Real-life Skills Coaching Alert!

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Neuropsychological Evaluation

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15

Parenting is a Hard Job – Remember You are Good Enough!

By | NESCA Notes 2022

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

Much has been published about parenting and parenting styles, whether in YouTube clips, books, podcasts, scholarly articles, newspaper articles, and so much more. But basically, if you are a parent, you are just doing your job – you are parenting, trying to guide your children, teens, and young adults on their own paths so they grow up to be “good humans and lead happy, successful lives.”

My guess is you probably haven’t given your parenting style too much thought. You just go about whatever the day brings you with whatever you’ve got in your tank that day. You’ve probably heard the terms Helicopter Parents, Tiger Moms, Free-range Parenting, etc., to describe different parenting styles. Usually, our parenting styles emerge from our own histories, role models, experiences, and personalities. You may be parenting how you were parented because it worked for you or because you disliked the way you were parented so you moved to the complete opposite way of parenting.

Remember the book, “Battle Hymn of The Tiger Mother,” by Amy Chua from 2011? She wrote this book as a memoir – not as a parenting guide – but what a controversy it stirred regarding parenting styles! Alan Paul, a journalist for The Wall Street Journal then wrote, “Tiger Mom…Meet Panda Dad,” as a commentary against the Tiger Mom mentality and to bring dads into the parenting discussion. During this time period, there was much written about parenting styles, often characterized into four styles: Authoritative, Authoritarian/Disciplinarian, Permissive/Indulgent, and Uninvolved/Neglectful. As you can imagine, each style has its driving principles. In case you are interested in what the research says about the four parenting styles, the Authoritative parenting style wins out over the others in helping children develop into well-functioning adults.

No matter what style you are, you are giving it your best shot. Each of the styles has much written about them and their impact on child development – some good some not so good. Parents may change their style(s) depending upon a variety of factors and adopt new ways. Try to be aware of your style and its impact on your kids – this realization may happen as you go. That’s okay. You are learning this job as you go, and we all know there is no manual. You are just doing it, living each and every day with what it brings to you. Most parents do not think about what parenting style they are going to use in the moment. Sometimes you may “catch yourself,“ see your child’s reaction, and adjust your style. Perhaps you are the “softie” most of the time, but then turn on the “tough love” style when needed.

As a parent consultant, I often hear, “I must be the worst parent you’ve ever seen. You must think I’m a fool. Do all kids do this? Am I the only one who struggles getting their kids to follow directions?”…and so much more. Sure, I give them specific suggestions for parenting their child who has ADHD or is autistic; however, I match my recommendations to their parenting styles and personalities.

As a consultant, I often find myself saying these mantras in parent sessions:

You are good enough.
Show and tell your kids you love them.
You are giving it your best shot in this moment.
Be kind and gentle with yourself and your kids.
Have compassion and empathy for yourself and your kids.
Stay calm in the eye of the storm. ___ Happens!
You are human, and humans make mistakes – own them.
Don’t expect perfection. It is overrated. Cut yourself some slack.
Point out the positives. Catch ‘em being good!
Tell them what to do not what not to do.
Develop honest, authentic relationships with your kids.
Lead with your heart.

And as the saying goes….

If you are interested in learning more about NESCA’s Consultation Services, please complete our online Intake Form.

References

Alan Paul http://alanpaul.net/panda-dad/

4 Research-Backed Parenting Styles and How they affect your kids by Caroline Bologna https://www.huffpost.com/entry/four-parenting-styles-affect-kids_l_6270493fe4b0bc48f57e705f

4 Types of Parenting Styles and their effects on the child https://www.parentingforbrain.com/4-baumrind-parenting-styles/

Here’s what makes ‘authoritative parents’ different from the rest—and why psychologists say it’s the best parenting style by Francyne Zelster
https://www.cnbc.com/2021/10/05/child-psychologist-explains-why-authoritative-parenting-is-the-best-style-for-raising-smart-confident-kids.html

 

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 neuropsychologists, complete NESCA’s online intake form. Indicate whether you are seeking an “evaluation” or “consultation” and your preferred clinician/consultant in the referral line.

 

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.

 

39

Making the Most of Summer – Setting a Few Life Skill Goals (for College and Life in General after High School)

By | NESCA Notes 2022

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

Summer in the United States is in full swing. If you have teenagers, they may be working, completing driver’s education, visiting colleges, travelling, or even getting started with their college application this summer. No matter what your teenager is doing, this is great time to sit down and set a few “simple” life skill goals for the summer.

