To accommodate requests for neuropsychological evaluations after the start of the new school year, NESCA has added evaluation dates in its Newton, MA office. Immediate openings are now available for scheduling. Please complete our Inquiry/Intake Form for more information or to start the scheduling process.

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42

Transition Assessment: What Are You Testing that Hasn’t Already been Tested?

By | Nesca Notes 2023

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

Transition planning is a complex process centered around helping students, typically who receive special education services, to set goals for their postsecondary adult lives and to engage in learning, services, and experiences that will help them to ultimately reach those goals. Assessment is a critical aspect of this process, both as a means for collecting baseline information about the student and measuring progress throughout the planning process. Transition planning is federally mandated for students at age 16. However, some states require schools to start the process earlier. For instance, transition planning is required as part of the IEP process for students turning age 14 in Massachusetts.

Transition assessment is therefore required in middle school or early high school for most students in the United States. By this point in time, students on IEPs have often participated in lots of testing. Students may have had academic testing, psychological evaluation, speech and language testing, occupational and physical therapy assessments, functional behavioral assessment, and even home or health assessments. They have participated in so much previous testing, that some parents or professionals may ask, “What could a transition specialist be testing that has not already been addressed through other evaluations?”

The answer is, “A lot!” There are many areas that can and should be evaluated as part of an informed transition planning process, but which are not frequently evaluated when creating earlier IEPs. This is because initial IEPs and early reevaluations focus on helping students to access education and school life, but transition planning is about helping students to develop necessary skills for accessing learning, living, community, and employment as an adult. The following tables are based on on the Transition Assessment Planning Form developed by the Transition Coalition at the University of Kansas in 2008. These highlight many areas of assessment that can and should be considered as part of a comprehensive transition assessment and planning process. These also indicate which areas have usually not been considered for evaluation prior to a thorough transition assessment process.

Please note that every student on an IEP is an individual with unique strengths and disability-related needs and so these tables are offered as a general picture of what has been observed at NESCA in the majority of cases. Additionally, while all of the areas above are considered as part of a comprehensive transition assessment and planning process, they may not need direct assessment depending on student profile, postsecondary goals, and existing evaluation or report data.

For more information about transition assessment and transition planning at NESCA, visit our transition services page and our transition FAQs.

 

About the Author
Kelley Challen, Ed.M., CAS, is NESCA’s Director of Transition Services, overseeing planning, consultation, evaluation, coaching, case management, training and program development services. Ms. Challen also provides expert witness testimony in legal proceedings related to special education. She is also the Assistant Director of NESCA, working under Dr. Ann Helmus to support day-to-day operations of the practice. Ms. Challen 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 additionally 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. Ms. Challen is 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. She is also a proud mother of two energetic boys, ages six and three. 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.

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

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

11

Understanding Behavior as Communication

By | Nesca Notes 2023

By: Cynthia Hess, PsyD
Pediatric Neuropsychologist

School is out for many, and it is no surprise to many that it was a challenging year for teachers, parents, and children. One word that captures the experience of the 2022-2023 school year is stress. Teachers were stressed as their students continued to contend with the academic and social deficits that resulted from the pandemic. Many students have struggled to adapt to post-pandemic learning, and incidents of acting out behavior have increased precipitously. How do we make sense of children’s behavior while helping them develop and effectively manage the academic, social, and behavioral expectations of an ever-changing world?

Ross Greene, Ph.D., states, “Children want to do well and would if they could.” Behavior is not just random or meaningless. It serves as a way for children to express their needs, feelings, and experiences, especially when they have not yet developed strong verbal or communication skills. When the demands of the environment exceed a child’s capacity to manage them, they are apt to become stressed, increasing the likelihood that they will act out. Stress is a complex concept that is a response to perceived or anticipated demands or pressures that exceed an individual’s coping abilities.

When stressed, the adrenal glands release cortisol, a stress hormone that helps mobilize energy reserves for the fight-or-flight response. Fear and anxiety also increase individuals’ vulnerability to responding with fight or flight. So, while fear is focused on a specific threat, physiologically, it feels much the same as stress. Behavior is, therefore, a way of communicating that something is amiss. For instance, a child who acts aggressively may express frustration, which is stressful. And a child who becomes withdrawn might feel overwhelmed or anxious, triggering a stress response. Behavior is a natural way for children to communicate their needs, emotions, or reactions to the environment.

Our job as adults is first to check our own emotional status, because if we are tired or stressed, it will likely influence how we respond when children behave badly. Observing and interpreting behaviors with a curious and open mindset is important. By paying attention to patterns, triggers, and context, adults can gain insights into what a child might be trying to communicate through their behavior. Our job is not to manage the behavior but to understand, per Dr. Greene, what skills are lagging or what problems need to be solved, build relationships, and work collaboratively with children to solve problems and change behavior.

Resources:

The Explosive Child, Ross Greene, Ph.D., 2021

Beyond Behaviors; Mona Delahooke, Ph.D., 2019

Podcast: Two Sides of the Spectrum; episode dated April 5, 2023; “Safety as the Foundation for Everything

 

About the Author

Dr. Cynthia Hess (Cindy), a licensed psychologist, worked as an elementary counselor and school psychologist for 15 years before starting her doctorate. In this role, she developed extensive expertise and aptitude for working with individuals and groups struggling with a wide range of emotional and learning challenges.

She completed her pre-doctoral internship with Rochester Institute of Technology in Rochester, N.Y., where she trained at Hillside Family of Agencies in a therapeutic residential school. At Hillside, she worked with youth ages 5-17 who had experienced complex developmental trauma.

She earned her Psy.D. in Counseling and School Psychology from Rivier University in 2018. Having a strong interest in the impact of social media on children and our culture, her doctoral dissertation studied the impact social media has on social skills development in fourth- and fifth-grade children.

