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

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9

Approaching 2021 with Ease and Grace

By | NESCA Notes 2021

By Dot Lucci, M.Ed., CAGS

Director of Consultation and Psychoeducational Services, NESCA

I think we are all relieved that 2020 is behind us. All of us experienced a “mental health crisis” of some level of anxiety, depression and fear since March, 2020. As the pandemic spread across our globe, ravaged our lives, took loved ones from us, created economic upheaval, food insecurity and amplified the technological discrepancies that existed within our communities, we adapted and survived…we had to. And the Black Lives Matter movement gained strength also because it had to. From the crisis came opportunity.

Hopefully we learned something about ourselves and each other both across the globe and within our small circles. Now we know the unfathomable and unexpected can and does happen, and it upends our lives like we never expected. What we once thought was important doesn’t seem as important any more. Hopefully, as the months passed in 2020, we settled into the “new normal” and began to develop rhythms and beliefs that sustained us and fed our souls. Let’s hope that we developed a sense of what is truly important and can approach 2021 with new-found hope, resiliency, ease and grace. Approach 2021 by cultivating and remembering the bright spots of this past year, the surprises or treasures of 2020. They may help you think more clearly about 2021.

At the start of a new year, many people make New Year’s resolutions that are long-term goals. Some people manage to keep their resolutions while others aren’t able to sustain the motivation and commitment. Given this past year, it may be difficult to think about resolutions or even conceptualize what the future will look like. Even with vaccines on the horizon, our brains are not ready for long-term planning as our futures may still be a bit unclear. We can hope for a “return to normal,” but what will that “normal” look like?

There is still an uncertainty of what the future holds, so my thinking is to keep it simple. As we start 2021, remember what’s important. If you chose to make New Year’s resolutions, keep them manageable and small. Hopefully what you learned in 2020 can guide your thinking in 2021. Some everyday ideas might be to be kind and gentle with oneself and others. Don’t sweat the small stuff; most of it is small stuff. Smile and laugh every day. Promise yourself to go outside every day and breathe fresh air, be amazed at the glistening snow, the warmth of the sun, the flight of a bird. Take a walk. Three times a day, focus on your breath for at least three minutes. Before going to sleep, think of something to be thankful and grateful for. 2021 can be a year of hope, wonder and faith in a “newer normal” that will emerge, where each of us is responsible for creating a better day, world and a normal that may be even better than the normal of the past.

To everyone, peace, good health and Happy New Year!

 

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.

 

5

I Can Tell You a Story…I Just Can’t Write It

By | NESCA Notes 2020

By: Alissa Talamo, PhD
Pediatric Neuropsychologist, NESCA

According to understood.org, “Written expression disorder is a learning disability that results in a person having trouble expressing their thoughts in writing… They might have the greatest ideas, but their writing is disorganized and full of grammar and punctuation mistakes.” Experts believe that between 8 and 15 percent of people have a written expression disorder and it often co-occurs with other learning challenges, with two of the most common being dyslexia and attention-deficit/hyperactivity disorder (AD/HD).

Writing is difficult because it depends upon many separate components that need to be integrated into a complex whole. For example, to write well, a person needs to have acquired knowledge about the topic, retrieve needed vocabulary and express the information in a way that can be followed by the reader. At the same time, the writer needs to be able to self-monitor their progress, including switching between the main idea and writing mechanics, such as spelling, punctuation and grammar. People with written expression disorder might be able to tell an organized and interesting story, but struggle when asked to recreate that information in written form. Receiving a formal diagnosis can help a child receive extra help at school or even specialized instruction. Also, a diagnosis can possibly lead to accommodations at college.

There are also several methods of instruction that can help a student organize their writing. These programs help a student visualize or represent abstract ideas by using visually-based templates. While many of these methods are copyrighted and cannot be reproduced in this blog, some examples are programs such as Thinking maps by David Hyerle, Ed.D. or “Brain Frames.” These programs have developed specific graphic organizers to help a student with a variety of writing assignments (e.g., comparing and contrasting, ordering and sequencing) and provide specialized instruction that can help a student greatly improve their ability to express their ideas in writing.