In 2020, I wrote a two-part blog series focused on eight life skills that are critical to build before college:

  1. Getting up “on time” each morning
  2. Washing, drying, and putting away laundry—including sheets
  3. Basic kitchen skills
  4. Using basic tools (e.g., screwdriver, hammer, measuring tape, etc.)
  5. Medication management
  6. Money management
  7. Routine exercise
  8. Using a calendar for scheduling

For teenagers in high school or heading off to college, these are great skills to begin tackling over the summer months. For example, getting up by a certain time is something that can be especially important to work on when consequences are low. For instance, it is hard to let a teen sleep in when they are going to miss an AP exam, but it can be easier to let them practice using an alarm (and possibly oversleeping) when they are going to a movie with a friend or attending a camp. Summer is a great time for teens to be able to experience natural consequences as they practice taking on new risks and responsibilities associated with some of the life skills above.

A challenge when working with, or parenting, teenagers who have a lot of skills to develop is figuring out where to start or how to gain “buy-in.” One of the ways that I like to work with students to set life skill goals is to have the student take a basic life skills inventory, such as the Casey Life Skills Toolkit, Life Skills Inventory, or Adolescent Autonomy Checklist. After a student rates their own skill levels, I ask them to review skills that they cannot already do and identify how important those skills are on a scale of 1 to 10. Then, we go through the list again, and I ask which skills they would like to learn in the next 2 months, 6 months, and year. Once the teenager has identified the importance of a skill and the desire to work on the skill in the near future, it is much easier to set short-term goals. We can work out a skill-building plan for the summer. including how much time to dedicate on a daily or weekly basis. We can also talk about the types of barriers or challenges that might get in the way of the teenager practicing these skills. Additionally, we can set expectations for how often the teen is going to report back to me on the skill so that there is built-in accountability, and the teen knows to expect the check-ins rather than feeling like someone is checking up on them.

Every teenager is different. If you are a parent wanting to help your child make the most of summer, you may find that you can go through the same process that I do to help your child set a few short-term goals. Other teenagers will be able to work on goals themselves—once they have gone through the exercise of setting them. And others, may benefit from having a coach who can build a relationship, support development of executive function and coping skills, and partner with the teen in making the most of summer. If you think your child would benefit from some coaching or an “expert” to work with them, we have a great team of professionals here at NESCA who are ready to help.

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

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.

6

Why Kids Need to Outdoor Free Play

By | NESCA Notes 2020

Edit date and time By: Angela Currie, Ph.D.
Pediatric Neuropsychologist, NESCA
Director of Training and New Hampshire Operations

One of the best ways to make the most of your summer is to get outside and engage in lots of outdoor play. We live in a society where we tend to over-schedule ourselves and our children. Particularly during the school year, this makes it very difficult for children to get the amount of free play that they require. With this, I’m going to tell you five great reasons why you should throw away your schedule, put down the tablet, and get outside.

The first reason is probably the most obvious. Outdoor play provides great benefits to physical development. It improves motor coordination, strength, and balance, and it puts kids in an overall healthier position.

The next reason to play outside is that there are benefits for internal regulation. Not only does it make kids sleep better at night, but there is research to show that it aids attentional control and stress reduction. Being outdoors also provides kids with different sensory experiences – such as feeling the texture of sand and mud, or feeling the wind blow on your face – which will help to build children’s sensory tolerance.

The next reason to get outside is to improve cognitive development. Being outdoors provides a lot of opportunities to make observations, draw conclusions about things, see cause and effect, and be imaginative.

Next, playing outside aids emotional development. When we are over-scheduled, children do not have the opportunity to feel confident in their ability to step outside of their comfort zone or take risks. Experimenting and taking risks during outdoor play can help children understand that they have some control over what they can do within their environment, as well as begin to recognize boundaries.

Finally, the last reason to get outside is that it really bolsters social development. When there is no structure or there are no rules to follow, kids have to learn how to initiate their interactions, engage in conversation with each other, communicate, problem solve, and find ways to along, even when others have different ideas.

With all of the above benefits, outdoor free play is one of the best things you can give to your child. So as the weather is getting nicer and summer is fast approaching, if you are looking for something to do, sometimes it is best to just put down your schedule, get outside, and get dirty.

 

About the Author

Dr. Angela Currie is a pediatric neuropsychologist at NESCA. She conducts neuropsychological and psychological evaluations out of our Londonderry, NH office. She specializes in the evaluation of anxious children and teens, working to tease apart the various factors lending to their stress, such as underlying learning, attentional, or emotional challenges. 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.

 

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.

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Londonderry, NH, Plainville, MA, and Newton, MA serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call (603) 818-8526.

4

Coping Strategies for Anxiety and Panic

By | NESCA Notes 2022

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

Do you, your child or your loved one deal with frequent anxiety? Stress? Panic? Sometimes it may feel like you are spinning out of control. With so much going on in the world, in our own lives, and in our own head, it can feel like an impossible task to quiet the mind and calm the body. However, there are things we can do to regulate the nervous system, thereby relaxing the body and reducing the effects of anxiety. Below is a list of these strategies, but they are not one-size-fits all. Try each of them and see what works best for you or your loved one.