Dr. Hess’s first post-doctoral fellowship was with The Counseling Center of New England, where she provided psychotherapy and family therapy to children ages 5-18 and young adults.

Dr. Hess joined NESCA’s Londonderry, N.H. office in 2019, where she completed a second two-year fellowship in pediatric neuropsychological assessment. Dr. Hess now conducts neuropsychological evaluations as a pediatric neuropsychologist and has a particular interest in working with children and young adults with complex emotional and behavioral profiles. Her experience allows her to guide families in navigating the complicated options for school and other support services.

 

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

 

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

 

13

Welcoming Renee Cutiongco Folsom, Ph.D., Pediatric Neuropsychologist

By | Nesca Notes 2023

By: Jane Hauser
Director of Marketing & Outreach, NESCA

NESCA recently welcomed Pediatric Neuropsychologist Renee Cutiongco Folsom, Ph.D. to its clinical staff. Dr. Cutiongco Folsom brings a wealth of experiences and vast knowledge in assessing and diagnosing autism spectrum disorders (ASD) as well as conducting international evaluations. Take a moment to learn more about Dr. Cutiongco Folsom from my interview with her. 

Tell us about your background and how you got to NESCA.

I grew up in the Philippines. I started my career as a preschool teacher there for two years. At that point, I knew I wanted to work with children. I eventually got my master’s degree in psychology and took a neuropsychology class with a professor who was trained at Boston Children’s Hospital. I immediately fell in love with neuropsychology. I then came to the U.S. to pursue my Ph.D. and did my fellowship in neuropsychology at UCLA. I planned to go back to the Philippines but met my husband here in the U.S. and decided to stay here.

Since I did not go back to the Philippines, I was interested in practicing neuropsychology internationally, which I was able to do in Baltimore at Johns Hopkins. I was interested in the work NESCA has been doing internationally. The opportunity to work with a talented team at NESCA and the ability to do international evaluations was the right move for me.

What do you mean by looking beyond the data when conducting neuropsychological evaluations?

I refer to employing the “Boston Process Approach” in my evaluations and assessments because my mentor in the Philippines was trained in this approach when she did her postdoctoral work at Boston Children’s Hospital. She tried to ingrain this methodology in her trainees. What it means is that when we look at the data, we do not just look at a score. There is so much more to a child’s story than a number. As neuropsychologists, we are always looking at how the child comes up with an answer to a test. It is possible for a child to get a low score on a test of reproducing designs using blocks, for example, because the child threw or even ate the blocks! We must decipher what is behind the process by which the child produced the answer. This critical information falls outside of the data or what a score is. It tells us how the child learns, and what will help them at school, at home, and in their day-to-day life. This is the approach I take when I work with a child. I take a LOT of notes! I look to see what the child says and does, whether he or she is paying attention, and note other behaviors throughout the evaluation process. Then, I analyze all the data and look for patterns and discrepancies across various tests and measures.

When we see the data associated with the performance on a test, we must ask why, for instance, they achieved a low score. What other factors are at play? Is it anxiety or a visual-motor issue? What we observe throughout the evaluation can guide us to administer some tests that may not have been initially scheduled. Our knowledge, experiences, and careful observations help us to tease apart where a score came from and what it is telling us. We end up with a fuller picture of both the strengths and vulnerabilities of a child or adolescent.

What kind of international work were you doing previously?

After I completed my fellowship in neuropsychology at UCLA, my first job was with the Kennedy Krieger Institute at Johns Hopkins. Because so many families go there from other countries seeking answers, the organization assembled interdisciplinary teams to serve international patients. We conducted week-long intensive and comprehensive evaluations involving a neurologist, neuropsychologist, occupational therapist, speech-language pathologist, and social worker who could help them access resources in their home country. At the end of the week of intense evaluation, we came together as a team to make a diagnosis, if warranted, and provide recommendations for interventions. It was a challenging and intense program because we needed to develop our impressions immediately. And we often saw some of the most difficult and complex cases because the families had already exhausted all the resources available to them in their home countries before traveling overseas.

What do you find most rewarding about being a pediatric neuropsychologist?

I have been practicing neuropsychology for a long time. I chose to work in pediatric neuropsychology vs. adult because we can do so much more with children. We have a particularly good chance of making a bigger impact on their lives at such an early age.

What I find most rewarding is to have patients come back for a follow-up evaluation, and I can see how the child has progressed. Their parents often thank me for providing them with a diagnosis and helping them to access resources and attest how far their child has come. Working alongside families to change the trajectory of a child’s life is very powerful.

 You specialize in autism spectrum disorders (ASD). How do you make a diagnosis and differentiate ASD from its related challenges?

You rely on years of training, your knowledge and expertise, trust your clinical judgment, and factor in the wisdom of colleagues when needed. This is how you make meaningful conclusions and diagnoses that impact a child’s life.

What do you feel makes NESCA a unique environment and practice?

The beauty of a practice like NESCA is that we get a broad spectrum of clients who present with different challenges or diagnoses. We get to see a range of ages and draw clients from all over the New England region as well as internationally. That variety enriches your perspective and gives more insight into your clinical work.

I have been at NESCA for about a month, and they take collaboration to heart. My colleagues at NESCA are a giving group of professionals when it comes to sharing experiences and knowledge. The clinicians are humble, candid, open, and eager to help children, adolescents, and young adults. As a pediatric neuropsychologist, I also get to collaborate with transition specialists, educational consultants, OTs, SLPs, and more. The multidisciplinary approach, learning from other perspectives, is a refreshing addition to my work experience.

