Real-life Skills Coaching Alert!

NESCA now has two Occupational Therapists offering in-person, community-based Real-life Skills Coaching in the Newton area. To learn more or book sessions, complete our Inquiry/Intake Form.

Tag

Neuropsychological Evaluation

Subscribe to NESCA Notes

3

The Path Back to Fitness

By | NESCA Notes 2021

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

One of the well-known impacts of the pandemic has been the loss of physical fitness in children and adolescents because of the loss of opportunities to play sports and generally move around. In addition, many children and adolescents have gained weight during this time. Maintaining a healthy weight and being physically fit offer many benefits for social-emotional development as well as academic performance. Numerous research studies link physical exercise to significant improvements in the regulation of mood and anxiety as well as attention and executive functioning.

Parents are often at a loss for how to help their child get back into good habits to lose weight, exercise regularly, or get back into a sport. Common parenting approaches, such as offering “helpful suggestions,” encouraging, nagging and bribing usually don’t work for long term—or even short term—positive change. Instead, these approaches often “back fire,” making the child feel even more ashamed or powerless—emotions that are not likely to fuel motivation to change habits.

So how do we support children and adolescents in developing the positive habits that are necessary for maintaining health and fitness? The key lies in empowering the child to determine his or her own goals and establishing their “why” through discussion of why they would like to reach this goal, what they will get by achieving the goal, and, perhaps most important, how they will feel when they reach this goal. This type of motivational interviewing builds internal motivation, which beats external motivators every time in terms of creating long term change.

Once the child or adolescent is clear on what they would like to achieve and why, the next step is determining the behavior changes that will help the child achieve their outlined goal and working with the child to figure out what’s manageable so that success can be ensured. For example, one adolescent might easily commit to a 30-minute daily bike ride, whereas another might want to start with a daily 10-minute walk. Success breeds success, so it is important to set goals that are challenging but also achievable. Throughout this process, the focus is on creating a positive mindset and positive emotional state of empowerment, hopefulness, optimism, and pride.

Some children may be open to this type of process with their parents; however, most adolescents will likely not want to be involved at this level with a parent. NESCA offers health and life coaching, aimed at helping adolescents and young adults with this process. Coaching offers a structured approach to helping an adolescent or young adult define his/her own goals and motivations as well as understanding the obstacles that they have encountered in reaching those goals, which are usually limiting beliefs (e.g., “I can never stick to things.”) or faulty self-identities (e.g., “I’m not athletic.”). The coaching process works through a combination of structured activities as well as a highly supportive personal relationship. To learn more, please join us for a webinar on Thursday, September 23 at 1:00 PM ET, view a previous webinar on this topic on our website or contact Health & Life Coach Billy Demiri for a free 30-minute consultation to determine if health coaching might be helpful for your child.

 

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 or therapists, 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.

14

Going with the Flow

By | NESCA Notes 2021

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

It’s September, and a new school year has already begun for most children. We had hoped that Covid would be behind us and the start of this school year would begin with a greater semblance of the old normal. Sigh…it has not. We are still wearing masks, keeping our distance and washing hands amongst other health considerations. Many students are eager to get back to school and in-person learning even though they have to wear masks. Many are accustomed to it, and it is no big deal. However, there are those students who preferred virtual learning and have grown more and more anxious at the thought of going back to in-person learning.

Back at the start of the pandemic, I wrote a blog about going with the flow, and it seemed appropriate to reintroduce the topic again as we start another school year still with so much uncertainty. Will there be outbreaks of the new variants at school? Will there be quarantines happening again? Will someone in my family, class, school get sick and how serious will it be?  We don’t know the answers to these questions, and worrying about them doesn’t help us be in the moment. In Bostonia’s current cover piece, “The kids are stressed, anxious, lonely, struggling, learning, grateful, adapting, alright,” Eric Moskowitz summed it up accurately. What researchers found is that children who were at a disadvantage before the pandemic suffered the most – which is not surprising – yet overall kids are resilient.

In  Angela Currie’s recent blog, “Helping Students Transition Back to School,” she covers the essentials of establishing bed time/morning routines, connecting with teachers, mask wearing routines and many more. I would like to add to her list with the psychological, social and emotional routines and ways of being that will also make the transition smoother.

Education Week offers a few social-emotional checklists that are good to review to help you set your student off on the right foot as they start this school year.