  • 5, 4, 3, 2, 1 Grounding Technique: This technique is helpful to ground yourself in the present moment. Often, we can get stuck in our own head, and our worries and fears spiral out of control. This strategy is helpful to pull yourself out of those thoughts and into the present moment. The procedure is as follows:
    • Identify five things you can see. Feel free to describe them. What color are they? What are their shapes?
    • Identify four things you can touch. Get up and actually touch them! How do they feel? Are they soft? Hard? Squishy? Wet?
    • Identify three things you can hear. Is there a car driving by? Are the noises loud or soft?
    • Name two things you can smell. Are the smells pleasant? Neutral? Familiar?
    • Finally, name one thing you can taste. Can you taste the remnants of dinner on your tongue? Perhaps you have a piece of candy nearby you want to put in your mouth and describe.

Hopefully, completing this technique helps break the anxiety spiral. Feel free to repeat it as many times as you need. You can try to identify new items and sensations each time.

    • Weighted blanket or deep pressure: Deep pressure activates the parasympathetic nervous system, which is responsible for relaxing your body. Therefore, if you are feeling anxious, try sitting with a weighted blanket. Alternatively, if you have a pet, put them on your lap. Both the pressure of their body and the act of petting them is great for relaxing. You could also try giving yourself a hand massage or tight hug.
    • Box breathing: This is a breathing technique that also activates the parasympathetic nervous system and relaxes the body. The steps of this technique are as follows:
      • Take a slow breath in through your nose (if possible) for four seconds
      • Hold that breath for four seconds
      • Slowly breathe out for four seconds
      • Hold your breath again for four seconds
      • Repeat this cycle three or four times
    • Funny videos: Sometimes it can be helpful to distract the mind with a funny video. Animal videos can be great! Or perhaps you have a favorite comedian that will always make you laugh.
  • Progressive Muscle Relaxation: This technique involves tightening different muscle groups and then letting them go. It helps to relax the body and reduce tension. You can find a guided YouTube video to walk you through the process, or you can also try it on your own by moving from head to toe, tightening different muscle groups. You may start by tightening all of the muscles in your face for 5-to-10 seconds as you inhale and relaxing the face muscles as you exhale. Give yourself 10-to-20 seconds to relax before moving on to the next muscle group.

 

About the Author

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. 

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

39

Testing Outside the Box—Vocational Assessments for Nonverbal, Nonreading and/or Hard-to-Test Students

By | NESCA Notes 2022

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

My colleague Tabitha Monahan and I have dedicated several recent blog entries to vocational assessment—a vital tool for helping students to learn about career planning and employment and to set career goals for themselves. Previous blogs have included an overview of vocational assessment as well as an in depth look at career interest inventories, career aptitude testing, assessing work motivation and values and real-life experiences, such as informational interviews and job shadows.

However, many of the most “popular” or common tools for vocation assessment are intended for use with students who have functional reading abilities (i.e., basic reading skills at or above 5th grade levels). While there are many accommodations a skilled evaluator might use to help a wide range of students effectively access these tests, there are also students who receive special education services and cannot access these word-based and rating-based assessment tools. So, what tools can be used effectively with these students? How do we assess interests and aptitudes for students who are nonverbal, have reduced reading skills, or may provide unreliable responses to language-based testing methodologies? Below are a few of the methods that we find particularly useful at NESCA.

  • Picture-based Interest Inventories

Instead of using text-based items and rating scales, picture-based career interest inventories help individuals to express their occupational interests by selecting preferred pictures of people at work or people performing work-related tasks. Pictures are presented in sets of two, three, or more, and the student points to or circles the picture that seems most interesting. Based on the number and types of pictures selected, the test identifies work themes that are most appealing to the student. Evaluators can also look for themes among pictures selected, such as a student who selects a high number of pictures that have multiple people, computers, vehicles, outdoor activities, etc. Three popular picture-based assessments are the Picture Interest Career Survey (PICS) published by JIST, the Reading-Free Vocational Interest Inventory-Third Edition (RFVII-3) by Katherine Synatschk and Ralph Becker, and the Career Interest Inventory – Pictorial Version by Shasta Twenty-first Century Career Connections.

  • Video-based Interest Assessment

Video-based career interest assessments are more difficult to find but can be incredibly useful nonverbal tools for vocational evaluation and career planning. A tool that we use at NESCA is Your Employment Selections (YES), which is a CD-ROM-based reading-free job preference and career exploration program that has 120 videos of different jobs which are viewed and compared strategically in pairs. Through initial video-based trial, students indicate preferences, such as a desire to work indoors or outdoors, work alone or with coworkers, interact with the public or coworkers, and do light or heavy lifting work. These preferences are used to determine which subset of job videos the student will view. Traditional testing involves the student watching two videos and pointing to, or clicking on, the one they like more. However, the evaluator can work with a student who has limited verbal abilities to determine some of the features or tasks the student likes most, or dislikes most, within the specific job videos shown. While this video program is no longer available for retail, there are plenty of great career videos that can be used to carry out similar informal assessment on web sites, such as CareerOneStop, Dr. Kit, MassHire Career Information System, and even YouTube.