 

About the Author

Dr. Renee Cutiongco Folsom, Ph.D. has been working with families in the greater Boston area since 2015. Prior to this, she was on staff at Johns Hopkins University and trained at the University of California, Los Angeles (UCLA). She provides comprehensive neuropsychological evaluations of children, adolescents, and young adults who have learning, behavioral, and socio-emotional challenges. Her areas of expertise include Autism Spectrum Disorder and other conditions that usually co-occur with this diagnosis; Attention-Deficit/Hyperactivity Disorder; Dyslexia and other Specific Learning Disabilities; and Anxiety/Depression. She thinks that the best part of being a pediatric neuropsychologist is helping change the trajectory of children’s lives.

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

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

 

39

So, You Are Taking a Leave of Absence from College—Now What?

By | Nesca Notes 2023

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

Over three-quarters of college students (76%) reported moderate to severe psychological distress during the 2022-2023 school year (National College Health Assessment, American College Health Association, Spring 2023). College students across the country are continuing to struggle with depression, anxiety, self-harm, and suicidal thoughts this school year. My appointment calendar is often made up of meetings with college students or parents of college students beginning the process of taking a leave of absence and wondering what to do next. Here are some tips that I shared with many of these students and families.

Get Treatment

Many students need to participate in skill-based therapies (cognitive behavioral therapy, dialectical behavioral therapy, exposure and response prevention, acceptance and commitment therapy, etc.) in order to build up coping skills that may not have been developed in high school. Depending on the severity of current mental health issues, a student may need to participate in an intensive inpatient or outpatient treatment. Ultimately, many students need to find a supportive outpatient therapist—ideally someone who will be able to continue treating the student if they plan to make a future college attempt.

Psychopharmacological intervention (i.e., medication) can be important to consider. Sometimes students have not been taking medications as prescribed or they are taking medications exactly as prescribed but not gaining the intended benefits. Consulting with a prescriber can be an important treatment step for determining whether medication, or medication changes, are necessary.

Get Exercise

For any student, having a regular routine for exercise, sleep, and healthy diet has an impact. However, this is even more critical for students who are vulnerable to anxiety and/or depression. Exercise does not have to start big. Walking (with or without the dog), hiking, or just moving along to a YouTube fitness video for 10 minutes a day will make a difference. It’s critical to schedule the exercise in and often easiest if this is part of a morning or evening routine. For some students, working with a personal trainer or attending scheduled classes helps with accountability. Using a wearable exercise tracker like a Fitbit, Garmin Watch, or Apple Watch can also help with motivation and consistency.

Get a Job

Over the past 25 years, we have seen a notable decrease in the number of high school students who have participated in paid employment. Many students went off to college without taking time to connect college participation with future career interests. Using time off from school to explore work preferences and build transferrable skills (and a resume) can help students experience efficacy and improve mood. As a college student, no one is particularly excited when you show up to class, and the professor certainly doesn’t depend on you in order to get their job done. However, as an employee, students can experience tangible success through accomplishing work activities, receiving gratitude from coworkers and supervisors, and earning money. Work can also provide an important social experience. This is also an historic time to be looking for a first or early career position in the American workforce. Entry-level workers can make good wages. and there are plenty of part-time job openings across industries. Moreover, it’s difficult to get fired right now because good help is truly hard to find.

For students who are not ready to commit to paid work, and need time to recover and build energies up, volunteer jobs are also good opportunities. Some students will do better with brief drop-in volunteer activities while others my want to schedule more routine work hours.

Consider Taking Classes

When students take a leave of absence from college, the assumption is that the student will want to return to a college experience. But many students take a leave of absence and determine that they do not want to go back to college or that they do not want to go back to the same college. If a student wants to keep up academic skills, they can audit or take one or more college courses during the spring semester (depending on their college’s policies and whether they are planning to return). Community colleges, state colleges, and part-time or online college programs (like Harvard Extension School) are good options to explore for classes of interest as a non-degree seeking student. Starting back with a class that is high interest or a low degree of difficulty can be helpful for students who need to rebuild confidence. Additionally, when students are unsure if they are going to return to college or uncertain of a potential future major, it can be good to try classes that are likely to transfer and generally meet basic liberal arts requirements.

Get a Coach

Some students with mental health issues have other underlying challenges that contributed to their struggles in college. There could be a learning disability that wasn’t appropriately being addressed with accommodations, executive function challenges that impacted keeping up with pace, or volume of academics, social challenges that were exacerbated by the highly social dorm environment, or other issues. It is important to consider whether there are skill deficits that may have contributed to a student experiencing anxiety or depression. Some students will benefit from life skills, executive function, or social coaching in order to build up areas that are weaker before heading back to college (or may want to continue with that coaching when they head back).

Other students may want to take time to work with a career or transition coach to do some self-exploration. Taking a step back to participate in self-assessment related to one’s preferences and interests and to determine how those align with potential college major and future career interests can be helpful. I have worked with several students on leave to go through a career planning process. For some, they discover that they chose exactly the right college and major, and that can increase motivation when they get back to school, with proper supports in place. For others, this process sets a student on a completely new path.

Let us know, in our online Intake Form, if your student needs support during their time off from school and/or coaching to assist during their time off or when they return to college.

 

About the Author
Kelley Challen, Ed.M., CAS, is NESCA’s Director of Transition Services, overseeing planning, consultation, evaluation, coaching, case management, training and program development services. Ms. Challen also provides expert witness testimony in legal proceedings related to special education. She is also the Assistant Director of NESCA, working under Dr. Ann Helmus to support day-to-day operations of the practice. Ms. Challen 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 additionally 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. Ms. Challen is 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. She is also a proud mother of two energetic boys, ages six and three. 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.

 

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, call 617-658-9800 or complete our online Intake Form.