If you believe that your child may be experiencing difficulties in the area of writing, 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.

Sources:

https://www.understood.org/en/learning-thinking-differences

http://www.ldonline.org/article/33079/

http://www.thinkingmaps.com

http://www.architectsforlearning.com

 

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.

19

Transition Assessment: What is it anyway? How is it different from neuropsychological evaluation?

By | NESCA Notes 2020

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

If you have a child who receives special education services or work in education, you are likely familiar with the Individuals with Disabilities Education Improvement Act of 2004 (IDEA 2004). This is the law that guarantees students with disabilities the right to free appropriate public education (FAPE) and that dictates that the purpose of special education and related services is to prepare students with disabilities for further education, employment, and independent living.

IDEA 2004 mandates that students have measurable postsecondary goals written in their individualized educational programs (IEPs), that describe the outcomes that a team expects for the student to achieve after exiting public education and that these goals must be “based upon age-appropriate transition assessments related to training, education, employment, and where appropriate, independent living skills.”[1] But, IDEA 2004 does not specifically define transition assessment.

Instead, the best and most commonly accepted definition for transition assessment comes from the Division on Career Development and Transition (DCDT). DCDT defines transition assessment as an “…ongoing process of collecting data on the individual’s needs, preferences, and interests as they relate to the demands of current and future working, educational, living, and personal and social environments.”[2]

Transition assessment can include formal testing, such as a standardized, published tests that compare students to others by age or grade or informal activities, such as interviewing or observing a student. Most students who are transition-aged (i.e., 14 or older in Massachusetts; 16 by federal law) have already had some assessments that will inform their transition planning, such as school evaluations, private evaluations, standardized academic testing, report cards, or even activities that happen within their guidance curriculum (e.g., assessment of strengths, learning style, personality type, career interests). But often, there will still be some testing needed to help better determine a student’s strengths and aptitudes, their preferences and interests for postsecondary adult life, and the gaps between their current knowledge and abilities and the requirements of the living, learning, and working environments in which they plan to function when they exit high school.

At NESCA, transition assessment is a highly individualized process that is designed to get a better sense of a student’s postsecondary living, learning, social, and vocational goals, to determine the strengths the student has that will help them reach those goals as well as the skills a student needs to develop to get there. While it is rare for two students to have the same assessment battery, transition assessment at NESCA often evaluates abilities, such as self-care, self-direction, self-advocacy, career interests, career aptitudes, communication, community use, functional academics, health and safety, domestic skills, leisure, readiness for college or other forms of postsecondary learning and training, transferrable work skills and readiness for employment. Once the student’s profile is understood, specific recommendations, aimed at readying that student for transition from high school to the next phase of life, are provided.

Often parents of transition-aged students are familiar with the term “neuropsychological evaluation“ and a student may have even had this type of private evaluation. But there can be some confusion regarding the difference between these two types of comprehensive testing. Neuropsychological evaluation focuses primarily on a student’s learning profile and the fit of that learner within their current academic setting. A good neuropsychological evaluation is a comprehensive assessment of a child’s functioning in many domains, including communication, visual-spatial ability, problem solving, memory, attention, social skills, and emotional status. The assessment of these functions is based upon information obtained from the child’s history, clinical observations, and testing results. Moreover, one of the most important aspects of a neuropsychological evaluation is the integration of all the information about a child into a meaningful profile of functioning that describes “The Whole Child.”

In contrast, a transition assessment evaluates the fit between a student and their future preferred learning, living, and employment activities and environments. While information from a neuropsychological evaluation about a student’s learning profile is greatly informative, a transition assessment gives equal weight to a student’s daily living skills, social skills, coping skills, pre-vocational skills, career interests and preferences, and self-advocacy skills. While transition assessments provide detailed recommendations related to current educational programming and transition services, a strong focus of transition assessment is an emphasis on what will be needed now, and in the near future, to assist a student in functioning, and, actually being successful and satisfied, in their postsecondary adult life.

