
Founder & Director, NESCA

NESCA supports your clinician—so your clinician can support you and your child

When you choose NESCA, you’re not just hiring an individual clinician—you’re accessing an entire organization built to deliver excellence to each family who works with us. From the first intake call to the final report, every step of our process is designed to ensure quality, accuracy, and the best outcomes for your family. Parents invest in this process to resolve complex questions about their child’s learning, development, or emotional well-being—questions that can only be addressed by a thoughtful, thorough evaluation leading to recommendations that will truly make a difference.

At NESCA, we believe that the best way to provide this level of care is to take extraordinary care of our clinicians. Our equation is simple:

Lower Case Volume + High Clinician Support =

Exceptional Evaluations + Better Outcomes

Supporting Clinicians in Doing Their Best Work
In some practices and settings, clinicians face heavy caseloads, which can make it difficult to dedicate as much time to each child as they’d like. With larger caseloads, clinicians are often left with little time for reflection, professional growth, or collaboration. At NESCA, we intentionally structure things differently. We greatly value our clinicians as highly educated professionals with many years of training and provide them with the support, environment, and opportunity to produce their most thorough and careful work.

From the beginning, NESCA was intentionally designed for clinicians to typically work with six or fewer clients each month—a low volume compared to many other practices or settings. This structure ensures that every child’s evaluation receives the time, attention, and individualized analysis it deserves.

We Care for Our Clinicians—So They Are Able to Care for Your Child
Behind the scenes, our clinicians are supported in ways that are uncommon in many private practices:

  • Professional Development: Weekly seminars, ongoing mentorship, and access to senior clinical directors to ensure that every clinician is continually learning and growing.
  • Collaboration: Regular case conferences provide a forum for discussing complex cases and drawing on the expertise of their NESCA colleagues who specialize in multiple disciplines, providing well-rounded and forward-looking perspectives. Your child’s clinician is never working in isolation.
  • Dedicated Support Staff: Psychometricians handle test scoring, and administrative staff manage scheduling and logistics. This frees clinicians to focus entirely on the heart of their work—understanding your child.
  • Quality over Quantity: Because we are not driven by volume, clinicians can invest the time needed to observe your child carefully, analyze test results holistically, speak with educators and providers on your team, and craft thoughtful recommendations.

What This Means for Families
We know that clinicians do their best work when they feel secure, valued, and engaged. That’s why NESCA provides stability, top notch administrative support, and a professional community. When challenges arise, we work with our clinicians to resolve them, offering mentorship and guidance rather than leaving them to struggle and produce work that doesn’t meet NESCA’s high standards.

This culture of care is not just good for our staff—it’s essential to the families we serve. It means that when you come to NESCA, you are working with professionals who are deeply committed, well supported, and fully equipped to provide the highest quality evaluations and recommendations.

We take care of our clinicians so that they can take the best possible care of your child.

 

About the Author

NESCA Founder and Director Ann Helmus, Ph.D., is a licensed clinical neuropsychologist who has beenAnn Helmus headshot practicing neuropsychology for 35 years and has been director of NESCA’s Neuropsychology practice for nearly three decades, continuously training and mentoring  neuropsychologists to meet the highest professional standards.

To book a neuropsychological evaluation at NESCA, complete NESCA’s online intake form. 

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

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Image of an SAT and an ACT exam with a quote from Dr. Erin Gibbons

Don’t Miss Out: Planning Ahead for College Entrance Testing Accommodations

By | NESCA Notes 2025

Image of an SAT and an ACT exam with a quote from Dr. Erin GibbonsBy: Erin Gibbons, Ph.D. 
NESCA MA Clinical Director; Pediatric Neuropsychologist

If you’re the parent of a high schooler with a disability, you might be thinking ahead to college entrance exams like the ACT or SAT. These tests can be stressful for any student, but for those who need accommodations—such as extended time, additional breaks, or accessible testing formats—planning ahead is especially important. One of the most common pitfalls families encounter is missing the deadline to apply for accommodations. Here’s why you should check those deadlines now, and how to get started.

Why Accommodations Matter

Accommodations help level the playing field for students with disabilities, ensuring they have the support they need to demonstrate their potential. Whether your student has ADHD, a learning disability, anxiety, or another disability, the right accommodations can make a significant difference in their performance and confidence.

Deadlines Sneak Up Fast

Exams, such as the ACT, SAT, and Advanced Placement, require students to apply for accommodations well in advance of the test date—sometimes several months ahead. The process involves gathering documentation, working with your child’s school, and waiting for approval. If you miss the deadline, your student may have to take the test without the support they need or wait for the next test date.

Don’t Forget About Updated Evaluations

One important detail to keep in mind: the College Board and similar organizations require current documentation to support accommodation requests. If your student’s last neuropsychological evaluation is more than 2 years old, you will likely need to schedule an updated evaluation this fall.

What You Should Do Now

  • Check the official website for deadlines: https://accommodations.collegeboard.org/
  • Contact your school’s guidance counselor or learning support specialist
  • Gather documentation – most recent neuropsychological evaluation, current IEP or 504 Plan
  • Schedule updated neuropsychological testing if needed
  • Apply early! If the requested accommodations are not approved, you may need to start an appeal process, which can take a good amount of time to gather the required documentation or other materials.

 

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. 