8

Summer Reading Ideas

By | NESCA Notes 2022

By: Alissa Talamo, PhD
Pediatric Neuropsychologist, NESCA

Research demonstrates that children lose reading skills over the summer break. A 2020 study found that students in 3rd to 5th grades lost, on average, about 20 percent of their school-year gains in reading during the summer. So, how do we encourage a reluctant reader to read during the summer? There are several fun opportunities that allow your child to read a book of their choice and earn prizes at the same time!

For example:

www.scholastic.com/site/summer-reading.html Scholastic Books offers a program that encourages children to “read books and stories; attend author events; interact with their favorite characters; play book-based games and activities; join dance parties; and more!” Children can read any book of their choice. They can also download and print a report of their reading progress. Additionally, by keeping Reading Streaks™, your child will help unlock a donation of 100,000 books from Scholastic to Save the Children, providing books to children in rural America with limited or no access to books.

Bookworm Wednesdays | Showcase Cinemas According to their website, Bookworm Wednesdays is “A fun and rewarding summer reading program developed to encourage young children to read during the summer months.” Bookworm Wednesdays allows children to earn free movie admission to a select children’s film when they present a book report at a participating Cinema de Lux, Showcase, or Multiplex Cinemas box office. There are several local participating sites, including Patriot Place and Legacy Place. (Parents, as well as children under the age of 6, receive free admission and do not need to submit a book report).

www.barnesandnobleinc.com This is an opportunity for your child to earn free books! Your child can read any 8 books and complete the reading journal available at the Barnes & Noble website. Then your child brings the completed reading journal to any participating Barnes & Noble bookstore and chooses their free book from the books listed on the Reading Journal list (see the website for the list of titles available to choose from this summer). Free reward books must be collected from a local Barnes & Noble store during July and August.

Finally, check out your local library for programs! Most local libraries have reading incentive programs that children can participate in all summer long.

Other ideas include…

  • Have your child read a book that has been made into a movie (If the book is above their reading level, read the book to them or allow them to listen to the book as an audio recording). Once the child has completed their reading, enjoy a family movie night with popcorn and more.
  • Have your child read about a specific topic or place and then plan a field trip. For example, an older student could read “Little Women” and then visit Louisa May Alcott’s house in Concord, MA, or watch the 2019 version of the movie and then visit Lyman Estate in Waltham where some of the filming took place!
  • Allow your child to pick their own books. Allow them to choose from subjects of interest to them (parent-approved, of course), as they are more likely to read something they picked! Also, allow them to choose books from different book types (e.g., paperback, graphic novel, audiobooks).
  • If you are going on a family vacation, encourage your child to read books about the area (fact or fiction) and plan to visit some of the places mentioned in the book. Day trips are also encouraged. Your child could read a book about animals and then visit a local zoo or aquarium.

If you are unsure of which books are at your child’s reading level, many libraries break down books by grade level. Ultimately, summer reading should not be so easy that it is boring, but it also should not be too difficult, as that can cause frustration. Allowing children to pick out books at their independent reading level is best. Research has found that children read more and learn best when they are allowed to select the books they read.

Happy Summer Reading!

 

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.

6

An Occupational Therapist’s Perspective – How AI Can Support Teens and Young Adults with Life Skills

By | Nesca Notes 2023

By: Lyndsay Wood, OTD, OTR/L
NESCA Transition Specialist & Occupational Therapist

Recently there has been a lot of talk in the media about artificial intelligence (AI) technology and the impact it will have on the world. With the recent development of ChatGPT and other AI technologies, the way we work, learn, and live may see some significant changes. While change can be difficult – and there are often many considerations to make before adopting a new technology system – ChatGPT is a useful tool that can support different aspects of life when used properly. Specifically, it may be a very helpful tool to support life- and transition-related skills for teens and young adults. Here are four ways that ChatGPT can support independence with real-life skills.

1.Meal Planning and Grocery Lists: Often meal planning can be daunting, and it heavily relies on strong executive functioning skills. To make this process easier, AI technology can be utilized. Simply tell ChatGPT that you would like a meal plan for the week (or any amount of time you desire), and it will create a specific meal plan and provide the grocery list if requested. It will also break down the nutritional value if requested. You can input dietary restrictions or any special considerations, and ChatGPT will create a plan in seconds. Below is an example of the prompt I provided and the response I received.

Prompt I input: Create a one-day vegan meal plan with a grocery list. Make sure it is high in protein.

Response from ChatGPT:

Breakfast:

  • Tofu Scramble with Spinach and Mushrooms
    1. 1 block of firm tofu
    2. 1 cup of spinach
    3. 1 cup of sliced mushrooms
    4. 1 tbsp of olive oil
    5. 1/4 tsp of turmeric
    6. Salt and pepper to taste
    7. 2 slices of whole grain toast

 Snack:

  • Apple and Almond Butter
    1. 1 apple
    2. 2 tbsp of almond butter

Lunch:

  • Quinoa and Black Bean Salad
    1. 1 cup of cooked quinoa
    2. 1/2 cup of black beans
    3. 1/2 cup of diced bell peppers
    4. 1/2 cup of diced tomatoes
    5. 1/4 cup of chopped cilantro
    6. 1/4 cup of diced red onion
    7. 1 tbsp of olive oil
    8. 1 tbsp of lime juice
    9. Salt and pepper to taste

 Snack:

  • Roasted Chickpeas
    1. 1 can of chickpeas
    2. 1 tbsp of olive oil
    3. 1 tsp of paprika
    4. 1/2 tsp of cumin
    5. Salt and pepper to taste

 Dinner:

  • Lentil and Vegetable Stir Fry
    1. 1 cup of cooked lentils
    2. 1 cup of mixed vegetables (broccoli, carrots, bell peppers, etc.)
    3. 1 tbsp of olive oil
    4. 1 tbsp of soy sauce
    5. 1/2 tsp of garlic powder
    6. Salt and pepper to taste
    7. 1 cup of brown rice

 Grocery List:

  • Tofu
  • Spinach
  • Mushrooms
  • Whole grain bread
  • Apple
  • Almond Butter
  • Quinoa
  • Black beans
  • Bell peppers
  • Tomatoes
  • Cilantro
  • Red onion
  • Olive oil
  • Lime juice
  • Chickpeas
  • Paprika
  • Cumin
  • Lentils
  • Mixed vegetables
  • Soy sauce
  • Garlic powder
  • Brown rice

This meal plan provides approximately 90 grams of protein, which is well above the recommended daily intake for most people.