  • Functional Assessments and Observations

For all students, regardless of communication or self-determination skills, functional assessments and real-world observations play a vital role in career assessment and planning. For students who struggle with reading- and writing-based assessments, it can be important to have access to more hands-on standardized assessments of employment strengths and abilities. One such assessment tool is the Skills Assessment Module (SAM) published by Piney Mountain Press, which includes an auditory directions screen to determine how well a student can follow verbal directions and 12 work-related activities that simulate actual work aptitudes required in training and jobs (e.g., mail sort, ruler reading, assembling small parts, etc.). However, evaluators who do not have access to formal assessments can purchase or create pre-vocational and vocational kits for assessing and learning work skills and can carry out functional assessment of real or simulated work-related tasks in school, community, and work settings.

Observing students performing work-related behaviors and tasks is one of the most powerful evaluation tools that we have for determining strengths and needed areas for growth. If a student is performing vocational activities at school or has a volunteer or paid job during the week, that can be critical for an evaluator to observe. There are also protocols that can be used to formally assess students’ skills during observations, such as the Vocational Skills Assessment Protocol from The Assessment of Functional Living Skills (AFLS), and the Becker Work Adjustment Profile – Second Edition (BWAP-2).

  • Interviews and Parent/Educator Participation in Interest Inventories

While some transition-aged students may have trouble clearly expressing interests using words or inventories, all students have some way of communicating information to people who know them well. Transition and vocational assessments often require creativity and effort to gain informal, subjective, and anecdotal information from educators, parents, and other stakeholders who know the student well. It is useful to interview several people, asking questions about the student’s preferred leisure and school activities, areas of strength, preferences that need to be taken into account when planning for future employment, and specifically asking if there are any jobs that the interviewee is aware of that they think might be a good fit for the student in the future. Another technique is to use career interest inventories which are intended for self-report, such as the O*Net Interest Profiler (IP) or RIASEC, and ask parents or educators to fill out the inventory with what they believe the student’s preferences would be. Having a high level of correlation between parent report, educator report, and the student’s responses on picture-based or video-based testing can be extremely helpful in knowing where to focus career planning energy for the student.

Conducting vocational assessment, or any assessment, for this population of students—when tests are often not explicitly designed for them–is difficult. There are some tremendous tools specifically designed for testing students who are nonverbal or nonreaders, and there are many other assessment tools which can be made, modified, or used in nontraditional ways to gain a more complete picture of the student. The most important aspect of assessment is to choose the tools that are going to best suit the student.

For more information about vocational assessment and transition assessment 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.

 

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.

9

ADHD & Social Skills

By | NESCA Notes 2022

By: Maggie Rodriguez, Psy.D.
Pediatric Neuropsychologist, NESCA

When most of us hear the term “ADHD (attention deficit hyperactivity disorder),” we think of the little boy who can’t sit still at his desk or the girl gazing out the window lost in her own thoughts during class. While difficulties with hyperactivity and/or attention are core features of ADHD–embedded directly in the diagnostic label–there are often co-occurring features that are less obvious. Moreover, even the central aspects of ADHD can have far-reaching impacts beyond the classroom. One of the most frequently misunderstood and overlooked facets of ADHD is its potential impact on social functioning.

In clinical practice, parents of children with ADHD are often confused by the unexpected and indirect ways that attentional and executive functioning deficits can affect social functioning. They sometimes wonder if their children have an additional challenge, such as autism spectrum disorder. Most often, that’s not the case. Rather, it’s more likely that one or more of the following is at play:

  • Kids with ADHD can have difficulty selectively attending to relevant social cues
    • Imagine looking through a camera with a broken zoom lens. At first everything is in frame at once; it’s too much information. Then you try to zoom in, but when you do, sometimes the lens focuses on unimportant things (like the random details in the background), leaving out what’s most relevant (like the person you’re trying to capture in your photo). Children with ADHD have difficulty figuring out what details to focus on and struggle to effectively “zoom in” on those elements. In social settings, which are often unstructured, kids with ADHD are even more prone to “zoom in” on unimportant things and miss the more salient information. They can also become easily distracted and fail to register important information in the moment. To others, this can come across as lack of interest (for instance, the child who seems not to be listening or is distracted by sounds, sights, or other sensory information in the moment). It can also lead children with ADHD to overlook contextual cues about what’s expected in a given social setting, which can lead to inappropriate behavior.
  • Children with ADHD often struggle with nuance, making inferences, and reading between the lines
    • Social situations are much more complex than we often realize. Successfully navigating social interactions requires paying attention, not just to surface level information but to the often subtle, implied meaning embedded in things like figures of speech, tone of voice, and body language. For many with ADHD, it’s already a challenge to maintain focus at the surface level; the task of trying to simultaneously attend to and interpret subtext is too much. Individuals with ADHD may focus on what another person says (the content of their speech) but fail to notice the eye roll or sarcastic tone of voice that goes along with it.
  • Impulsivity can lead to social faux pas
    • Impulsivity is a central feature of ADHD in many cases. In social settings, difficulty inhibiting impulses can take many forms. For some, it may simply present as rapid-fire speech, leaving little room for others to respond in conversation. It can also look like interrupting, cutting others in line, or expressing ideas and opinions in a way that can be hurtful or seem rude. Especially in younger children, impulsive behavior can lead to difficulty sharing, physical aggression towards others, and trouble with turn taking. Children who have more difficulty slowing down and inhibiting impulses are more likely to inadvertently offend others or to engage in behavior that their peers may view as odd or inappropriate; in turn, this can lead to trouble developing and sustaining friendships and other positive relationships.
  • Hyperactivity makes participating appropriately in some social settings difficult
    • There are some social contexts in which an abundance of energy is a very good thing. For this reason, many ADHD kids can excel in activities like sports, into which they can channel their high energy. But other social situations demand a different set of skills. For kids with hyperactivity as part of their ADHD, sitting still and maintaining quiet can be a challenge. They may struggle with activities like going to the library, watching a movie in a theater, attending church or religious ceremonies, or sitting at the table in order to have family dinner.

The good news is that there are ways to manage these social challenges. If your child with ADHD has difficulty with any aspects of social functioning, it may help to seek out social skills training with a therapist or through a structured social skills training program. Interventions often include a combination of explicit instruction, modeling, role playing, and feedback. Parents can also help by implementing simple, consistent ground rules for behavior and providing gentle but clear reminders as needed. Additionally, parents can facilitate play dates with peers, during which the parents take an active role in helping children utilize social skills and engage with each other appropriately.

Finally, though ADHD can present challenges in the social domain, kids with ADHD often possess many strengths that can help actually them succeed socially. Children with ADHD can be highly engaging, curious, energetic, creative, and open-minded. When these strengths are reinforced, kids with ADHD can often utilize them to create fun, rewarding social interactions and to develop rich, dynamic relationships.

 

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.

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.

37

Transition Assessment: How to Prepare for the Team Meeting

By | NESCA Notes 2022

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

Every child who receives special education services in the United States is entitled to transition services—a coordinated set of activities that will facilitate the student’s preparation for postsecondary education and/or training, competitive employment, independent living, and community participation.[1] In order to provide these services, an IEP team has to first conduct “age-appropriate transition assessment.”[2] I have written about transition assessment in previous blogs, including Transition Assessment: What is it anyway? How is it different from neuropsychological evaluation? and Vocational Assessment and Transition Planning.

A challenge for students and families who are participating in transition assessment for the first time, is knowing how to prepare for team meetings where transition planning and services will be discussed. When you attend a team meeting after an occupational therapy evaluation or academic evaluation, you know that you are going to be discussing what occupational therapy services or academic instruction your child may need as part of their IEP process. However, when a student has participated in transition assessment, the team will be discussing a whole variety of activities (e.g., regular and specialized instruction, related services, community experiences, linkage to adult human service agencies) that the student will need to participate in as the student is preparing for adulthood. Some transition assessment reports contain dozens of recommendations for comprehensive planning. Recommendations may include activities that you are used to discussing with your team, such as instruction and services for a current IEP period, but recommendations may also include other activities that should occur outside of school with support from a parent or community member or actions that may need to occur at a later date. To make the most of your team meeting, it is helpful to do a little bit of homework and preparation after you receive your transition assessment report.

As discussed in previous blogs, if the student is going to be part of the team meeting (which they should be), then the student should have the opportunity to discuss the assessment results with the evaluator or another trusted adult. If your school district conducted the transition assessment, ask when and how they are going to review the results with the student prior to the meeting. If you obtained an independent or private evaluation, ask if you can schedule a student feedback meeting with that evaluator prior to the student’s team meeting. Students need to be aware of the findings and the recommendations that are being made, and they need to be prepared to actively participate in discussion about the results. Whether a student supports or disagrees with recommendations from a transition assessment can have a large impact on changes that are made, or not made, to the IEP.

In addition to student preparation, all team members should be prepared to discuss the assessment recommendations in a planful and organized manner. As a parent, it is helpful to read each recommendation in the report and consider the following questions:

  • Is this a skill or activity that you can reasonably tackle at home this year or in coming years? Do you need any training or consultation to be able to support the student?
  • Is this a skill or activity that would be best supported by a community provider rather than a parent, family member, or school staff?
  • Is this a skill or piece of knowledge that the student must attain this academic year in order to make progress toward their long-term goals? Do they need specialized instruction or related services to learn the skills or gain this knowledge?
  • Is this a skill, piece of knowledge, or service that needs to be focused on at a later time, but documented somewhere so that the team does not forget the recommendation?