  • First check in with yourself and your own emotions/feelings. If you are feeling anxious, do something to help calm your emotions and gain some centeredness. Take care of yourself so you can take care of others.
  • Establish those all so important sleep, eating and exercise routines.
  • Establish a calming routine that the family can do together for a few minutes (i.e., yoga, mindful minute, deep breathing, etc.).
  • Acknowledge the breadth of feelings your child may have and how rapidly they may change. Point this out to him/her when they are calm. Introduce the realization that thoughts are connected to feelings, and they can change their thoughts to help their feelings change. Be understanding, supportive and empathetic yet also encourage your student to use their “past data” to support their progress forward through their feelings.
  • As Angela said, establish routines and predictability at home but also model and help your child know that things don’t always go as planned. Have routines yet be flexible, adaptable and a “go with the flow” mindset will be essential as s/he enters this school year. There are always Plans B, C, and D when Plan A doesn’t work. For instance, you may insist your child wear a mask and another child in his class, or afterschool activity/sport, may not. Preview this possible scenario so your child can adept and accept. Or, a student starts the year in-person, but then hybrid (hopefully not) happens…again. You get the idea about teaching flexibility.
  • Stay positive even in the midst of uncertainty, as this helps create the right biochemical mix that allows you to think more clearly.
  • Be aware of your thoughts and help your child be aware of their thoughts. Thoughts influence our mood, feelings and behavior, and we can exert control over them.
  • Be grateful (end the night with a gratitude moment).
  • Be supportive. Acknowledge the efforts, tasks, feelings, etc. that your kids are taking on and experiencing. It helps them develop self-confidence, self-esteem, self-efficacy, pride and a sense of competence.
  • Be hopeful. Yesterday is history (don’t dwell there), tomorrow is a mystery (don’t worry about it) and today is a gift (even if you don’t feel like it is). Be present and allow whatever feelings come up (positive or negative) to flow through you so you can make way for new feelings.

Wishing everyone a smooth start to the 2021-2022 school year, and may the force be with us as we continue to combat Covid.

Resources

https://www.bu.edu/bostonia/

https://www.edweek.org/leadership/preparing-for-in-person-learning-a-covid-19-checklist-for-parents/2021/08?utm_source=nl&utm_medium=eml&utm_campaign=eu&M=63136722&U=1970318&UUID=f2e19d19dbb5bd4e92068a32311b141c

 

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.

 

1

Helping Students Transition Back to School

By | NESCA Notes 2021

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

Back in June, I wrote a blog about dealing with uncertainty at the end of the school year. Now, two months later, families are focused on the transition back to school, and a level of uncertainty still remains. Many children are re-entering full in-person learning for the first time in over a year and a half. We are also facing the reality that our overall community health is not as improved as we hoped it would be by now. There is debate about how to appropriately re-enter school, and this stress is likely palpable for many children and teens. As a community, we are grieving the continued loss of “normalcy,” with no clear idea of when that will be recovered.

How do we help children, and their adults, transition back to school during such a time? Some of the basic strategies are similar to those that we do to help them cope with the end of the school year. This includes watching for signs that your child may be struggling (e.g., difficulty sleeping) and talking about their feelings related to starting school in an open and validating manner. In addition, here are some strategies for helping to ease the upcoming transition to school:

  • Start to work into your schoolyear daily routine within the last week or two of summer. This includes bedtimes and wakeup times.
  • Create a morning and evening routine checklist or schedule. Use visual prompts for young children. For example, a morning checklist may include: Wake Up, Get Dressed, Eat Breakfast, Brush Teeth, Pack Bag (listing words or pictures of what to pack), and Departure Time. Practice this checklist for a couple days ahead of school starting to help you child get into the routine and understand how long each task will take.
  • Preview your child’s schoolyear to the extent possible. This may include reviewing their class schedule, looking at their teacher’s profile or picture on the school website, going to a back-to-school event at their school, etc.
  • Help your child set some goals for the upcoming year, trying to create intrinsic goals (e.g., build confidence with reading; make a new friend; ask questions more; etc.), rather than extrinsic (e.g., get straight As).
  • For children who were full remote last year and whose schools have mask mandate, practice wearing a mask at home for increasing durations of time.
  • Avoid scheduling extra activities during the first two weeks of school, such as weekend trips or appointments, allowing for a more relaxed transition.
  • Particularly for elementary age children, email your child’s teacher ahead of the year starting in order to briefly introduce yourself and your child. If you child has specialized needs, concisely highlight key things that the teacher should be aware of heading into the year.
  • For children who will be using a locker for the first time, have them practice opening a combination lock at home before the year starts.
  • For families feeling dissatisfaction regarding your school’s COVID-related mandates or plan, work to keep this conflict or stress away from your child.

Understood.org has a range of tools to help children transition back to school, including a Back to School Update for teachers, Backpack Checklists, Back-to-School Worksheet, Introduction Letter templates, and a Self-Awareness Worksheet, among others. Consider the above tips and resources and determine which are most appropriate for your child and their current skill set and feelings regarding the return to school. With the right tools in place, children and families can feel more confident entering the school year.

 

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.