 

2. Role Playing Social Scenarios: ChatGPT can create role playing scenarios to help teens and young adults navigate challenging or new social situations. This can help teens figure out what wording they may want to use and what someone may say in response to prepare for an interaction. Below is an example of a role play created by ChatGPT to practice social introductions.

Prompt I input: I am trying to make friends. What is a good way to introduce myself to a classmate? What might she say back? Can you create a role play?

Response from ChatGPT:

Role Play:

You: Hi there! My name is Jane. What’s your name?

Classmate: Hi, Jane! I’m Sarah.

You: Nice to meet you, Sarah! How’s your day going so far?

Classmate: It’s going pretty well, thanks for asking. How about you?

You: It’s going pretty good too. I’m excited to be in this class. What do you think about it so far?

Classmate: Yeah, me too! I’m really interested in the subject matter. What about you?

You: Same here! I think it’s going to be really interesting. Hey, do you want to grab lunch together sometime this week and chat more about the class?

Classmate: That sounds great! I would love to. How about Thursday?

You: Thursday works for me. Let’s plan on meeting in the cafeteria at noon?

Classmate: Perfect. I’ll see you then!

You: Great! Looking forward to it. See you on Thursday, Sarah.

Classmate: See you then, Jane!

 

3. Writing Professional Emails: Many teens and young adults struggle with composing professional emails. Determining what to say and making it professional can be very difficult for folks who struggle with social pragmatics, written language, anxiety, and executive functioning. When provided with a prompt, ChatGPT can help support this skill. Below is a sample email composed by ChatGPT to ask a professor for an extension on an assignment because the student has been sick.

Prompt I input: Write a professional email to my professor asking for extended time on a project because I am sick.

Response from ChatGPT:

Subject: Request for an Extension on Project Submission

Dear Professor [Name],

I am writing to request an extension on the project submission deadline, which is due on [date]. Unfortunately, I have been unwell for the past few days, and I have been unable to work on the project as planned. I am currently under medication and resting to recover fully.

I am aware that the project is a crucial part of our coursework, and I understand the importance of meeting the deadline. However, given my current health condition, I am finding it challenging to complete the project on time. I am hoping that you can grant me an extension of [number of days] days to submit the project.

I assure you that I will utilize the extended time to work diligently on the project and submit it as soon as possible. I am willing to accept any penalty that comes with the late submission, and I am committed to ensuring that the quality of my work is not compromised.

Thank you for considering my request. I appreciate your understanding and support during this challenging time. Please let me know if you require any further information or clarification.

Sincerely,

[Your Name]

 

4. Job Applications: ChatGPT can provide a significant amount of support around job applications. ChatGPT can create a resume template, provide cover letter examples, outline a cover letter, and create sample interview questions. Below is a sample outline created by ChatGPT for a cover letter to Starbucks.

Prompt I input: Create an outline for a cover letter to Starbucks

Response from ChatGPT:

Introduction

  • Briefly introduce yourself and express your interest in working for Starbucks

Relevant experience and skills

  • Highlight any previous experience or skills that would make you a good fit for the company
  • Mention any experience working in customer service or the food and beverage industry
  • Emphasize your ability to work in a fast-paced environment and handle multiple tasks at once

Passion for coffee and the Starbucks brand

  • Discuss your love for coffee and how it has influenced your desire to work for Starbucks
  • Mention any knowledge you have about the company’s values and mission

Availability and willingness to learn

  • State your availability to work and any flexibility in your schedule
  • Express your eagerness to learn and grow within the company

Closing

  • Thank the reader for considering your application and express your excitement for the opportunity to join the Starbucks team.

These four examples are just a few of the many ways that AI can help support our teens and young adults with real-life skills. As with anything that is computer-generated, it is important to teach our teens and young adults to review the output and modify information for their needs or to match their own voice. It is exciting to see how these methods will evolve and be utilized in the classroom to supplement and support learning and independence in the future.

 

Note: it is important to make sure to check school/company policies around AI prior to using the technology and to remember that AI is not human and therefore may not afford the “human touch” that helps with some activities.

 

About Lyndsay Wood, OTD, OTR/L

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

 

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

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

16

Self-efficacy: An Important Characteristic to Develop in Children

By | Nesca Notes 2023

By Dot Lucci, M.Ed., CAGS
Director of Consultation and Psychoeducational Counseling Services, NESCA

We often talk a lot about wanting our children to have good self-esteem. There’s nothing wrong with good self-esteem; it means that a child has a positive view of themselves and their worth. However, self-esteem is not enough. Life has its challenges, failure being one of them. How are we helping children to pick themselves up and try again? If our children are lagging in this ability, we need to help them develop realistic self-efficacy.

