Neuropsychological Evaluation

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Image of the MA State House with quote from the blog

Access to Mental Health Care in Massachusetts: Challenges and Opportunities

By | NESCA Notes 2024

By: Rebecca Dautoff, Psy.D.
Pediatric Neuropsychologist, NESCA

Access to mental health care is an increasingly critical issue across the United States, and Massachusetts is no exception. While the state is often lauded for its comprehensive healthcare system and progressive policies, barriers to mental health care still persist. In this blog post, we will explore the current landscape of mental health services in Massachusetts, the challenges faced by individuals seeking care, and the initiatives being implemented to improve access.

The State of Mental Health Care in Massachusetts
Massachusetts has made significant strides in mental health care over the years. The state boasts some of the country’s leading hospitals, research institutions, and mental health professionals. Organizations such as the Massachusetts Department of Mental Health (DMH) and the Massachusetts Behavioral Health Partnership (MBHP) work to ensure that residents have access to necessary services, yet many still find it difficult to access care. There are also continuing racial inequities in medical and mental health care and a significant shortage of mental health providers of color.

Types of Services Available
Massachusetts offers a range of mental health services, including:

Inpatient Treatment: Hospitals provide acute care for individuals in crisis.
Outpatient Services: Clinics and private practices offer therapy and counseling sessions.
Community Support: Programs that focus on recovery and support that are community-based.
Telehealth Services: An increasingly popular option, especially since the COVID-19 pandemic, allows individuals to access care remotely.

Despite this variety of resources available, the gap between those in need and those receiving care remains significant.

Barriers to Accessing Mental Health Care

Stigma and Misunderstanding

Stigma surrounding mental health issues is a significant barrier. Many individuals hesitate to seek help due to fear of judgment or misunderstanding by others. This stigma can come from family, friends, or even within professional environments. Education and awareness campaigns are essential to reducing stigma and encouraging individuals to seek the care they need.

Insurance Limitations

While Massachusetts has implemented laws requiring insurance companies to provide equal coverage for mental and physical health services, discrepancies still exist. Many individuals find that their insurance plans have high deductibles, limited provider networks, or caps on the number of therapy sessions covered.

Workforce Shortages

There is a notable shortage of mental health professionals in Massachusetts, particularly in rural areas. While urban centers like Boston have many providers, individuals in more remote locations often face long wait times or a lack of available services altogether. The distribution of resources is uneven, exacerbating access issues.

Financial Barriers

Even with insurance, the cost of mental health care can be prohibitive. Copays, deductibles, and uncovered services can add up quickly, making it difficult for individuals to afford the care they need. Paying privately often leads to shorter wait times but is more expensive. Often families find themselves caught in a cycle where they need help but cannot afford it.

Current Initiatives and Improvements
To address these challenges, Massachusetts is taking steps to improve access to mental health care. Various initiatives are being implemented across the Commonwealth.

Legislative Efforts

The Massachusetts State Legislature has been active in introducing bills aimed at improving access to mental health care. The “Mental Health Parity” law ensures that mental health care is treated on par with physical health care in terms of coverage. Advocacy groups continue to push for reforms that address loopholes and improve enforcement.

Telehealth Expansion

The COVID-19 pandemic accelerated the adoption of telehealth services, which have proven to be a valuable tool for increasing access to mental health care. Telehealth allows individuals to connect with therapists and psychiatrists from the comfort of their homes, reducing barriers related to transportation, location, and time constraints.

Community-based Programs

Community-based mental health programs are essential in providing support and resources. Initiatives, like the Massachusetts Community Behavioral Health Center (CBHC) program, aim to create a network of services that meet the diverse needs of communities. These centers offer a variety of services, including crisis intervention and case management.

Educational Campaigns

Efforts to combat stigma and raise awareness about mental health are crucial. Organizations like the National Alliance on Mental Illness (NAMI) Massachusetts work tirelessly to educate the public about mental health issues, promote resources, and advocate for policy changes. These campaigns foster understanding and encourage individuals to seek help.

Looking Ahead: The Future of Mental Health Care in Massachusetts
The landscape of mental health care in Massachusetts is continually evolving. While significant challenges remain, the state is committed to addressing these issues through comprehensive reforms and community-based approaches.