8

The Relationship Between Dyslexia and Dyscalculia

By | NESCA Notes 2021

By: Alissa Talamo, PhD
Pediatric Neuropsychologist, NESCA

“Reading disability (RD) and math disability (MD) are common developmental disorders that are defined by significant academic underachievement that is unexpected based on an individual’s age and development (e.g., American Psychiatric Association, 2000).”

Research has shown that children who struggle with learning to read often also struggle with math and understanding numbers. It is not uncommon for students to have both a reading disability (dyslexia) and a math disability, with this co-occurrence found at a rate of approximately 40% (2013, ncbi.nlm.nih.gov).

Dyscalculia is a learning disability that makes math challenging to process and understand, with these problems not explained by a lack of proper education, intellectual disabilities, or other conditions. At this time, the estimated prevalence of dyscalculia in school populations is 3 to 6 percent. There is no medication that treats dyslexia or dyscalculia; however, treating any co-occurring issues (e.g., AD/HD, Anxiety) can be helpful.

What are some signs of dyscalculia?

Elementary School Difficulties:

    • trouble learning and recalling number facts
    • trouble processing numbers and quantities, such as connecting a number to the quantity it represents (the number 2 to two books)
    • difficulty counting, backwards and forwards
    • difficulties recognizing quantities without counting
    • weak mental math and problem-solving
    • trouble making sense of money and estimating quantities
    • difficulty quickly identifying right and left
    • difficulty identifying signs like + –
    • trouble recognizing patterns and sequencing numbers
    • poor processing of graphs and charts
    • persistent finger-counting is typically linked to dyscalculia, especially for easy, frequently repeated calculations
    • lack of confidence in areas that require math

Adolescent Difficulties:

    • trouble applying math concepts to money
    • difficulty counting backward
    • slow to perform calculations
    • weak mental arithmetic
    • poor sense of estimation
    • high levels of math anxiety

Under the Individuals with Disabilities Education Act (IDEA), students diagnosed with a Specific Learning Disability (SLD) with impairment in math (i.e., dyscalculia) are eligible for special services in the classroom. In-school dyscalculia services and accommodations may include:

    • direct, specialized pull-out instruction to target core, foundational skills
    • extra time on assignments, quizzes, and tests
    • use of a calculator
    • modifying the task
    • breaking down complex problems into smaller steps

If you believe that your child may be experiencing difficulties in the area of math, one step is to determine the root of the difficulty. For example, does the student have an underlying learning disability or reduced self-regulation that may be negatively impacting their progress? Receiving a neuropsychological evaluation could be a useful tool in determining the appropriate supports and services to best help your child. If you are interested in learning more about NESCA’s Neuropsychological Evaluations, email: info@nesca-newton.com or complete our online intake form.

Sources:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5987869/

https://www.understood.org/

https://safespot.org

https://www.additudemag.com/

https://dyslexiafoundation.org/

 

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.

32

Student Involvement in IEPs: Ten Tips to Help Middle School Students Get Started – Part 2

By | NESCA Notes 2021

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

As discussed in my previous blog, federal law requires that students with Individual Education Programs (IEPs) be invited to attend their transition IEP meetings. In Massachusetts, this means that students approaching the age of 14, often 8th graders, should be invited to attend their IEP meetings to start the process of transition planning if this has not already begun. However, many students are not invited to their team meetings until high school, if at all. Additionally, research has indicated that when students do attend team meetings, they have the lowest level of satisfaction about their IEP meeting of any team member and they feel the least comfortable sharing their thoughts and suggestions in the meeting.[i] Nevertheless, studies across the country have shown that students can learn skills to actively participate in their IEP meetings, especially when they are directly taught terminology, roles, and how to participate, and when team members expect student participation.[ii] In the first part of this blog series, I provided five tips for helping students to become involved in their IEP process: Explicitly learn about the IEP document and process; Talk about strengths; Talk about challenges; Complete interest and preference inventories; and, Talk about the student’s goals for after high school. Today, I am adding five more tips aimed at truly helping the student to be an instrumental part of their team meeting. After all, the student’s voice and their vision are the most important aspects of transition planning and special education.