Self-efficacy and self-esteem are related but are also qualitatively different. Self-efficacy is related to how you feel about your ability to succeed in different contexts. It is more specific and context-driven versus self-esteem. Is your child capable of preserving at performing a difficult task? Do they stay engaged and try again, or do they give up? Self-esteem is considered a global belief about oneself, whereas, according to psychologist Albert Bandura, self-efficacy is “the belief in one’s capabilities to organize and execute the courses of action required to manage prospective situations.”

A child with high self-efficacy believes their challenges are obstacles to overcome. Failures don’t immobilize them. Their inner voice says, “I’ve got this!” They may demonstrate good self-awareness by knowing their strengths and challenges, thus setting manageable goals and achieving success because the goals are indeed attainable. Their motivation to try difficult tasks is buoyed by a positive thinking style and an inner belief system that recognizes failure as a part of life. So, when they fail at something, their self-esteem remains intact. They don’t “beat themselves up” when they make a mistake. They recognize it as a part of learning. As they say, “they get back in the saddle.” Children with good self-efficacy have better self-regulation, utilize a growth mindset, and have a stronger sense of agency and mastery. As Henry Ford said, “Whether you think you can, or you think you can’t–you’re right.”

Children with poor self-efficacy often shy away from work that they failed at or with tasks that they perceive as difficult. They tend to believe that these tasks are beyond their capabilities, so they shy away from even trying to do them. Children with low self-efficacy often berate themselves when they make a mistake, lose confidence in themselves, and their self-esteem suffers.

Helping children develop self-efficacy is important to their overall social-emotional functioning and well-being. The earlier we start helping to develop self-efficacy in our children, the better off they will be at improving their self-efficacy independently throughout their lives. Bandura identified four influencers or sources that impact self-efficacy: performance experience, vicarious experience, social persuasion, and physical and emotional states. Using these as our guideposts when teaching our children enhances their development of self-efficacy.

Performance Experience refers to when we perform a task successfully, it strengthens our sense of self-efficacy. This can also be called Mastery Experiences. We feel good about ourselves, our skills, and our knowledge; however, the converse is true as well. Failing to perform a task well will further weaken self-efficacy, particularly if it was not strong to begin with. Thus, it is important to emphasize and normalize the concept that failure is a part of the learning process.

When we watch others who are like us succeed by persevering at and completing a difficult task, it can raise the observers’ beliefs that they, too, can achieve it. This is Vicarious Experience or Social Modeling. By watching another person succeed through dedication, a person can be inspired to achieve the goals they set for themselves.

Another way to improve self-efficacy is through Social Persuasion. It is just as it sounds – someone you trust as a credible source giving verbal encouragement about your ability to perform a task can have a positive impact on one’s self-efficacy, becoming a self-fulfilling prophecy.

The last influencer, Our Own Personal Physical Sensations, Moods, Emotional Reactions, and Stress Level, etc., can dramatically…and positively or negatively impact how a person feels about their skills and abilities to complete a task. Bandura, highlighted, “it is not the sheer intensity of the emotional and physical reactions that is important but how they are perceived and interpreted by the person.” If we can acknowledge the stress and minimize it when we are confronted with a challenging task, we can improve self-efficacy. These are all important ways to help facilitate a child’s development of self-efficacy.

Facilitating the development of self-efficacy in our children can be done through a variety of means, keeping Bandura’s four influencers in mind. Here are some approaches to consider:

  • Keep in mind Bandura’s four self-efficacy influencer types as your guideposts.
  • Model self-efficacy and point it out to your children. Share your struggles/set-backs and how you managed to persevere. Talk about how you are willing to work towards a goal even though you failed multiple times along the way. Typically, parents do it without even knowing it.
  • Help children develop realistic self-efficacy by praising them honestly and concretely. Praise their effort, not their ability. Help them recognize failure is a part of life and learning.
  • Preview new learning by saying something like, “Remember you’re learning ___. You might make some mistakes. It’s okay. Mistakes are a part of learning.”
  • Use failures to help build realistic expectations and self-confidence by pointing out growth from previous attempts. Help children learn from their set-backs.
  • Empathize with their emotions related to their failures, struggles, etc.
  • Name their strengths and challenges, and use them as jumping off points related to their effort, not ability.
  • Help children set “realistic” short-term goals and help them stay on track. Help children recognize that their achievements are related to internal strengths, skills, and thoughts – not on external factors (i.e., I learned that hook shot because I practiced, watched and analyzed videos, and listened to my coach, etc.).
  • Create opportunities that are within “their zone of proximal development” (i.e., just right learning level – not too hard or too easy). To help build self-efficacy, a child needs a difficulty level to hold their interest, feel challenged, and experience some amount of struggle while ultimately achieving success.

Self-efficacy is worth paying attention to as it is truly one of the best gifts we can instill in our children. As Mahatma Gandhi said, “If I have the belief that I can do it, I shall surely acquire the capacity to do it even if I may not have it at the beginning.”

References

Bandura, A. 1999. Self-efficacy in Changing Societies. Cambridge Univ. Press, UK.

Self-Efficacy: Helping Children Believe They Can Succeed https://www.forsyth.k12.ga.us/cms/lib3/ga01000373/centricity/domain/31/self-efficacy_helping_children_believe_they_can_suceed.pdf

If You Think You Can’t… Think Again: The Sway of Self-Efficacy https://www.psychologytoday.com/intl/blog/flourish/201002/if-you-think-you-can-t-think-again-the-sway-self-efficacy

 

About the Author

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

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

 

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

 

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

 

10

Shouldn’t We All Get Neuropsychological Evaluations, Then?

By | Nesca Notes 2023

By: Yvonne Asher, Ph.D.
NESCA Pediatric Neuropsychologist

One frequent question I have been asked by parents following a neuropsychological evaluation is, “Wouldn’t this process be helpful for everyone?” This tends to come up around the issue of disclosing results of an evaluation to children and teenagers and helping them better understand “how their brain works.” Many families with whom I have had the privilege of working come back months or years later with siblings of an initial client, noting that the process was so valuable the first time, they are hoping for a similar experience for their other child or children.