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

[1] 34 CFR § 300.320(b)

[2] Division on Career Development and Transition (DCDT) of the Council for Exceptional Children, 1997, p. 70-71

 

 

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. 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 or call 617-658-9800.

5

The Holiday Blues Coupled with Covid

By | NESCA Notes 2020

By: Angela Currie, Ph.D.
Pediatric Neuropsychologist, NH Director, NESCA

The holidays can be a time of great joy, but they can also be a time of great stress. Celebrations and merriment can be contrasted with pressure to amaze, long to-do lists, financial constraints or reminders of those we have lost. For many, it is a time of mixed emotions or strong internal conflict about why they cannot feel happy during a season that practically dictates it.

Holiday blues have been felt my many people for a long time, but now during a global pandemic, those feelings may be amplified and more prevalent than previous years. Families are trying to provide children with a positive holiday experience during a time of high stress and significant restriction. Family gatherings and holiday traditions are being cancelled, and many families are mourning the loss of loved ones. Adults are not the only ones feeling increased stress as we enter the holiday season. Children likely feel excited about the holiday but sad about not seeing family, not having holiday parties in school, and not being able to attend their traditional holiday events. This holiday season is simply different in ways that can bring great strain.

So, what can we do as adults to emotionally support children this holiday season? Do we allow them to observe our stress or do we keep it to ourselves in an effort to provide them with the happy holiday season that they deserve?

In June 2018, I wrote a blog post titled: “The Struggle is Not only Real, It is Necessary,” which discusses the importance of embracing uncomfortable, unwanted emotions as being necessary for personal growth and resiliency. By acknowledging, accepting and using unwanted feelings in a functional manner, we teach children to be competent and confident in their ability to navigate a stressful world. Of course, when I wrote the article, I could not have imagined the extent or duration of stress or discomfort that we would be facing in 2020. But does that change anything?

To put it simply, no, not really. Entering into the holidays with the expectation that we can protect our children from life’s stress is unrealistic. Attempting to do so will only add pressure while ignoring the mixed emotions that children are likely feeling as well. During this emotionally high-stakes time, acceptance of the struggles we face is even more critical. Adults and children both need “permission” to feel sad, frustrated, lonely or scared while also still allowing themselves to feel excited, thankful, and, yes, even joyful.

Here are some suggestions for how to help your family navigate the holiday blues this unique holiday season:

  • Talk about your feelings – wanted and unwanted ones – throughout the day, modeling and encouraging regular emotional discourse (e.g. “I love giving gifts, but getting all the shopping done is kind of stressful.”).
  • Help children label and interpret the emotions they may be having, as they may not have the right words or language for expressing them (e.g. “It sounds like you’re really disappointed we can’t go to Grandma’s house.”).
  • Be careful to not accidentally dismiss children’s feelings (e.g. “No need to be sad; we will find another fun way to celebrate.”), instead reflecting their emotion (e.g. “I know you’re sad that we can’t have a holiday party; I am, too.”).
  • Normalize the experience of mixed emotions (e.g. It’s okay to be excited for children while also feeling sad that we won’t see our family.).
  • Find new, safe holiday activities or events (e.g. holiday light drive, virtual gift exchange, etc.) and adapt previous traditions when able (e.g. virtual family gatherings).
  • Don’t romanticize the traditions that were lost this year (e.g. avoid such things as, “Our parties were always the most magical part of the holiday.”).
  • Help children understand new holiday plans as an opportunity to “celebrate” or “experience” the holiday, but be careful to not impose emotional expectations (e.g. “Enjoy the holidays!”) that can add pressure.
  • Reassure children that these changes are temporary, and traditions and visits will continue when it is safe to do so.

 

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.

9

Transition Planning for Adulthood—It Starts at Birth

By | NESCA Notes 2019

 

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

There are many transitions throughout a person’s life, but as a transition specialist working at a pediatric neuropsychology practice, my focus is most often on helping students who have struggled with learning, social and/or emotional difficulties to plan for and successfully navigate the transition from secondary school to whatever comes next in life (e.g., employment, transition program, community college, apprenticeship, etc.). I focus on helping young people envision their future selves and set short- and long-term goals for themselves—putting them into the driver’s seat for their own lives and helping them manage the risks and responsibilities that come with making choices for themselves.