  1. If testing is being discussed, make sure that an adult talks about the testing with the student BEFORE the IEP meeting—The ability to use assessment information to develop goals is one of the most important skills a student needs in order to be an active participant in their transition planning process. This means that students need to have access to, and an understanding of, assessment information just like every other member of the team. Professionals and parents all have the right to access evaluation results ahead of a team meeting and traditionally come to the meeting having read the evaluations, often more than once. Moreover, they have typically seen the same tests or similar tests beforehand and usually already have some sense of the student’s learning profile, strengths, and challenges. When the student has undergone evaluations that will inform IEP development, it is critical for the evaluator or another adult who understands the testing well to sit with the student and explain the findings and recommendations from the evaluations in a developmentally appropriate manner. The student needs to know what areas were evaluated, and to have a general sense of the strengths, challenges, interests, and preferences that were highlighted within the testing, in order to be able to participate in a meaningful discussion about their short- and long-term goals and the services that they need. Moreover, they need to have time to process this information, with support, before they are expected to participate in a discussion about what to do with the information.
  2. Give the student options as to how they would like to participate—Just like any other activity, an IEP meeting can be broken down through a task analysis process, and participation in the IEP meeting can be scaffolded, rather than taking an all or nothing approach. There are many actions and “micro-actions” that a student can take to be involved in their team meeting in a way that feels comfortable and satisfying to the student. Certainly, there are the preparatory activities described in my previous blog (e.g., participating in assessment, learning about the IEP, completing a one-pager, etc.). But there are also administrative tasks that the student can participate in, like photocopying materials or sending out invitations or reminders to participants. Students may also want to prepare a script, PowerPoint, video, work portfolio or other materials they can share with the team during the meeting. Also, they may want to share their experience at the meeting with peers afterward or present highlights of the meeting to a staff member or family member who could not attend. There are many examples of ways to participate before, during, and after the team meeting in this great brochure from the I’m Determined project (https://www.imdetermined.org/wp-content/uploads/2017/10/iep_participation_brochure.pdf). Some students may choose to take a more passive role, but it is important that the student has the opportunity to prepare and to make an informed choice regarding their participation. Over time, students should be building their skills for IEP participation so that they can ultimately lead one or more of their transition IEP meetings (http://www.ciclt.net/ul/mgresa/2.HowtoHelpStudentsLeadIEP.pdf).
  3. Practice!—This tip may seem obvious, but I am taking time to state it because it is often something that is forgotten. Participating in an IEP meeting, especially as the student, is not a normal activity. Sitting in tight quarters with your parents, general educators, special educators, therapists, counselors, and any number of other professionals, who are all talking about you and your challenges is inherently uncomfortable—especially if you have difficulties with language, social cues, anxiety, etc. One way to make the experience “less weird” is to practice. Generally, students will be asked questions about their concerns, strengths, accomplishments, challenges, and goals for the future. It helps to practice answering questions about these areas outside of the IEP meeting and to not be answering these types of questions for the first time in the meeting. An even more useful practice activity is to have a mock IEP meeting. There are plenty of scripts online that follow the typical format of an IEP meeting, such as introductions and attendance, questions and concerns, reports of current performance, transition planning, and IEP development. It is particularly important for the student to be aware of times in the meeting when they will be specifically asked for their contribution (e.g., introductions, student concerns, vision statement, etc.).
  4. Invite preferred staff—Scheduling team meetings is a logistical puzzle, and often not all staff can be present for the whole meeting, if at all. Ask the student who they feel knows them best and who they really want on their team. If you know which teachers are the most motivating for the student, make sure that they are invited. Moreover, when there is a choice related to staff participation, prioritize having the meeting at a time when staff who the student likes and feels comfortable with can be part of the meeting. For student’s who have 1:1 paraprofessional support, it is really important for the paraprofessional to be at the meeting so that the student can have the same level of assistance (and feel the same sense of safety and support) that they do throughout their school day. The student is the most important member of their IEP team, and they will feel most included if they look around the room and see familiar faces of people they know are on their side.
  5. Expect the student to participate!—The  most important thing that adults can do to assist students in participating in their IEP meetings is to make the time and space for the student to participate in the meeting. This may mean requesting a longer meeting than usual so that adults in the meeting can slow down or rephrase language in terms that are accessible for the student and so that the student has time to formulate their thoughts and language in order to participate in the meeting. Whatever accommodations a student needs to participate actively in a classroom discussion should be considered and put in place if they are needed for a student to participate actively in the team meeting discussion. Adults need to be respectful of the student’s voice and to not speak for the student, interrupt the student, talk over the student, or disregard the student’s input. The student’s participation needs to be expected, empowered, and applauded, because, after all, it is their IEP meeting, their education, and their life.

[i] http://www2.ku.edu/~tccop/files/Martins_Perspective.pdf

[ii] http://www2.ku.edu/~tccop/files/Martins_Perspective.pdf

 

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.

1

Growing in a Fog: The Impact of Sleep Loss on Children’s Development

By | NESCA Notes 2020

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

A recent study conducted at the University of Warwick, in the United Kingdom, supported the long-held belief that reduced sleep in children has a significant negative effect on their cognitive and emotional functioning. Findings were recently published in the journal Molecular Psychiatry, in an article, titled “Sleep duration, brain structure, and psychiatric and cognitive problems in children.”