Continued Advocacy

Ongoing advocacy at both the grassroots and legislative levels is essential in pushing for systemic changes. By uniting voices and sharing personal stories, advocates can influence policies that prioritize access to mental health care.

Innovative Solutions

As technology continues to advance, innovative solutions, such as mobile apps for mental health monitoring, digital therapy platforms, and AI-driven resources, could enhance accessibility.

Conclusion
Access to mental health care in Massachusetts is a multifaceted issue that requires ongoing attention and action. While challenges persist, the State legislature is committed to improving access to community programs and public awareness campaigns. By addressing stigma, financial barriers, and workforce shortages, Massachusetts can move closer to a system where mental health care is truly accessible for all. This journey continues. With continued advocacy and innovation, a brighter future for mental health care in the state is on the horizon.

How to Access Care
If you are or someone you love or care for is experiencing a mental health issue, you need to know how and where to find services. First, contact your primary care doctor or pediatrician. For parents or caregivers, the next contact should be someone at the child’s school. It could be an administrator, a teacher, or a mental health professional. Seek out additional information about what school personnel have observed about the child and find out about available resources at the school. This is an important part of treatment for a child.

If you or the person you’re seeking to assist requires a crisis response to meet immediate safety needs, call 911, go to your local emergency room, or find your local Emergency Service Program by calling 877-382-1609.

Call or text the Massachusetts Behavioral Health Help Line (MBHHL) at 833-773-2445 for free, confidential support 24/7. Live chat is available at: https://www.masshelpline.com/. This helpline is useful even if you’re not sure what kind of help you need. Interpretation in over 200 languages is available in real time. Deaf or hard of hearing individuals can contact MassRelay at 711.

NAMI Compass is the information and referral helpline at NAMI Massachusetts. They provide resources and support to help people navigate the complex mental health system and problem solve in challenging situations. The COMPASS helpline is available Monday through Friday, 9 AM – 5 PM. Call the helpline at 617-704-6264 or 1-800-370-9085, or email them at compass@namimass.org.

SAMHSA’s National Helpline, 1-800-662-HELP (4357), (also known as the Treatment Referral Routing Service) or TTY: 1-800-487-4889 is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations.

The Massachusetts Substance Use Helpline is a good resource for finding substance use treatment and recovery services. Helpline services are free and confidential. Call 1-800-327-5050.

The William James INTERFACE Referral Service aims to increase access to mental health and wellness services for individuals. Call the helpline at 888-244-6843 or 617-332-3666 from 9 AM- 5 PM on Monday, Wednesday and Friday, and 8 AM- 6 PM on Tuesday and Thursday, to work with a Resource and Referral Counselor who will help you navigate the challenges of finding mental health services. Communities served can be found on their website, https://interface.williamjames.edu/communities.

About the Author

Dr. Rebecca Dautoff provides comprehensive neuropsychological and psychological (projective) evaluation services for children, adolescents, Headshot of Rebecca Dautoff, Psy.D. and young adults who have complex presentations with a wide range of concerns, including attention deficit disorders, psychiatric disorders, intellectual disabilities, and autism spectrum disorders (ASD). She also values collaboration with families and outside providers to facilitate supports and services that are tailored to each child’s specific needs.

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

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

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Image of flowers coming out of a person's head, symbolizing various mental health disorders/diagnoses

Understanding Diagnostic Labels

By | NESCA Notes 2024

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

Throughout the evaluation process, many families express concern about the potential negative impacts of placing diagnostic labels on a child. Unfortunately, parental worries associated with stigmatization, as well as others making incorrect assumptions and placing inappropriate expectations on their child are common and valid. As such, it is reasonable to ask, “where does diagnostic labeling come from?”

In 1952, the first version of the Diagnostic and Statistical Manual of Mental Disorders (DSM) was developed by the American Psychological Association (APA) as the standard classification of mental disorders used by mental health professionals in the United States. Since that time, several iterations of the DSM have been developed. Most recently, the DSM-IV- Text Revision (TR) was published (2022), in which sections of text describing diagnostic categories and associated features were revised based on new research. Hundreds of international experts in all aspects of mental health contributed to the development of the DSM, as well as adjustments to subsequent versions.