It can be helpful to put together an abbreviated list of the goals, objectives, or services that you know your child will need this school year based on the assessment. Alternatively, some families find it useful to create a table or grid to organize transition planning activities. Here is one possible presentation that a family might use to prepare for a team meeting.

 

  Parent Community Providers School/IEP
Education/Training ·   Tour three colleges

·   Attend summer program on college campus

 ·   Counseling on enrollment process for postsecondary educational programs with Pre-Employment Transition Service (Pre-ETS) provider ·   Update postsecondary goals

·   Instruction of Study Skills, including notetaking

·   Assistive technology consultation

·   Personal Finance course

·   Sexual Health Instruction
Employment ·   Create first student resume

·   Set up informational interview with family friend who works as an accountant

 ·   Self-advocacy counseling with Pre-ETS provider ·   Help student obtain work permit

·   Support student in applying for paid part-time work
Independent Living ·   Review family health history

·   Teach student to complete medical history paperwork

·   Prepare questions with student ahead of medical appointments

·   Assist student in opening checking account

·   Include student in home maintenance activities

 ·   Individual counseling

 

 

 ·   Instruction in tracking sleep hygiene, diet, and exercise activities

·   Assistive technology consultation for health habits
Community Engagement ·   Support student in learning to carry out personal shopping activities ·   Social skills group with insurance-based provider

·   Study for driver’s permit test with Transition to Adulthood Program (TAP) provider

·   Travel orientation with local public transit authority

 ·   Make referral to Vocational Rehabilitation (VR) service provider

·   Invite VR service provider to team meeting with parent & student consent

 

 

It is also helpful to consider how the information from the transition assessment can flow through the IEP document. Information learned about the student’s postsecondary goals (i.e., the student’s goals for their life after high school) must be documented in the IEP and used to guide IEP development. Portions of the assessment may also be included as key evaluation results and current performance data, may inform how the team considers various federal and state special factors such as the students need for assistive technology or more functional means of communication, may suggest linkages that are needed with state resources and adult human service agencies, and may inform other aspects of the IEP. It is important to think about each section of your child’s IEP and how the assessment results might impact the team’s discussion of that section.

Many schools and families are familiar with transition assessment services at NESCA but do not realize that our transition specialists will consult with students, parents, and teams to plan for transition assessments, review assessments that have been conducted by other clinicians, or support the team meeting process. For more information about transition planning, consultation, and assessment services at NESCA, visit our transition services page and our transition FAQs.

[1] https://sites.ed.gov/idea/regs/b/a/300.43

[2] https://sites.ed.gov/idea/regs/b/d/300.320/b

 

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.

5

Pediatric Neuropsychologist Maggie Rodriguez, Psy.D., Joins NESCA

By | NESCA Notes 2022

By: Jane Hauser
Director of Marketing & Outreach

In today’s blog, I have the pleasure of introducing you to NESCA Pediatric Neuropsychologist Maggie Rodriguez, Psy.D., who recently joined our team of expert clinicians.

How did you discover your interest in neuropsychology?

It was a long and winding road! I went into college, interested in a wide range of subject areas, including medicine. Eventually, I realized my area of interest was truly in psychology. I discovered that I really enjoyed neuropsychological evaluations, since they combined my interests in psychology, neuroscience, working with medical providers, educators, as well as writing and the creativity involved in making a child come alive in a report.

In graduate school, I was fortunate to learn from a number of extremely talented neuropsychologists in a variety of settings. While completing a placement at Children’s Hospital Boston, I remember hearing my very wise supervisor say that, “one year in the correct school placement is worth two years of therapy.” As I continued on with my coursework and clinical training, I repeatedly saw the truth in that statement. I witnessed the value of nuanced neuropsychological assessment in allowing students to receive accurate diagnoses and, in turn, the correct academic accommodations and interventions. I wanted to be part of that, not only to help children and teens succeed academically but to prevent the secondary effects that undiagnosed and untreated learning disorders, neurodevelopmental disorders, and cognitive challenges can have on emotional health, self-esteem, and social functioning.

On the personal side, my interest in neuropsychology was sparked again when I had my own child evaluated. It was surprisingly powerful to go through the process on the parent side, and after taking some time off to have a family, I knew that I wanted to get back into neuropsychology again!

Why did you choose to come to NESCA when re-entering your professional career?

There were several reasons that I looked into NESCA and ultimately opted to join its team. I learned about NESCA while researching neuropsychologists for my child’s evaluation and was impressed with what I saw. Additionally, one of my former testing supervisors told me NESCA is among the best in the business. Having that kind of endorsement from such a trusted source provided me with great confidence being part of NESCA.