When examining children ages nine to 11, reduced sleep was associated with higher levels of depression, anxiety and impulsive behavior, as well as poorer cognitive performance. Findings showed that, on average, behavior problems were 53% higher in children who got less than seven hours of sleep, compared to those who got nine to 11 hours. Additionally, on average, total cognitive scores were 7.8% lower in the children with reduced sleep.

Negative effects of sleep loss were not only observed through children’s behavior and task performance, but there were table differences within brain structure as well. Shorter sleep duration was related to lower volume in brain structures that are responsible for decision making, learning, emotion regulation, memory, executive function, sensory regulation, language function and spatial perception, among other skills. Because sleep is a highly active process, during which children’s brain circuitry reorganizes, it is thought that sleep loss can interfere with actual physical brain maturation, not just emotional, behavioral and cognitive functioning.

This study conducted by the University of Warwick is not the first to demonstrate how a lack of sleep negatively impacts children’s and adolescent’s functioning. In addition to better emotional and cognitive health, adequate sleep is also related to better physical health, including reduced injuries, heart disease and obesity (www.aap.org).

The American Academy of Pediatrics recommends that preschoolers get 10 to 13 hours of sleep per day; grade school children get 9 to 12 hours of sleep; and teenagers get eight to 10 hours of sleep. While this is so, children are often chronically sleep deprived due to excessive school, social and extracurricular demands. Increasing screen time and access to social media is also problematic, not only because these distract children and teens from sleeping, but technology use interferes with the release of melatonin, reduces REM sleep and activates the wake center of the brain. It is thus not surprising that a 2015 analysis of data from the Youth Risk Behavior Surveys found that approximately 57.8% of middle schoolers and 72.7% percent of high schoolers are not getting enough sleep. In spite of this, school start times remain early, expectations for extracurricular involvement remain high, and blue-light-filled technology is increasingly necessary for the completion of late-night homework assignments. This occurs alongside a steady rise of stress and anxiety within pediatric populations, pointing to the importance of re-evaluating the demands and conditions under which our children are expected to grow and learn.

Sleep is a foundational necessity on which cognition, emotion regulation, attention and learning build. The negative effects of sleep loss can be felt at any age, but they are particularly concerning in childhood, a time when the brain is rapidly developing. The American Academy of Pediatrics has provided some tips on how to support healthy sleep in a child of any age. These can be accessed at www.healthychildren.org, at the below link.

References

University of Warwick. (2020, February 4). Children’s mental health is affected by sleep duration. Retrieved on February 24, 2020 from www.sciencedaily.com/releases/2020/02/200204094726.htm

Wheaton AG, Jones SE, Cooper AC, Croft JB 2018, ‘Short Sleep Duration Among Middle School and High School Students — United States, 2015’, MMWR Morb Mortal Wkly Rep., vol. 67, pp. 85–90.

American Academy of Pediatrics (2016). American Academy of Pediatrics Supports Childhood Sleep Guidelines, June 13, 2016. Retrieved on February 24, 2020 from https://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/American-Academy-of-Pediatrics-Supports-Childhood-Sleep-Guidelines.aspx

American Academy of Pediatrics (2018). Healthy Sleep Habits: How Many Hours Does Your Child Need? Retrieved on February 24, 2020 from https://www.healthychildren.org/English/healthy-living/sleep/Pages/Healthy-Sleep-Habits-How-Many-Hours-Does-Your-Child-Need.aspx

 

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.

23

Executive Function Skills in the Outdoors

By | NESCA Notes 2021

By Renée Marchant, Psy.D.
Pediatric Neuropsychologist

Executive functioning skills are a “family” of skills that operate in a “top-down” process, controlling and regulating brain regions associated with attention, impulse control, emotion regulation, and meta-cognition or “thinking about thinking.” For more information about executive function skills, please refer to my previous NESCA blog “Teenage Stress and Executive Functioning.” As an evaluator, I often emphasize two key points about executive function skills: (1) Developing executive function skills is a combination of brain development and life experience; and (2) These skills are built through interactions (with others and our world) and practice.

Now with more access to New England summer weather, there are plenty of opportunities for children and teens to grow executive function skills in interaction with the natural world. I recommend a “must-download” if you want to review practical, science-based activities and games for children from the ages of six months old through adolescence, “Enhancing and Practicing Executive Function Skills with Children from Infancy to Adolescence.” This is a wonderful resource that provides a clear list and description of practical activities to strengthen executive function skills based on a child’s age. This resource was developed by The Center on the Developing Child at Harvard University, a multidisciplinary team supporting research, policy, and practice for childhood development. Their website also provides excellent free resources for parents, clinicians, and educators related to topics such as stress, resiliency, play, and brain structure/development.