There are certainly benefits and drawbacks for making specific diagnoses, a few of which are detailed below:

Pros	Cons
Provides a common language in an effort to help mental health and medical professionals communicate effectively. May provide some relief to clients who come to find their symptoms are associated with a disorder that others also experience. Helps guide providers in recommending appropriate treatment options based on diagnostic presentation.	May not fully account for contextual influences, such as ethnicity and culture on the development of psychopathology. Potential for disagreements related to interpreting diagnostic criteria when trying to make diagnostic decisions. Places individuals into “boxes,” which can lead to stigmatization.

Broadly, much of the neuropsychological evaluation process focuses on identifying how a child’s behavioral, emotional, and/or social functioning may be discrepant from that of their peers for the purpose of identifying appropriate treatment and educational services to support the child. Of equal importance is highlighting the child’s strengths, as well as understanding individual family values and cultural factors that may be contributing to a child’s presentation.

As neuropsychologists at NESCA, we take a holistic view of your child and consider multiple sources of information when answering referral questions, including information from parents, teachers, providers with whom the child has developed strong rapport, as well as our observations throughout the evaluation process. While we do refer to the DSM when making diagnoses, we pride ourselves on taking an incredibly individualized approach and high level of care when working with clients. Our goal is not to simply put your child in a “box” and send you on your way. We seek to understand your child’s symptoms and how they impact functioning across environments. We consider initial evaluations as the first step in your journey to fully understanding your child, treating the aspects of their presentation that you’d like to prioritize, and ultimately promoting their overall well-being and success.

About Lauren Halladay, Ph.D.

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

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

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

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Image of the words Fading Prompts fading out

Helping Students Become Independent: The Role of Fading Prompts

By | NESCA Notes 2024

Image of the words Fading Prompts fading out By: Sarah LaFerriere, M.Ed.
Transition Specialist & Special Educator, NESCA

Supporting students with disabilities is an experience filled with opportunities to help them grow and succeed. One key area to focus on is promoting independence, which involves carefully managing the use of prompts. If not handled well, prompt dependence can become a significant barrier, especially as students move toward transition age.

What is Prompt Dependence?
Prompt dependence happens when students become overly reliant on external cues, like verbal or written instructions or physical guidance – from teachers, therapists, or caregivers. While prompts are a helpful tool in teaching, over time, too much reliance on them can make it difficult for students to act independently. This can become a bigger issue as they get older and need to function more independently in real-world situations, such as in jobs or community settings.

Why Fading Prompts Matters and How to Do It
Fading prompts is a technique used to gradually decrease the level of support given to students, helping them gain the skills they need to act independently. The goal is to provide enough support initially so that students can learn, and then slowly reduce that support as they become more capable on their own. This isn’t about suddenly withdrawing help but rather about making a gradual shift that encourages students to rely on their own skills.

Start Early—Addressing prompt dependence early on is crucial. When introducing prompts, consider how you’ll gradually reduce them. For younger students, this could mean starting with more hands-on assistance and gradually moving to less direct forms of support, such as verbal or visual cues.
Reduce Support Gradually—Fading prompts involves a step-by-step reduction of assistance. Begin with more direct prompts and, as the student improves, shift to more subtle forms of support. It’s important to pace this reduction based on the student’s progress, ensuring they have enough opportunity to practice and succeed before making further changes.
Promote Self-awareness—Encouraging students to recognize when they need help and how to seek it can be very effective. By developing self-monitoring skills, students can learn to manage their own needs and understand when they are capable of performing tasks on their own.
Be Consistent and Patient—Consistency among all those involved in a student’s education is key. This means that teachers, therapists, and family members should use the same approach and follow the same plan for reducing prompts. Patience is also important, as progress can be gradual and may require repeated practice.
Customize Approaches—Every student is different, and so their path to independence will be unique. Tailoring the approach to each student’s specific needs can make a big difference. This might involve adjusting how quickly prompts are faded or choosing the types of support that work best for the student. Regularly reviewing and adjusting the plan ensures that students are receiving the right level of support.

Involving Families and Service Providers
Families and service providers are essential in this process. Good communication and teamwork between educators, therapists, and families help create a consistent approach to fading prompts. Families can support the skills being taught in various settings, and service providers can offer valuable insights and guidance.

Preparing for the Future
As students reach transition age, being able to act independently becomes even more important. By addressing prompt dependence early and using effective fading techniques, we can help students develop the skills and confidence they need for adult life. This preparation not only aids students but also benefits their families and communities by fostering a more inclusive environment.