When a family walks into my office for the first time, it is common for one parent or caretaker to worry aloud that they are starting transition planning for their child “too late.” I consistently respond that it is never too late to start planning and to begin transferring responsibility from one generation to the next. But today, I also want to emphasize that “it’s never too early” to start to plan for your child to be a more independent and competent adult—the best transition planning starts at birth.

Some common examples of transitions that start at a very early age that many parents and caregivers can relate to are: a child sleeping through the night for the first time unsupported, holding a cup and drinking without spilling, feeding oneself with a spoon, and/or riding a bicycle. Each of these activities is an example of a child building competence and independence while their parents simultaneously relinquish some amount of control. Often times, mistakes, messes and even pain are a natural part of the process.

From a young age, there are many skills that children can learn that will make a big difference for them later in life. Some examples include:

  • Picking out clothes for the next morning
  • Putting dirty clothes in a hamper
  • Loading the washing machine
  • Putting clean clothes away in drawers
  • Washing hands before eating, after using the bathroom and after playing outside
  • Setting the table (maybe not plates or glasses, but perhaps napkins, forks and spoons)
  • Carrying dishes to the counter and placing them next to the sink after dinner—or even in the dishwasher
  • Putting their own garbage in the trash
  • Collecting small trash bins to dump into a larger bin/bag on trash day
  • Helping to pack their own lunch
  • Helping to prep a meal (e.g., washing veggies, pouring ingredients, etc.)
  • Getting condiments from the refrigerator and putting them away after dinner
  • Getting a snack for self or a sibling from the refrigerator or pantry
  • Wiping down the table after a meal
  • Feeding/providing water for pets
  • Weeding
  • Raking leaves
  • Shoveling snow
  • Helping to get the mail
  • Brainstorming for/making a shopping list
  • Finding assigned items at the grocery store
  • Carrying light grocery bags
  • Helping to pack belongings for a family trip
  • Making gifts/cards for a celebration
  • Budgeting a few dollars to buy inexpensive but thoughtful gifts for family members

Some of these will apply to your child and some of them will not. And some of these may require adding time to your schedule, allowing a child to complete tasks at their own pace, or doing some household reorganization, allowing a child to access items necessary to complete tasks. Finally, a lot of deep breathing and patience—for both you and your child—will be required!

At any point in time, you can identify a task  you regularly do for your child and consider where there are pieces they can do for themselves. If your only role in the task is to prompt your child, consider whether there might be a low-technology tool (post-it, photograph) or high-technology tool (alarm, phone reminder) that could take the place of your prompt. If you are not sure how to make a change, it may be a good time to get help from a teacher, pediatrician, behavioral therapist, special educator, etc.

The important thing is that you are starting to think about where there is a potential for increasing competence, independence, confidence and self-esteem for your child. You are starting to plan for your own obsolescence in your child’s life, or at least in their carrying out every day self-care activities and chores. While that is a scary thing, it is also a beautiful and empowering thing!

*This blog was originally published in August, 2019.

 

If you are interested in working with a transition specialist at NESCA for consultation, 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 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 seven and eleven. 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 or call 617-658-9800.

 

2

Early Detection of Autism: NESCA’s New ASD Diagnostic Clinic

By | NESCA Notes 2020

By: Erin Gibbons, Ph.D.
Pediatric Neuropsychologist, NESCA

Children with autism spectrum disorder (ASD) vary widely in terms of the intensity of their symptoms as well as the age at which symptoms emerge. In some cases, signs of autism are apparent during infancy. For other children, concerns about autism might not arise until toddlerhood or even early childhood.

As neuropsychologists, we have become increasingly adept at detecting and diagnosing ASD using a combination of developmental history, clinical observation and standardized assessments. We are constantly learning more about ASD and fine-tuning the tools we have available to us to make a diagnosis.