So, should we all get neuropsychological evaluations? Largely, I think this question is motivated by parents who are eager to help their children understand their own strengths and weaknesses. This is a wonderful goal, as self-understanding is one of the most valuable and lifelong gifts we can give our children.

In my experience, many people come to this kind of self-understanding naturally, over time, through experiences in adolescence and young adulthood. In particular, experiences that involve more independence in living and learning promote this kind of understanding. During childhood, we may learn our relative skill among family members (“I’m good at soccer, and my sibling is good at piano”), but these relative differences may not hold once we leave our family of origin. Many people venture out into the world and find that, compared to their peers, they are actually quite skilled at getting groups of friends together, doing everyday math, putting their thoughts down in writing, or staying organized. These real-world strengths often reflect the strengths that could be found through formal evaluation. As we gain self-understanding, we may be prompted to enter certain professions, take on particular hobbies, or pursue friends and partners with specific traits.

A neuropsychological evaluation can “speed up” the process of self-understanding, giving some young people a head start on the identity formation process that naturally occurs during adolescence. For some, this head start is vital – their brains are structured in ways that present clear, observable differences between them and their peers. This may be the case with diagnoses like autism spectrum disorder, a learning disability, or ADHD. For these individuals, the feedback from a neuropsychological evaluation can (under the best of circumstances) stave off feelings of inadequacy, negative self-esteem, and shame, helping a young person to recognize the deeply important strengths that are present alongside their more observable challenges. In these cases, a neuropsychological evaluation is not only for self-understanding, but also for self-compassion. Our goal as neuropsychologists in these cases is not just to help the child or teen understand themselves, but also to be gentle and kind with how they view their difficulties. Our hope is that, when these individuals venture out of their families and into the broader world, they are able to show resiliency in the face of the obstacles that will almost certainly be present.

 

About the Author

Dr. Yvonne M. Asher enjoys working with a wide range of children and teens, including those with autism spectrum disorder, developmental delays, learning disabilities, attention difficulties and executive functioning challenges. She often works with children whose complex profiles are not easily captured by a single label or diagnosis. She particularly enjoys working with young children and helping parents through their “first touch” with mental health care or developmental concerns.

Dr. Asher’s approach to assessment is gentle and supportive, and recognizes the importance of building rapport and trust. When working with young children, Dr. Asher incorporates play and “games” that allow children to complete standardized assessments in a fun and engaging environment.

Dr. Asher has extensive experience working in public, charter and religious schools, both as a classroom teacher and psychologist. She holds a master’s degree in education and continues to love working with educators. As a psychologist working in public schools, she gained invaluable experience with the IEP process from start to finish. She incorporates both her educational and psychological training when formulating recommendations to school teams.

Dr. Asher attended Swarthmore College and the Jewish Theological Seminary. She completed her doctoral degree at Suffolk University, where her dissertation looked at the impact of starting middle school on children’s social and emotional wellbeing. After graduating, she completed an intensive fellowship at the MGH Lurie Center for Autism, where she worked with a wide range of children, adolescents and young adults with autism and related disorders.

 

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

 

To book an appointment with Dr. Yvonne Asher or another NESCA clinician, please complete our Intake Form today. For more information about NESCA, please email info@nesca-newton.com or call 617-658-9800.

 

10

Signs and Symptoms of Common Eating Disorders

By | Nesca Notes 2023

By Miranda Milana, Psy.D.
Pediatric Neuropsychologist

In today’s world with the toxicity and normalization of diet culture, it can be difficult to identify possible signs and symptoms of a more serious problem such as an eating disorder. At what point does counting calories cross over into anorexia? When does binge eating meet criteria for bulimia? Listed below are the criteria for several eating disorders, possible warning signs, as well as information on how to seek help if you believe your child needs further help/treatment.

Anorexia nervosa is an eating disorder characterized by the restriction of food intake and is characterized by two subtypes: restrictive and binge-purging.

For both presentations, criteria for anorexia nervosa include:

  1. Restriction of food intake leading to a significantly low body weight for age, sex, and developmental trajectory
  2. Intense fear of gaining weight that interferes with one’s ability to gain weight
  3. Feeling disturbed by one’s weight or shape, reduced self-worth second to weight/body shape, or a lack of recognition of the seriousness of their low bodyweight

Criteria for the restricting type include not having recurrent binge eating or purging within the last 3 months

Criteria for the binge eating/purging type include recurrent episodes of binge eating or purging within the last 3 months

Bulimia nervosa is an eating disorder characterized by recurrent episodes of binge eating that include the following:

  1. Eating a “definitively” larger amount of food in a 2-hour period than what most other individuals would eat in similar circumstances
  2. Feeling as though one cannot stop eating or control how much they are eating
  3. Recurrent and inappropriate behaviors aimed at preventing weight gain (e.g., self-induced vomiting, misusing laxatives, fasting, excessive exercise) that occur, on average, at least once a week for 3 months
  4. Self-evaluation being dependent on body shape/weight
  5. Symptoms not occurring exclusively during episodes of anorexia nervosa

Bulimia nervosa is also characterized by two subtypes: purging type and nonpurging type.

To meet criteria for the purging type, one must have regularly engaged in self-induced vomiting, the misuse of laxatives, diuretics, or enemas.

To meet criteria for the nonpurging type, one must have used inappropriate behaviors, such as fasting or excessive exercise without self-induced vomiting, the misuse of laxatives, diuretics, or enemas.