In summary, fading prompts is a crucial practice in helping students with disabilities become more independent. By understanding and applying strategies to reduce prompt dependence, we can better prepare students for a future where they can navigate the world with confidence and self-sufficiency. This not only supports the students but also contributes to a more supportive and inclusive community.

About the Author

Sarah LaFerriere, M.Ed., is a transition specialist and special educator who has nearly a decade of experience working with transition aged students in public schools, college, and home-based settings. She provides transition assessment, consultation, and coaching services to a wide range of clients, and specializes in supporting students with autism, intellectual disabilities, developmental disabilities, mental health conditions, and medical conditions.

To book a consultation with Sarah LaFerriere or one of our many other expert transition specialists, neuropsychologists, or other clinicians, complete NESCA’s online intake form.

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

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Child in bed suffering from a concussion, holding their head in pain

What School Supports Does My Child Need After A Concussion?

By | NESCA Notes 2024

By: Alison Burns, Ph.D.
Pediatric Neuropsychologist, NESCA

Unfortunately, every year, many children and adolescents experience concussions. A concussion is a mild traumatic brain injury that occurs when an individual sustains a blow to the head or body that results in the brain moving rapidly back and forth. This causes the brain to stretch and strain, resulting in a vast array of possible symptoms. Symptoms of a concussion include:

list of physical, cognitive, emotional, and sleep concussion symptoms

Recent studies have shown that while it is important to rest for the initial few days after an injury, slowly reengaging in cognitive activities at a tolerable level helps to promote recovery. This period of rest followed by a slow increase in cognitive activity means that children are often out of school/slowly transitioning back to school for an unspecified period after injury. As such, many children will benefit from support and accommodation at school during the recovery period. Parents are encouraged to talk to their child’s academic team and school personnel to discuss the need for these supports. As children and adolescents experience differing sets of symptoms after an injury, the accommodations and supports should be tailored to the individual’s unique symptom profile.

Physical Symptoms: Students who experience headaches or fatigue may benefit from rest breaks or even a nap during the school day. Dizziness, balance problems, or nausea may necessitate the need for an elevator pass and it may be helpful for the student to transition to class before the bell rings when there are less people to navigate around in the hallway. Light and noise sensitivity can be particularly hard within the school setting. Students may need to wear sunglasses or a hat, be seated away from the window, and may need teacher notes as looking at a smartboard may be painful. In addition, computer-based work may need to be printed during the recovery period for light sensitive students. Students with noise sensitivity may need to wear ear plugs, avoid crowded and noisy areas, such as the lunchroom, assemblies, or music class, and they may need to transition to the next class before the bell rings and the hallway becomes noisy.

Cognitive Symptoms: A concussion can temporarily impact an individual’s attention, executive functioning skills, and processing speed. Therefore, it may be necessary to reduce a child’s workload (e.g., odd/even problems only, outline a paper instead of writing it fully, reduce homework load) and assign only essential work (i.e., waive non-essential assignments, quizzes, and tests). In addition, it may be helpful to break down tasks into smaller “chunks,” repeat information or instructions, and allow for extended time to complete essential classwork, quizzes, and tests. They may need access to teacher notes if they are unable to keep up with the pace of the instruction to take proper notes, and they may need information presented in a slower manner or repeated to ensure comprehension. Teachers should consider alternative ways to ensure mastery of information (e.g., oral discussion, multiple choice instead of open-ended questions) as students may not be able to demonstrate their true knowledge in standard ways while recovering from a concussion. Tests and quizzes should only be given if symptoms do not interfere, and the student is adequately prepared.

Emotional Symptoms: Emotional symptoms following concussion are often overlooked as they are not a commonly known symptom of concussion. Some children and adolescents may become overwhelmed about missing school and the accumulating workload, and they may feel isolated from their friends. This would also suggest the need to reduce a child’s workload for a short period of time, including waiving non-essential assignments, quizzes, or tests. Students should also be allowed to socialize with their peers as tolerated (e.g., quiet lunch setting with a few close friends).

Sleep Symptoms: A child or adolescent experiencing sleep difficulties as a result of their concussion may not have the energy to complete a full day of school. They may need a later start time or only be able to complete a half day of school. Some students with disrupted sleep may be able to complete a full school day, but they may require a nap in the nurse’s office.