One of the most important things we have learned through longitudinal research over the past 10 years is that early detection of ASD is a crucial part of a child’s prognosis. Young children who receive intensive services are much more likely to develop language, play and social skills. Because their brains are still in a state of rapid development, they are much quicker to acquire new skills and make progress in the areas where they are struggling. Children who receive early intervention for ASD are typically better able to participate in inclusion settings with same-age peers once they enter elementary school.

Unfortunately, many parents are told to “wait and see” when they express concerns about their child’s development – especially with children who are not yet in preschool. This is a risky and sometimes harmful approach as it leads to children with developmental disabilities not receiving the services they need.

In light of our understanding about the importance of early detection of ASD, NESCA is proud to introduce its ASD Diagnostic Clinic. The clinic offers testing that is targeted specifically at identifying ASD in children between the ages of 2 and 5. For children who do receive a diagnosis of ASD, the report will allow parents to start accessing services immediately. As with all of our families, we hope to establish a lifelong relationship and will be available for follow-up consults and additional evaluations at any time.

 

About the Author: 

Erin Gibbons, Ph.D. is a pediatric neuropsychologist with expertise in neurodevelopmental and neuropsychological assessment of infants,

children, and adolescents presenting with developmental disabilities including autism spectrum disorders, Down syndrome, intellectual disabilities, learning disabilities, and attention deficit disorders. She has a particular interest in assessing students with complex medical histories and/or neurological impairments, including those who are cognitively delayed, nonverbal, or physically disabled. Dr. Gibbons joined NESCA in 2011 after completing a two-year post-doctoral fellowship in the Developmental Medicine Center at Boston Children’s Hospital. She particularly enjoys working with young children, especially those who are transitioning from Early Intervention into preschool. Having been trained in administration of the Autism Diagnostic Observation Schedule (ADOS), Dr. Gibbons has experience diagnosing autism spectrum disorders in children aged 12 months and above.

 

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

 

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

21

Key Facts about Early Diagnosis of Autism Spectrum Disorder (ASD)

By | NESCA Notes 2020

By Renée Marchant, Psy.D.
Pediatric Neuropsychologist

Early diagnosis is a catalyst for propelling children on positive trajectories. If a family and child identify and focus on areas of growth earlier rather than later, there is more time and more possibility of change and improvement. This tenant is particularly critical for diagnosing ASD in toddlerhood and early childhood.

Here are critical facts about the diagnosis of ASD in early childhood and the positive impact of early diagnosis on youngsters as they age into adulthood.

  1. Most children with ASD are not diagnosed until approximately 4 years-old, yet ASD can be reliably identified by the age of 2. There is also expanding research on early identification of infants who may be at risk for ASD. Early detection is possible.
  2. Genes play an important role in ASD. A child’s odds of having an ASD diagnosis increases if he/she has a sibling or parent with ASD, attention deficit hyperactivity disorder (ADHD), intellectual disability, schizophrenia, depression, bipolar disorder or anxiety. Family medical history is an important factor for families considering a diagnostic evaluation.
  3. Co-occurring disorders (such as anxiety and depression) are more likely in individuals with ASD than the general population. Identifying emotion regulation issues in early childhood is thus essential.
  4. Neuroplasticity matters. Because ASD is a neurodevelopmental disorder, early treatment improves neuroplastic brain functioning and subsequent behavior. As a child develops, his/her brain becomes less plastic.
  5. Interventions geared at a child’s “first relationships” with their caregivers may exert a strong positive effect on the developmental trajectories of toddlers at high-risk of ASD and also have a positive impact on a child’s social skills with peers as they age.
  6. Research indicates that parent-child interactions in early childhood predict long-term gains in language skills into adulthood for individuals with diagnoses of ASD. Acquiring communicative, pragmatic and useful language by kindergarten has also been identified as a strong predictor of adaptive or functional “real life” skills, which are needed to navigate the environment in adolescence and adulthood.
  7. Social skills instruction in a child’s early years increases competency with peers in school. This social competency is associated with greater adaptive independence in children with ASD.
  8. Working with a “diagnostic navigator” early in your child’s life improves outcomes. Research clearly indicates that social support is vital to relieve stress associated with caregiving for a child with ASD and that a positive parent–professional relationship is helpful in alleviating family stress.