Binge eating disorder and avoidant restrictive food intake disorder (ARFID) are also eating disorders recognized in the Diagnostic and Statistical Manual of Mental Health Disorders (DSM-5).

Binge eating disorder is characterized by:

  1. Recurrent episodes of binge eating (defined by eating an amount of food in a 2-hour period larger than what most people would eat in a similar period of time under similar circumstances as well as feeling a lack of control during the binge eating episode)
  2. Three or more of the following: eating more rapidly than normal, eating until feeling uncomfortably full, eating large amounts of food when not hungry, eating alone due to embarrassment over the amount of food being consumed, feeling disgusted, depressed, or guilty after overeating.
  3. Distress regarding binge eating
  4. Binge eating occurring on average at least 1 day a week for 3 months
  5. Binge eating not associated with the regular use of inappropriate compensatory behaviors, such as purging, fasting, and/or excessive exercise, and does not occur exclusively during the course of anorexia nervosa or bulimia nervosa

Avoidant restrictive food intake disorder (ARFID) is characterized by:

  1. A lack of interest in eating or food, avoidance of food based on sensory characteristics, and/or concern about consequences of eating that lead to one or more of the following:
    1. Significant weight loss or failure to achieve expected weight gain
    2. Dependence on enteral feeding or oral nutritional supplements
    3. Interference with psychosocial functioning
  2. The eating challenges should not be attributable to a medical condition or better explained by another mental health diagnosis. If there is another mental health diagnosis, the severity of the eating disturbance must exceed what is routinely associated with the mental health condition
  3. The eating challenges should not be better explained by a lack of available food or associated with cultural practices
  4. The eating challenges should not occur exclusively during the course of anorexia nervosa or bulimia nervosa

What are warning signs of an eating disorder that I should be looking out for?

  • A preoccupation with weight loss, dieting, exercise, and/or controlling food consumption
  • Refusing to eat certain foods, such as carbohydrates or fats
  • Not being comfortable eating around others, skipping meals, or eating smaller portions
  • Withdrawing from friend groups and/or typical activities
  • Noticeable fluctuations in weight
  • Stomach complaints/digestive concerns
  • Menstrual irregularities
  • Difficulties concentrating
  • Sleep challenges
  • An increase in dental problems

If you suspect your child has an eating disorder, begin by talking to a medical or mental health professional. You can also contact the National Eating Disorders Association (NEDA) Helpline at 1-800-931-2237 or by texting NEDA to 741-741. The Multi-Service Eating Disorders Association (MEDA) is another source of information with support groups and resources. More information can be found at https://www.medainc.org/.

 

References:

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596

Warning signs and symptoms. National Eating Disorders Association. (2021, July 14) https://www.nationaleatingdisorders.org/warning-signs-and-symptoms

 

About the Author

Dr. Miranda Milana provides comprehensive evaluation services for children and adolescents with a wide range of concerns, including 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.​

 

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

 

To book an appointment with Dr. Miranda Milana or another expert NESCA neuropsychologist, please complete our Intake Form today. For more information about NESCA, please email info@nesca-newton.com or call 617-658-9800.

 

4

Explaining Neuropsychological Testing to Your Child

By | Nesca Notes 2023

By: Lauren Halladay, Ph.D.
Pediatric Neuropsychologist, NESCA

Neuropsychological testing can be confusing for adults to understand and explain, let alone children. Some of the most common questions that parents ask our neuropsychologists prior to their in-person appointments include:

  • “How do I explain the evaluation to my child?”
  • “How can I best prepare my child for what to expect when they are in the office?”

The answers vary depending on several factors. To name a few, your child’s age, level of awareness of areas they are struggling, and your child’s language abilities guide decision-making about the best way to discuss their upcoming evaluation experience. It is important to talk with your neuropsychologist to plan the most appropriate approach for your child. However, below is some standard guidance.

When describing the evaluation itself, I advise parents to use language that reduces pressure on the situation. In other words, it is best to frame the evaluation as a low stakes experience. For example, using words like “testing” or “evaluation” can create unnecessary worry. I often recommend describing the evaluation experience as a variety of “activities,” some of which may include looking at pictures, playing with toys, drawing, and answering questions. Other activities may seem similar to what your child is asked to do in school, such as reading stories, completing math problems, and writing.

Oftentimes, when children hear they are going to the “doctor” they may worry about medical exams. For this reason, it can be helpful to reassure your child that they are not going to be getting poked and prodded; and definitely will not be getting any shots!

To explain the reasons for doing the evaluation, some key phrases to use with your child include:

  • We want to understand how you learn, because everyone learns differently. It’s great that everyone learns differently because it keeps life interesting!
  • Everyone has things they are really good at and other things that are more challenging for them. This will help us understand what comes easy to you and what might be a little trickier, so that we can help you with things like schoolwork, completing activities around the house, and play.
  • We can also share this information with your teacher so they can better understand your learning style and support you at school.
  • Some activities might seem easy and others might be hard, but your job is just to try your best!

For more helpful tips, please see Dr. Gibbons’ previous blog posts, “How Do I Prepare My Child for a Neuropsychological Evaluation?” and “Preparing our Kids to Reenter the Community.”

 

About Lauren Halladay, Ph.D.

Dr. Halladay conducts comprehensive evaluations of toddlers, preschoolers, and school-aged children with a wide range of developmental, behavioral, and emotional concerns. She particularly enjoys working with individuals with Autism Spectrum Disorder, Intellectual and Developmental Disabilities, and complex medical conditions. She has experience working in schools, as well as outpatient and inpatient hospital settings. She is passionate about optimizing outcomes for children with neurodevelopmental disabilities by providing evidence-based, family-oriented care.

 

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

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton and Plainville, Massachusetts, Londonderry, New Hampshire, and Burlington, Vermont, 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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