In sum, a concussion presents in many ways and often has a significant impact on the day-to-day functioning of a child or adolescent. In particular, school is often disrupted after a concussion, even for children and adolescents who have a short recovery. School supports and accommodations should be tailored to the child’s individual profile of symptoms to best support them throughout their recovery.

About the Author

Dr. Burns conducts comprehensive evaluations of school-aged children, adolescents, and young adults with a variety of developmental, learning, and emotional difficulties. She has expertise in the evaluation of individuals following a concussion/mild traumatic brain injury and particularly enjoys working with individuals with attention (ADHD) and executive functioning (EF) difficulties. Dr. Burns is passionate about helping individuals and their families better understand their areas of strength and weakness and provides tailored treatment recommendations based upon that unique profile to make the evaluation most helpful for each client.

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

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

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How Do You Know if an IEP Addresses Transition Planning Requirements?

By | NESCA Notes 2024

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

As educators and professionals who support parents, having a checklist focused on transition planning requirements for students with disabilities can help to ensure that students are prepared for life after high school.

The most obvious source for such a checklist is Indicator 13, which is a compliance indicator required by the Individuals with Disabilities Education Act (IDEA) of 2004.

Every IEP must include a transition plan that addresses the student’s future goals, including postsecondary education, vocational training, employment, and independent living (when appropriate) and the steps needed to achieve those goals.

Here’s a checklist of what should be included in a transition-rich IEP:

Age-appropriate Transition Assessment: Adequate transition assessment information (including input from the student) about the student’s strengths, preferences, interests, and needs.
Measurable Postsecondary Goals: Clearly defined goals related to training, education, employment, and, where appropriate, independent living skills. These goals must be based on age-appropriate transition assessments and be updated annually.
Transition Services: A detailed outline of the transition services (e.g., life skills training, job coaching, vocational training, career counseling, work-based learning, agency linkages, etc.) that will reasonably enable the student to meet their postsecondary goals.
Course of Study: A multi-year description of the coursework that will reasonably enable the student to meet their postsecondary goals. Indication as to when the student is expected to exit public education and what type of completion document the student will attain.
Annual IEP Goals: Specific, measurable, annual skill-based goals related to the student’s transition services needs. Skills that need to be addressed this year to ensure the student progresses toward their goals.
Student Involvement: Indication that the student was invited to meetings where transition services were discussed. Documentation that the student has been involved in the transition planning process.
Interagency Coordination: If appropriate, evidence that outside agencies (e.g., vocational rehabilitation, pre-employment transition service provider, department of developmental services, postsecondary education admissions or disability services, center for independent living) are involved in the transition planning with appropriate consent from the adult student and/or parent/family.

Remember: Transition planning is a collaborative effort. Student and parent/family involvement are vital to creating a successful roadmap for the student’s future.

For more detailed information, feel free to reach out or visit the IDEA website: https://sites.ed.gov/idea.

National Technical Assistance Center on Transition also has excellent Indicator 13 checklists and training resources: https://transitionta.org/i13-checklists/ (registration is required to use the site, but there is no paywall).

Together, let’s empower students to make a successful transition into adulthood!

About the Author
Kelley Challen, Ed.M., CAS, is an expert transition specialist and national speaker who has been engaged in evaluation, development, and direction of transition-focused programming for teenagers and young adults with a wide array of developmental and learning abilities since 2004. While Ms. Challen has special expertise in working with youth with autism, she enjoys working with students with a range of cognitive, learning, communication, social, emotional and/or behavioral needs.

Ms. Challen joined NESCA as Director of Transition Services in 2013. She believes that the transition to postsecondary adulthood activities such as learning, living, and working is an ongoing process–and that there is no age too early or too late to begin planning. Moreover, any transition plan should be person-centered, individualized and include steps beyond the completion of secondary school.

Through her role at NESCA, Ms. Challen provides a wide array of services including individualized transition assessment, planning, consultation, training, and program development services, as well as pre-college coaching. She is particularly skilled in providing transition assessment and consultation aimed at determining optimal timing for a student’s transition to college, technical training, adult learning, and/or employment as well as identifying and developing appropriate programs and services necessary for minimizing critical skill gaps.

Ms. Challen is one of the only professionals in New England who specializes in assisting families in selecting or developing programming as a steppingstone between special education and college participation and has a unique understanding of local postgraduate, pre-college, college support, college transition, postsecondary transition, and 18-22 programs. She is additionally familiar with a great number of approved high school and postsecondary special education placements for students from Massachusetts including public, collaborative, and private programs.