I also was really drawn in by NESCA’s emphasis on the continued growth and learning for its clinicians. It was obvious that NESCA is comprised of a highly invested and collaborative team. Every one of us has a lot to learn still, and I valued the opportunity for not just a job, but the continued learning.

NESCA also offers a great work/life balance. Having a family of my own and parents who are approaching the stage where they also require care is a lot to balance. NESCA’s emphasis on supporting its staff in balancing work and life has made it very rewarding. I’ve seen several examples of how the culture of understanding is very much active.

On a very practical level, having clear protocols for handling day-to-day Covid strategies, like masking, cleaning, etc., has been comforting. Returning to clinical work in the midst of a pandemic has been a big transition, and knowing NESCA has put in place measures for keeping staff and clients safe is tremendously important to me. Seeing the creativity and agility in the way the team here tackled the larger challenges—evaluating clients safely and in-person—during Covid was inspiring and told me a lot about the team and culture. Learning that NESCA adapted its methods of testing via the two-office model demonstrated to me that they, as a practice, they are able to roll with those kinds of challenges. That was also very reassuring.

Finally, the interview process provided me with the chance to speak with a number of NESCA’s clinical staff. I was able to get a great feel for the culture and high standards the practice has, which made me confident that this was the right fit for me.

What kinds of concerns do you evaluate or enjoy the most?

I really enjoy working with kids of varying ages, but I do have a keen interest in working with families and children who are just hitting the adolescent years. I get the opportunity to help them understand how all the, sometimes confusing, pieces fit together.

I really enjoy working with kids who may be deemed as “complicated,” where things may have previously been overlooked. Maybe things were going fine for them until they hit a wall academically. Perhaps they got to middle school or high school or even college and began to wonder why things seemed to be falling apart for them. I enjoy the challenge of working with kids who are experiencing executive function deficits, social communication issues, kids whose disability or disabilities are not as straightforward. I like to tease apart whether there are executive function (EF) issues, Attention-Deficit/Hyperactivity Disorder (ADHD), or sensory integration challenges…or perhaps explore whether it could be something else altogether. Is a child’s rigidity due to anxiety, an Autism Spectrum Disorder (ASD), Obsessive-Compulsive Disorder (OCD), cognitive issues or a combination of overlapping challenges? I love teasing all of these things apart. I also work with children whose families have concerns about potential language-based learning disabilities (LBLD), communication issues and challenges with social pragmatics.

It’s incredibly rewarding when you are able to help families understand answers to these kinds of questions that they may have been grappling with for a long time.

 

About Pediatric Neuropsychologist Maggie Rodriguez, Psy.D. 

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.

To book a neuropsychological evaluation with Dr. Rodriguez or another expert neuropsychologist at NESCA, 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 and Plainville, Massachusetts, as well as Londonderry, New Hampshire. NESCA serves clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

10

Risk Factors & Warning Signs of Substance Use

By | NESCA Notes 2022

By Miranda Milana, Psy.D.
Pediatric Neuropsychologist

It is estimated that approximately one third of adults in the United States have met criteria for an alcohol use disorder at some point in their lives, while approximately 10% have met criteria for another substance use disorder. While these numbers are staggering, what is even more astonishing is the fact that consuming substances before the age of 14 increases the likelihood of abusing substances later in life by 400%. In fact, The National Child Traumatic Stress Network reports that 9 out of 10 individuals who abuse substances began using these substances before the age of 18. So, what are the risk factors and early signs to watch out for? What can you do to help?

Risk Factors:

  • Family history—if you have a family history of addiction, it is important to talk about this with your children just as you would have a conversation about a family history of cancer, diabetes, or any other mental illness. Determine when and how to approach this conversation by talking with your pediatrician.
  • Comorbid diagnoses—having an existing mental health diagnosis (e.g., ADHD, depression, anxiety) increases the chances that one will use and abuse substances later in life. Many individuals start using substances as a method of self-medicating if their mental health symptoms are not well managed.
  • Exposure—having easy access to substances, being exposed to peer groups or family members who use substances, or being exposed to media messages encouraging substance use can also increase the risk of substance use and abuse.
  • Additional risk factors include poor coping skills, academic failure, chaotic home or peer environments, as well as impulsivity and risk taking behaviors.