If you suspect your child has or is at higher risk for ASD and you are looking for a “diagnostic navigator” for your child, consider an evaluation with NESCA.  While early diagnosis of ASD can make a positive impact on a child’s trajectory, obtaining the accurate diagnosis and recommendations for interventions at any age is critical.

 

References:

Elder JH, Kreider CM, Brasher SN, Ansell M. Clinical impact of early diagnosis of autism on the prognosis and parent-child relationships. Psychol Res Behav Manag. 2017;10:283-292. Published 2017 Aug 24. doi:10.2147/PRBM.S117499.

Dawson G, Jones EJ, Merkle K, Venema K, Lowy R, Faja S, Kamara D, Murias M, Greenson J, Winter J, Smith M, Rogers SJ, Webb SJ. Early behavioral intervention is associated with normalized brain activity in young children with autism. J Am Acad Child Adolesc Psychiatry. 2012 Nov;51(11):1150-9. doi: 10.1016/j.jaac.2012.08.018. PMID: 23101741; PMCID: PMC3607427.

Jokiranta-Olkoniemi E, Cheslack-Postava K, Sucksdorff D, Suominen A, Gyllenberg D, Chudal R, Leivonen S, Gissler M, Brown AS, Sourander A. Risk of Psychiatric and Neurodevelopmental Disorders Among Siblings of Probands With Autism Spectrum Disorders. JAMA Psychiatry. 2016 Jun 1;73(6):622-9. doi: 10.1001/jamapsychiatry.2016.0495. PMID: 27145529.

Kasari C, Siller M, Huynh LN, Shih W, Swanson M, Hellemann GS, Sugar CA. Randomized controlled trial of parental responsiveness intervention for toddlers at high risk for autism. Infant Behav Dev. 2014 Nov;37(4):711-21. doi: 10.1016/j.infbeh.2014.08.007. Epub 2014 Sep 26. PMID: 25260191; PMCID: PMC4355997.

Mayo, J., Chlebowski, C., Fein, D.A. et al. Age of First Words Predicts Cognitive Ability and Adaptive Skills in Children with ASD. J Autism Dev Disord 43, 253–264 (2013). https://doi.org/10.1007/s10803-012-1558-0.

Siller, M., Swanson, M., Gerber, A., Hutman, T., & Sigman, M. (2014). A parent-mediated intervention that targets responsive parental behaviors increases attachment behaviors in children with ASD: results from a randomized clinical trial. Journal of Autism and Developmental Disorders, 44(7), 1720-1732.

Xie S, Karlsson H, Dalman C, Widman L, Rai D, Gardner RM, Magnusson C, Schendel DE, Newschaffer CJ, Lee BK. Family History of Mental and Neurological Disorders and Risk of Autism. JAMA Netw Open. 2019 Mar 1;2(3):e190154. doi: 10.1001/jamanetworkopen.2019.0154. PMID: 30821823; PMCID: PMC6484646.

 

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.

 

18

Linking Strengths and Interests to College Majors and Careers: The MassHire Career Information System

By | NESCA Notes 2020

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

Due to Covid-19, many schools are functioning in a hybrid or remote learning status, making access to school-based guidance counselors, college counselors and transition personnel more complicated. Consequently, I am working with an unusually high number of high school students and families to provide assistance with the college selection and admissions process this year. For these students and others, working with a private transition specialist or college consultant/coach provides the structure and consistent support needed to ensure the student is able to find colleges that will be a great match, highlight the student’s strengths as a college applicant and complete the application process efficiently. Most importantly, the added support reduces anxiety—which is a natural response to the college process as well as living through a pandemic.