Ms. Challen enjoys the creative and collaborative problem-solving process necessary for successfully transitioning students with complex profiles toward independent adulthood. As such, she is regularly engaged in IEP Team Meetings, program consultations, and case management or student coaching as part of individualized post-12th grade programming. Moreover, she continually works to enhance and expand NESCA’s service offerings in order to meet the growing needs of the families, schools and communities we serve.

When appropriate, Ms. Challen has additionally provided expert witness testimony for families and school districts engaged in due process hearings or engaged in legal proceedings centering on transition assessment, services and/or programming—locally and nationally.

Nearly two decades ago, Ms. Challen began her work with youth with special needs working as a counselor for children and adolescents at Camp Good Times, a former program of Milestones Day School. She then spent several years at the Aspire Program (a Mass General for Children program; formerly YouthCare) 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. Also, she 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 skill and transition programs.

Ms. Challen received her Master’s Degree and Certificate of Advanced Graduate Study in Risk and Prevention Counseling from the Harvard University Graduate School of Education. While training and obtaining certification as a school guidance counselor, she completed her practicum work at Boston Latin School focusing on competitive college counseling.

Ms. Challen has worked on multiple committees involved in the Massachusetts DESE IEP Improvement Project, served as a Mentor for the Transition Leadership Program at UMass Boston, participated as a member of B-SET Boston Workforce Development Task Force, been an ongoing member of the Program Committee for the Association for Autism and Neurodiversity (AANE), and is a member of the New Hampshire Transition State Community of Practice (COP).

She is also 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: Innovations that Enhance Independence and Learning.

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

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

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Correct Pronoun Use Saves Lives

By | NESCA Notes 2024

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

Let me explain…

For anyone who is working with children, teenagers, or young adults in 2024, there is no question that we are working with more openly transgender and nonbinary youth than we were in 2004. Because of this, NESCA recently held a staff seminar led by Dr. Sebastian Barr, speaking about the Psychosocial Wellbeing of Trans & Nonbinary Youth.

As Dr. Barr eloquently identified, “more people are recognizing their trans and nonbinary identities earlier in life.” These youth “have more unique needs” and are “more likely to struggle and need services.” But, for most of us working in education or health care, our academic experiences taught us very little, if anything, about supporting trans and nonbinary youth. Fortunately, in current times, there is research and publishing around this topic. And I was lucky to be able to absorb some of that research in just 75-minutes listening to Dr. Barr.

I learn well in lectures, and there is a lot that will stick with me from the presentation, but the most impactful point made was that “correct pronouns are suicide prevention.” If we care about kids and people, we should do whatever work we need to ourselves in order to learn and use correct pronouns. Trans and nonbinary individuals, especially teens and young adults, are at much greater risk of experiencing mental health issues, and suicidal thinking. There are many studies identifying factors associated with this risk such as bias, non-affirmation, exclusion, marginalization, trauma, etc. Fortunately, there are also studies identifying protective factors that are associated with wellbeing. Some of these variables include:

Parental and sibling acceptance
General affirmation of gender, like correct pronoun use
Access to competent medical support
Community support

Importantly, research from the Trevor Project, indicates that “transgender and nonbinary youth who reported having pronouns respected by all or most of the people in their lives attempted suicide at half the rate of those who did not have their pronouns respected.” *

This is why Dr. Barr indicated that many people in the field will say “correct pronouns are suicide prevention.” He emphasized that if you do make a mistake, you should “correct it quickly, not draw attention, and practice so you don’t repeat the mistake multiple times.”

I am not sharing this with any interest in getting into a debate about feelings or beliefs. I am sharing this in hopes that someone reads this, finds it useful in their parenting or professional work, and makes an effort to use correct pronouns in order to potentially save a life.

Resources:

If you want more information about Dr. Barr or his work, you can visit: https://www.sebastianmitchellbarr.com/

To download a Pronoun Fact Sheet from the @American Psychological Association, you can click here: https://www.apadivisions.org/division-44/resources/pronouns-fact-sheet.pdf

*For more information and data regarding #LGBTQ Youth Mental Health, check out the National Survey on LGBTQ Youth Mental Health 2020: https://www.thetrevorproject.org/survey-2020/