NESCA is a multidisciplinary practice with offices or staff in Newton, Hingham, and Plainville, Massachusetts; Londonderry, New Hampshire; the Burlington, Vermont region: and Coral Gables/Miami, Florida, 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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image of adults observing a school classroom

Why School Observations Matter in a Neuropsychological Assessment

By | NESCA Notes 2025

image of adults observing a school classroomBy Miranda Milana, Psy.D.
Pediatric Neuropsychologist

When families seek a neuropsychological evaluation for their child, it’s usually because they’re looking for a deeper, more comprehensive understanding of their child’s profile—including both strengths and challenges. This kind of evaluation helps answer important questions about how a child learns, thinks, manages emotions, and interacts with others.

By gaining this insight, we can better support a child in all areas of life—at school, at home, with friends, and in community settings. Sometimes, however, the most valuable piece of the puzzle doesn’t come from test scores at all.

In some cases, your neuropsychologist may determine that observing your child in their natural learning environment—a school observation—can provide crucial information that simply can’t be gathered in an office setting.

What Is a School Observation?

A school observation involves a trained professional—usually the neuropsychologist conducting your child’s evaluation—visiting your child’s school to observe them in real time.

This observation might include time spent watching your child:

  • During classroom instruction
  • In social settings like lunch or recess
  • While transitioning between classes
  • In additional services, such as speech/language therapy or occupational therapy

The purpose is to see how your child functions across different settings and situations throughout their school day.

Why Is a School Observation So Valuable?

You might wonder: if the evaluator already has detailed testing results, rating forms from parents and teachers, and information from the intake appointment and outside providers, why observe at school?

Even the best testing environment can’t fully replicate real-world situations. In a quiet, 1:1 testing setting, a child might appear regulated, focused, and engaged—but in a classroom filled with distractions and increased demands, their behavior and overall presentation might look very different. A school observation helps us understand how a child manages in the real-world environments where challenges often arise.

Observations allow us to:

  • Identify situations that may be triggering challenging behaviors (like transitions, group work, or unstructured time)
  • Determine whether a child is well-matched with their peers or may be in the wrong instructional group
  • Notice social dynamics—Are they connecting with peers? Are they withdrawn or overly controlling during play?

Another critical area we assess during school observations is whether the learning environment is a good fit for your child:

  • Is the classroom appropriately structured?
  • Are staff using the tools and supports outlined in the IEP?
  • Does your child respond well to the strategies, like visual schedules or token boards, being used?

Observing how a child responds to the classroom setup and supports can help determine whether their current environment is truly meeting their needs—or if changes are required to allow them to access the curriculum.

When Is a School Observation Recommended?

Not every evaluation requires a school observation, but there are several situations where it can provide especially meaningful insight. Examples include:

  • A child who struggles with behaviors at school that aren’t seen at home or during testing
  • A child who performs well on standardized tests but is reported to be having a hard time keeping up in class
  • Uncertainty about whether the child’s current classroom or program is the right fit for their learning profile
  • Questions about whether the child would benefit from a different instructional approach, such as a language-based classroom or one using ABA methods

At NESCA, our clinicians are trained to determine when a school observation would add helpful information to the evaluation process. We view it as one of many tools to build the most accurate picture of your child’s needs.

What to Expect During the Observation

If you and your evaluator decide that a school observation would be helpful, we’ll coordinate the visit with your child’s school—with full permission from you and the school team.

On the day of the observation:

  • The evaluator typically sits in the back of the classroom, making every effort not to disrupt the flow of the day.
  • The goal is to blend in and observe naturally occurring interactions and behaviors.
  • Observations are done in a respectful, non-intrusive manner with the sole purpose of helping your child.

Afterward, the evaluator will include a summary of the observation in the written report, and the insights gained will be integrated into the diagnostic impressions and recommendations.

A school observation is about understanding your child in the context of their daily environment. When paired with testing, rating scales, and interviews, this real-world view helps ensure that recommendations are not only accurate, but truly actionable.

If you have any questions about the school observation process—or want to know whether it might be helpful for your child—don’t hesitate to reach out to your evaluator. We’re always here to help guide you through the process and help your child get the support they need to succeed.

 

About the Author

Dr. Miranda Milana provides comprehensive evaluation services for children and adolescents with a wide range of concerns, includingMiranda Milana PsyD headshot attention deficit disorders, communication disorders, intellectual disabilities, and learning disabilities. She particularly enjoys working with children and their families who have concerns regarding an autism spectrum disorder. Dr. Milana has received specialized training on the administration of the Autism Diagnostic Observation Schedule (ADOS).

Dr. Milana places great emphasis on adapting her approach to a child’s developmental level and providing a testing environment that is approachable and comfortable for them. She also values collaboration with families and outside providers to facilitate supports and services that are tailored to a child’s specific needs.

Before joining NESCA, Dr. Milana completed a two-year postdoctoral fellowship at Boston Children’s Hospital in the Developmental Medicine department, where she received extensive training in the administration of psychological and neuropsychological testing. She has also received assessment training from Beacon Assessment Center and The Brenner Center. Dr. Milana graduated with her B.A. from the University of New England and went on to receive her doctorate from William James College (WJC). She was a part of the Children and Families of Adversity and Resilience (CFAR) program while at WJC. Her doctoral training also included therapeutic services across a variety of settings, including an elementary school, the Family Health Center of Worcester and at Roger Williams University.

Dr. Milana grew up in Maine and enjoys trips back home to see her family throughout the year. She currently resides in Wrentham, Massachusetts, with her husband and two golden retrievers. She also enjoys spending time with family and friends, reading, and cheering on the Patriots, Bruins, Red Sox, and Celtics.​

To book an appointment with Dr. Miranda Milana or another expert NESCA neuropsychologist, please complete our Intake Form today. 

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

 

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