There are so many factors to consider when choosing a college—size, religion, location, tuition and fees, availability of internships, academic support, etc.—and one of the most important differentiating factors is often the availability of majors that a student is interested in. As such, career exploration is a very important part of my work with college-bound students. There are certainly many online resources that are useful for career exploration—YouScience, O*NET OnLine, Naviance, Khan Academy, Dr. Kit, CareerOneStop, etc.—but my personal favorite site to help teenagers learn to use is MassHire Career Information System (Previously MassCIS; https://portal.masscis.intocareers.org/).

MassHire CIS is a portal that any individual, from middle school to adulthood, can access for free by logging in with their Massachusetts City or Town Name and their Zip Code. Once inside, users can complete assessments related to their interests, skills and values, preferred lifestyle and more. The site also allows students to link results from previously taken career assessments to information about occupations and occupation categories within MassHire CIS.

Using career interests, from assessments or just a self-reported interest (e.g., photographer, elementary school teacher, personal trainer), users can research occupations and find out everything from the tasks associated with the occupation, to helpful high school courses that relate to the job, and expected future wages and occupational outlook. Users can also watch videos to learn more about occupations.

Importantly, users can easily click from careers of interest to programs of study and ultimately to Massachusetts Schools or other US Colleges and Universities that offer majors leading to occupations of interest.

MassHire CIS is one of my favorite resources to share with teens, young adults and families as part of a college transition process—but also when students are building career awareness at other times or seeking a different path to employment. I hope that by spotlighting this in my blog, more families, educators and professionals will also explore and adopt this resource as a favorite!

 

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. 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 or call 617-658-9800.

16

Positive Coping Strategies for Stress, Anxiety and Trauma During Times of Crisis

By | NESCA Notes 2020

By Renée Marchant, Psy.D.
Pediatric Neuropsychologist

Amidst the global pandemic, children, their caregivers, their teachers and therapists are naturally experiencing heightened stress and anxiety. We are more likely to be sent into “fight, flight, freeze, mode” – the body and brain’s critical survival strategy to prepare and deal with perceived threat. For example, when you see a Grizzly Bear on your hiking trail, you instinctually run, fight back or hide.

However, we can become “stuck” or more sensitive to this instinctual urge, which is not adaptive and can negatively impact physical, emotional and social health. For example, chronic deployment of the “flight, flight, freeze” response occurs for individuals who experience post-traumatic stress disorder. Chronic deployment of “fight, flight, freeze” responses is also more likely amidst a global pandemic, such as COVID-19. Importantly, chronic deployment of “fight, flight, freeze” responses also occurs for individuals and communities who experience chronic racial injustice and oppression.

Under chronic experiences of stress and threat, our body remains activated and hyper-aroused, even when deploying this response is not helpful. For example, children may shut down or dysregulate when faced with even small stressors – making an error on a math worksheet or even accidentally spilling something on the table. Children and teens may be more irritable, defiant or isolative. Overall, chronic deployment of the “fight, flight, freeze” response heightens anxiety, stress and general feelings of malaise.

So, what can we do? What can we do to “turn off” or lessen this stress response? What are some ways to positively cope during these difficult times?

  1. Research shows that the #1 resiliency factor is the reliable presence of at least one supportive relationship with an adult. Build connection and community through shared activities and conversations about your experiences. Remember to always take care of yourself before taking care of others – self-care is critical.
  2. Focus on validation first; problem-solving second. Validating, acknowledging and accepting pain, distress, hurt and the like builds communication and naturally decreases tension and stress. Validation is the essential first step prior to action, problem-solving and positive coping.
  3. In order to grow positive coping, it is helpful to build mastery and self-expression. Strategies that can help to both organize and “release” feelings and stressful experiences rather than “bottle them up” include:
  • Use your body to heal your mind: play, do yoga, engage with nature, exercise;
  • Engage in shared action to promote communication and change at a community and systemic level. Volunteer or advocate for a cause of importance. Contact your local legislators and express your concerns;
  • Write or draw about your experience. Use collages, images or videos to express your goals, experiences and fears;
  • Engage in therapeutic movement. Create a music playlist for various emotions. Dance or engage in rhythmic actions (e.g. knitting, pottery);
  • Identify your strengths and what you value in life. Happiness is fleeting – goals and values last longer and support positive coping. For a free strengths and values survey, check out: https://www.viacharacter.org/;
  • Connect with community resources available in your area, such as therapists, mentors, religious organizations, support groups, local-nonprofits, etc.; and
  • Be kind to yourself and practice self-compassion.