Warning Signs to Watch for:

  • Unexplained and/or extreme mood swings
  • Dilated pupils/bloodshot eyes
  • Changes in appetite
  • Change in sleep patterns or levels of fatigue
  • Changes in friends
  • Loss of interest in previously preferred hobbies
  • Being secretive about friends and activities
  • Withdrawing from family members and loved ones
  • Not respecting curfew or breaking other house rules
  • Running away from home or sneaking out
  • Stealing or having unexplained amounts of money
  • Increased absences from school
  • Decline in grades
  • Increase in behavioral problems

How to Help:

  • Start the conversation when it is appropriate. Talking to your pre-teen or teen about the effects of substances and alcohol/drug laws is essential in keeping the lines of communication open. Ask them first about their level understanding and what they have already learned or heard about.
  • Increase coping skills—having appropriate communication skills, positive social-emotional connections, strong self-esteem, and confidence in dealing with peer pressure are all extremely beneficial in helping children and teens navigate adolescence. If your child struggles in one or more of these areas, it is important to target these vulnerabilities early on through the appropriate therapeutic supports (i.e., psychotherapy, social skills groups, school counseling, occupational therapy, executive function coaching).
  • If you are concerned your child is using substances, you may contact their pediatrician or find support through SAMHSA’s national helpline (call 1-800-662-HELP or text HELP4U to 435748 to receive information on local treatment facilities, support groups, and local community organizations).

References:

Grant BF, Goldstein RB, Saha TD, et al. Epidemiology of DSM-5 Alcohol Use Disorder: Results From the National Epidemiologic Survey on Alcohol and Related Conditions III. JAMA Psychiatry. 2015;72(8):757–766. doi:10.1001/jamapsychiatry.2015.0584

Grant BF, Saha TD, Ruan WJ, et al. Epidemiology of DSM-5 Drug Use Disorder: Results From the National Epidemiologic Survey on Alcohol and Related Conditions–III. JAMA Psychiatry. 2016;73(1):39–47. doi:10.1001/jamapsychiatry.2015.2132

 

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.​

 

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.

 

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

 

4

Testing the Limits

By | NESCA Notes 2022

By: Ann Helmus, Ph.D.
NESCA Founder/Director; Clinical Neuropsychologist

In the world of assessment, “testing the limits” means essentially bending the rules of test administration in order to see if the change in administration allows the test-taker to demonstrate their knowledge more effectively. For example, some children and adolescents respond impulsively to multiple-choice tests, picking the first choice that appears to be correct without looking at all of the choices. Standardized test administration dictates that the evaluator accepts that impulsive response and, as such, impulsivity will compromise the client’s score.

In the example above, the student was unable to demonstrate their knowledge or skills effectively on tests because of the standardized administration procedures. While it is important to generate these scores, it is also important to gain an understanding of what the student actually knows, and this is where testing the limits comes in. For the impulsive student, the evaluator would test the limits by reminding the student to slow down and look at all the choices before responding. This is non-standard test administration, and so the score is not considered valid but the results give us a great deal of information about the student’s strengths and weaknesses. There is a big difference between the student who is able to achieve the correct score when cued to slow down and the student who still answers incorrectly, even with reminders to slow down. The former student can be said to have much higher potential than the latter student. However, their ability to demonstrate their potential is hampered by impulsivity, a problem that needs to be addressed.

In the course of most neuropsychological evaluations, we are trying to understand the student’s profile of strengths and weaknesses, which often requires testing the limits. This raises the question of the value of the standardized scores. The standardized scores likely reflect the level at which the child or adolescent is functioning in the “real world.” Impulsive test-takers are almost certainly impulsive students; just as they don’t demonstrate their true potential in testing, they are not doing so in school.

Many students are able to fully demonstrate their skills and knowledge with standardized testing and don’t require “testing the limits.” However, at NESCA, we also see many highly complex students whose ability to access their potential is limited by issues of attention, executive functioning, communication, or emotional/behavioral regulation. In these cases, we routinely “test the limits” and report both standardized administration and non-standardized (“testing the limits”) scores and explain what these scores mean for the individual, what the scores tell us about daily functioning as well as untapped potential.

 

About the Author
NESCA Founder/Director Ann Helmus, Ph.D. is a licensed clinical neuropsychologist who has been practicing for almost 20 years. In 1996, she jointly founded the  Children’s Evaluation Center (CEC) in Newton, Massachusetts, serving as co-director there for almost ten years. During that time, CEC emerged as a leading regional center for the diagnosis and remediation of both learning disabilities and Autism Spectrum Disorders.

In September of 2007, Dr. Helmus established NESCA (Neuropsychology & Education Services for Children & Adolescents), a client and family-centered group of seasoned neuropsychologists and allied staff, many of whom she trained, striving to create and refine innovative clinical protocols and dedicated to setting new standards of care in the field.

Dr. Helmus specializes in the evaluation of children with learning disabilities, attention and executive function deficits and primary neurological disorders. In addition to assessing children, she also provides consultation and training to both public and private school systems. She frequently makes presentations to groups of parents, particularly on the topics of non-verbal learning disability and executive functioning.

To book an evaluation with Dr. Helmus, NESCA Founder and Director, 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 and Plainville, Massachusetts, as well as Londonderry, New Hampshire. NESCA serves 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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