Here is a short list of outdoor summer executive function activities based on your child’s developmental age:

  1. 6-18 months-old: Peekaboo and Patty-Cake on the grass and other textures, such as dirt, mud, water, or wood (a multi-sensory experience), encourage joint attention and object focus by naming, pointing, and sustaining focus on natural objects at the beach or in the woods.
  2. 18-36 months-old: Match/sort natural objects, such as placing rocks in one bucket and flowers in another bucket, blow bubbles with a variety of wand shapes, pretend play as fishermen, construction workers, or farmers/gardeners.
  3. 3-5 years-old: Pretend to be an outdoor superhero in an obstacle course or race (e.g., running through Hula Hoops or around traffic cones), assist with cooking/preparing an outdoor picnic, or make a nature bracelet.
  4. 5-7 years-old: Play the I-Spy game and participate in scavenger hunts, use strategy board games (e.g., Uno, Concentration) on land or maybe even in the water, go on a sensory walk (name something you see, hear, smell, taste, and touch).
  5. 7-12 years-old: Star-gaze and find/name constellations, create a bird house or other wood structure through woodworking activities, garden one or more plants, play with a super soaker toy or laser/flashlight tag.
  6. Adolescents: Maintain a summer sketching and drawing journal of natural objects, participate in sunrise or sunset yoga or dance classes, outdoor animal-assistant yoga (e.g., Goat Yoga), or sports-oriented camps and activities.

 

About the Author:

Dr. Renée Marchant provides neuropsychological and psychological (projective) assessments for youth who present with a variety of complex, inter-related needs, with a particular emphasis on identifying co-occurring neurodevelopmental and psychiatric challenges. She specializes in the evaluation of developmental disabilities including autism spectrum disorder and social-emotional difficulties stemming from mood, anxiety, attachment and trauma-related diagnoses. She often assesses children who have “unique learning styles” that can underlie deficits in problem-solving, emotion regulation, social skills and self-esteem.

Dr. Marchant’s assessments prioritize the “whole picture,” particularly how systemic factors, such as culture, family life, school climate and broader systems impact diagnoses and treatment needs. She frequently observes children at school and participates in IEP meetings.

Dr. Marchant brings a wealth of clinical experience to her evaluations. In addition to her expertise in assessment, she has extensive experience providing evidence-based therapy to children in individual (TF-CBT, insight-oriented), group (DBT) and family (solution-focused, structural) modalities. Her school, home and treatment recommendations integrate practice-informed interventions that are tailored to the child’s unique needs.

Dr. Marchant received her B.A. from Boston College with a major in Clinical Psychology and her Psy.D. from William James College in Massachusetts. She completed her internship at the University of Utah’s Neuropsychiatric Institute and her postdoctoral fellowship at Cambridge Health Alliance, a Harvard Medical School teaching hospital, where she deepened her expertise in providing therapy and conducting assessments for children with neurodevelopmental disorders as well as youth who present with high-risk behaviors (e.g. psychosis, self-injury, aggression, suicidal ideation).

Dr. Marchant provides workshops and consultations to parents, school personnel and treatment professionals on ways to cultivate resilience and self-efficacy in the face of adversity, trauma, interpersonal violence and bullying. She is an expert on the interpretation of the Rorschach Inkblot Test and provides teaching and supervision on the usefulness of projective/performance-based measures in assessment. Dr. Marchant is also a member of the American Family Therapy Academy (AFTA) and continues to conduct research on the effectiveness of family therapy for high-risk, hospitalized patients.

 

To book an evaluation with Dr. Marchant 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, 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.

 

32

Student Involvement in IEPs: Ten Tips to Help Middle School Students Get Started – Part 1

By | NESCA Notes 2021

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

Federal law requires that students with Individual Education Programs (IEPs) be invited to attend their transition IEP meetings. In Massachusetts, this means that students approaching the age of 14, often 8th graders, should be invited to attend their IEP meetings to start the process of transition planning if this has not already begun. For many, the idea of a middle school student attending an IEP meeting, an activity that can often be intimidating and upsetting for parents, can initially be overwhelming. And historically research has indicated that when students do attend team meetings, they have the lowest level of satisfaction about their IEP meeting of any team member and they feel the least comfortable sharing their thoughts and suggestions in the meeting.[i] However, research across the country has also shown that students can learn skills to actively participate in their IEP meetings, especially when they are directly taught terminology, roles, and how to participate, and when team members expect student participation.[ii] Student participation in IEPs is not only important because it is federally mandated, it is also essential because the IEP is supposed to be based on the student’s strengths, interests, preferences, and needs as well as the student’s post-high school goals—and because it’s the student’s life! For those reasons, I am choosing to focus this blog (and some future blogs) on tips for helping middle school students to become involved in their IEP processes.