 

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.

 

9

Organizing Screen Time During Remote Learning

By | NESCA Notes 2020

By Dot Lucci, M.Ed., CAGS

Director of Consultation and Psychoeducational Services, NESCA

Working remotely has placed all of us on our screens more. My eyes, back and head hurt!  For months, screen time has been our lifeline to our family and friends, work and learning. Adults and children are on screens to connect with our families/friends, to learn, to play etc. And with remote or hybrid learning most likely here to stay to some degree for the 2020/2021 school year – even with lessening restrictions – our students will remain on screens. Helping students manage the amount of screen time they have is and will remain a daunting task.

I often talk to parents about what goes into their day for healthy living (i.e. exercise, sleep, work, play, outdoor time, etc.). We can add things like responsibilities/chores, alone time, down time, family time, etc. A child’s day also consists of routines, activities, chores, sleep, outdoor time etc. This becomes even more critical as we think about all the ways we are using screens nowadays.

To help manage screen time for our kids, it is important for parents to set boundaries and guidelines around screen time and clearly communicate the specific activities they do on screens. Create a clear way to communicate about screen time:

  • “Friend Time/Social Time”
  • “Family Time” (talking with relatives, playing Pictionary over Zoom)
  • “School Time” (Math, ELA, etc. – whether it be asynchronous or synchronous)
  • “Down Time” (i.e. meditation apps, sleep apps, etc.)
  • “Free Time” (the child’s choice with parent guidance)
  • “Indoor Exercise Time” (movement apps, online exercise shows or classes, etc.)

By creating a clear and common language around screen time/use within your home, children will better understand what their role is within each of these blocks, and communication related to screens becomes easier. Children and parents can talk more clearly about what the child is doing, what the child should be doing, what they want to be doing, and about learning expected behaviors and limits around each specific time. For instance, during family screen time (talking with grandma and grandpa), it’s okay to be wearing your pajamas or be in bed,  but for school screen time, this is not okay – the child needs to be dressed and at their designated workspace.

Establishing some guidelines, expectations and rules around screen time also allows parents and caregivers to talk with their children about healthy living and responsibilities (i.e. getting outdoors, exercising, eating, chores/responsibilities, relaxation, etc.) and how all this fits into a day. For example, 30 minutes of exercise is part of every day, playing a board game as a family is a part of every week, doing chores and completing daily living routines (dressing, brushing teeth, etc.) are a part of every day, reading a book or being read to happens every day, etc.

To help children understand and comply with screen time and use guidelines, Create a screen time agreement/contract jointly with your child. After explaining the above distinctions, guide them to figure out what goes into each category. The types of activities, games they play, who’s on the calls, etc. and what the expectations are for each. Take notes during this brainstorming session to then create an actual agreement/contract from those notes. Make sure to include rewards and consequences. There are “have-to” or “non-negotiable” activities that parents want children to do. Make these clear to the child, especially about the number of warnings they receive to get off of a device when prompted. Use and make sure your child knows that parental controls exist and that you will use them as well as time- tracking technology to help them be successful in meeting their goals, getting their rewards and being a great family member. Make sure there are screen time-free zones/hours (no one in the house is on a screen). This helps the child develop and learn non-technology-based entertaining behaviors. Everyone agrees to and signs the contract.

Finally, you might want to create creative/imaginative time activities, quite time activities, among others, to round out your child’s development. Get a hold of screen time before it takes hold of you and your child. Screen time can be a very slippery – even dangerous – slope for all of us these days. Help your child and yourself to be more mindful of the amount of time you are using screens and for what purpose. Good luck!

 

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.

 

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