  1. Explicitly learn about the IEP document and process—There are clear rules and vocabulary used to govern the IEP process. However, these are wholly unfamiliar and strange to anyone who has not participated in the process before (and even perplexing for those of us who have a lot of experience at team meetings). Therefore, one of the most critical ways to prepare a student to attend transition IEP meetings and to be a self-directed member of their IEP team is to equip them with knowledge of the vocabulary and rules that govern the process. One organization that has created useful materials for helping to teach students about the IEP process is imdetermined.org which has documents designed to assist students in understanding the IEP (https://imdetermined.org/resource/understanding-my-iep-differentiated/) and preparing for the IEP (https://imdetermined.org/resource/understanding-my-iep-differentiated/), but it may also be important to reference and simplify certain sections of the IEP Process Guide (https://www.doe.mass.edu/sped/iep/proguide.pdf). If students are not ready to review their entire IEP (which many students are not), it may be helpful just to think about the present levels of performance, strengths, or accommodations.
  2. Talk about strengths—While it’s critical that students be able to talk about their strengths and challenges, sometimes it’s easiest to start with strengths. People can have all kinds of strengths, such as character strengths, social strengths, language strengths, academic strengths, technical strengths, extracurricular strengths, and more. For kids who have a hard time with open-ended questions, there are checklists that can be found or completed online, such as character strengths inventories, transferable skills checklists, and strengths worksheets. There are also activities that can be useful for documenting strengths over time, such as this Strengths Chain activity (https://www.understood.org/articles/en/strengths-chain-for-kids), keeping a running list or journal of strengths and accomplishments, or building a deck of strength cards. All students need help learning to describe their strengths, especially the first time. Some students may have a hard time identifying the strengths they see in themselves, but may have an easy time sharing what other people say about them or compliment them on. Talking about strengths is not a one-time activity. Make sure that you are talking about and referring to the student’s strengths often while also highlighting how various members of the household or students in the class have different strengths and skills.
  3. Talk about challenges!—While transition planning is a strengths-based process, an IEP is based on a student needing specialized instruction and related services because the student has a disability and would struggle to make effective progress in school or the general education curriculum without special education. If we are going to ask students to be actively involved in a process of goal-setting based principally on their having a disability and related challenges, it is critical that the student has the opportunity to talk about what is hard for them and what they want to get better at… in their own words. At the same time, it is important to normalize the fact that all people have challenges, learn different information at different rates, and need help (and tools) to function successfully. Ultimately, being able to use a diagnostic label and understand the impact of a diagnosis on functioning is important, but what is more important is being able to describe what is hard on a daily basis and what makes those difficult activities easier. For some students, it is helpful to read a book or watch a television show or movie with characters who face similar struggles and to label similarities between the youth and the character. Some of the same checklists mentioned for documenting strengths can be helpful for identifying areas of challenge or undeveloped skills. It may also be helpful to start filling in a worksheet similar to this one-pager (https://imdetermined.org/resource/one-pager/) or this self-awareness worksheet (https://www.understood.org/articles/en/download-self-awareness-worksheet-for-kids). Just as with strengths, it is important to talk about and refer to specific challenges that each person in the household or class faces.
  4.  Complete interest and preference inventories—Learning to engage in self-assessments and talk about those self-assessments is an important part of transition planning and IEP participation. There are so many fun interest and personality quizzes online that can be taken in minutes. Some examples include these personality tests from National Geographic Kids (https://kids.nationalgeographic.com/games/personality-quizzes), this free personality type explorer (https://www.16personalities.com/free-personality-test), or even the O*Net Career Interest Profiler (https://www.mynextmove.org/explore/ip). Have the student take the test—and take these tests yourself—and talk about how your results are similar or different and how well the student thinks the results of the assessment capture them. Think about whether there are strengths or challenges to add to their running lists or worksheets based on their experience taking these inventories.
  5. Talk about the student’s goals for after high school—Students have the right to input as much as possible into their postsecondary vision statement, no matter how realistic or unrealistic their input is. The only way that they can be prepared to provide input at a team meeting is if they have spent some time thinking and talking about their post-high school goals and learning about their choices and options. Just recently, my colleague Becki Lauzon wrote a blog with important discussion points for talking about post-high school goals with students, which can be found here. A robust transition planning process should include helping a student to have detailed goals for their future education or training, employment, independent living, and community engagement; however, initial discussions might just include ruling in or out things like obtaining a high school diploma, continuing learning after high school, having a paid job, driving a car, and living with other people. In middle school, the goal of talking with a student about their postsecondary vision is just to help the student learn to comfortably engage in those discussions and to find out where future work needs to be done in order to help the student build a more complete picture of their adult postsecondary life.

Every student is different and is able to engage in the process in different ways and at different times, but I hope that there is at least one tip in these blogs that is useful for you. Next month, I will be writing a second blog with more tips for engaging middle school students in the IEP process.

If you are interested in having your child work with Kelley Challen or another NESCA transition specialist to plan and prepare to be part of their IEP meeting, please fill out an intake for our transition consultation and planning services or our student coaching services today!

[i] http://www2.ku.edu/~tccop/files/Martins_Perspective.pdf

[ii] http://www2.ku.edu/~tccop/files/Martins_Perspective.pdf

 

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.

14

Summer is Here, but There are Still Chores to Do – The Importance of Chores in a Child’s Development

By | NESCA Notes 2021

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

What a year it’s been! Hopefully with the pandemic restrictions lifted and the start of summer, we are all breathing a sigh of relief. I’m certainly looking forward to traveling, seeing relatives and getting out without masks. The pandemic upturned our lives in so many ways, but now that there is a “sense of normalcy” returning, we may be tempted to kick back and really relax this summer. However, I would caution that in kicking back and relaxing, there are still chores that need to be done. So, why not include your children in taking ownership and helping out around the house? There is research that states that toddlers who are taught to “help out” around the house continue to help out as they age. Many children in indigenous communities grow up asking to help or just help out because it is needed. Wouldn’t it be nice if that were the case in the United States?

Jim Fay, co-founder of the Love and Logic parenting website, says that all of us need to feel needed and know we are making a contribution to those around us or to our world at large – even kids. In many families, chores are a tradition, but in others they have fallen by the wayside. Many upper and middle class families have hired household help, so the need to do chores isn’t as great, and fighting with children to do chores doesn’t seem worth it. Let’s face it, no one likes to do chores, but they have to get done. Psychologist Roger McIntire, author of Raising Good Kids in Tough Times, says, “A child has to have some responsibilities.” The family is a community, and everyone should chip in and help out. Helping out with family responsibilities and doing one’s own personal responsibilities are useful and necessary skills for a child’s development. The American Academy of Child and Adolescent Psychiatry states that, “there are benefits to including chores in a child’s routine as early as age 3. Children who do chores may exhibit higher self-esteem, be more responsible, and be better equipped to deal with frustration, adversity, and delayed gratification. These skills can lead to greater success in school, work, and relationships.” Research also shows that children who grow up contributing to the family responsibilities grow up to be adults who work well in collaborative groups and have a “can-do” attitude.

Helping kids learn that they have to do chores and that they are a part of life teaches them that it’s not just about me and what I need at this moment, but that I’m part of a system. I’m part of a family (I set the table). I’m part of my class at school (I clean up after an art project). I’m part of my sports team (I carry the bat/ball bag). I’m part of the workplace (I do my part). Humans crave a sense of belonging and connection, and helping others out and doing work for the good of the whole helps us understand why connection is important. The more we can do to foster this in our kids, the better off they will be as adults. Chores are a form of selflessness and help children develop a sense of responsibility and awareness of the needs of others. They begin to recognize that when they pick up, they can find their toys and they are grateful for the small things. Parents show gratitude when children do chores. Praise is good! Children feel appreciated and connected, and gratitude helps wire our brains to notice more things to feel thankful for, leading us to feel better overall.

Chores are powerful teachers. They help a child develop a greater sense of responsibility and awareness of the needs of others, and they also contribute to a child’s social and emotional well-being. Chores help children believe that they are competent and capable and help them develop greater self-esteem. Doing chores can also help children learn problem solving skills as well as the consequences of not doing their chores (i.e., not putting your baseball shirt in the laundry so it’s dirty for the next game). Chores are an excellent teacher of life skills. Knowing how to set the table, walk the dog, pick up toys, do laundry, prepare a meal, sweep/vacuum the floor, change a vacuum cleaner bag, etc., all help prepare a child for the responsibilities of adulthood. More involved tasks (i.e., cleaning out the garage) can be used in the development a child’s executive functioning skills, prompting them (perhaps with parent assistance) to figure out how to tackle the task in the most efficient, most systematic manner. And they learn about solutions that may be applied to a host of other life responsibilities.

Being a part of a family and taking responsibility for oneself and contributing to the family by doing chores is a powerful gift to give to children, even if they may not do the chores perfectly, may need to be reminded to do them, or grumble while they are doing them. It’s okay. Over time, these will lessen. Stay with it and help your child recognize and understand that life is work, and they have to be a part of the work of life.

If you aren’t having your child do chores now, consider it while the summer is here. It will help them out in many ways in the long run, helping them to be better functioning and more capable adults. If you need help figuring out which chores are age-appropriate, there are many lists online offering ideas and ways to assist in helping children do chores without too much complaining!

References

https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Chores_and_Children-125.aspx

https://www.loveandlogic.com

https://www.nytimes.com/2018/08/18/opinion/sunday/children-chores-parenting.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.

 

Skip to content