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Neuropsychological Evaluation

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6

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

By | Nesca Notes 2023

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

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

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

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

Response from ChatGPT:

Breakfast:

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

 Snack:

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

Lunch:

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

 Snack:

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

 Dinner:

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

 Grocery List:

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

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

 

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

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

Response from ChatGPT:

Role Play:

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

Classmate: Hi, Jane! I’m Sarah.

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

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

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

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

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

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

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

Classmate: Perfect. I’ll see you then!

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

Classmate: See you then, Jane!

 

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

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

Response from ChatGPT:

Subject: Request for an Extension on Project Submission

Dear Professor [Name],

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

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

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

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

Sincerely,

[Your Name]

 

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

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

Response from ChatGPT:

Introduction

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

Relevant experience and skills

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

Passion for coffee and the Starbucks brand

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

Availability and willingness to learn

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

Closing

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

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

 

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

 

About Lyndsay Wood, OTD, OTR/L

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

 

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

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

16

Self-efficacy: An Important Characteristic to Develop in Children

By | Nesca Notes 2023

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

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

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

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

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

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

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

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

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

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

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

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

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

References

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

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

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

 

About the Author

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

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

 

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

 

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

 

10

Shouldn’t We All Get Neuropsychological Evaluations, Then?

By | Nesca Notes 2023

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

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

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

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

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

 

About the Author

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

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

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

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

 

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

 

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

 

10

Signs and Symptoms of Common Eating Disorders

By | Nesca Notes 2023

By Miranda Milana, Psy.D.
Pediatric Neuropsychologist

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

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

For both presentations, criteria for anorexia nervosa include:

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

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

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

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

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

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

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

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

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

Binge eating disorder is characterized by:

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

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

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

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

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

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

 

References:

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

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

 

About the Author

Dr. Miranda Milana provides comprehensive evaluation services for children and adolescents with a wide range of concerns, including attention deficit disorders, communication disorders, intellectual disabilities, and learning disabilities. She particularly enjoys working with children and their families who have concerns regarding an autism spectrum disorder. Dr. Milana has received specialized training on the administration of the Autism Diagnostic Observation Schedule (ADOS).

Dr. Milana places great emphasis on adapting her approach to a child’s developmental level and providing a testing environment that is approachable and comfortable for them. She also values collaboration with families and outside providers to facilitate supports and services that are tailored to a child’s specific needs.

Before joining NESCA, Dr. Milana completed a two-year postdoctoral fellowship at Boston Children’s Hospital in the Developmental Medicine department, where she received extensive training in the administration of psychological and neuropsychological testing. She has also received assessment training from Beacon Assessment Center and The Brenner Center. Dr. Milana graduated with her B.A. from the University of New England and went on to receive her doctorate from William James College (WJC). She was a part of the Children and Families of Adversity and Resilience (CFAR) program while at WJC. Her doctoral training also included therapeutic services across a variety of settings, including an elementary school, the Family Health Center of Worcester and at Roger Williams University.

Dr. Milana grew up in Maine and enjoys trips back home to see her family throughout the year. She currently resides in Wrentham, Massachusetts, with her husband and two golden retrievers. She also enjoys spending time with family and friends, reading, and cheering on the Patriots, Bruins, Red Sox, and Celtics.​

 

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

 

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

 

4

Explaining Neuropsychological Testing to Your Child

By | Nesca Notes 2023

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

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

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

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

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

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

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

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

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

 

About Lauren Halladay, Ph.D.

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

 

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

 

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

5

Getting to Know NESCA Pediatric Neuropsychologist J. Michael Abrams, Ph.D.

By | Nesca Notes 2023

By: Jane Hauser
Director of Marketing & Outreach

I recently spoke with J. Michael Abrams, Ph.D., pediatric neuropsychologist practicing in NESCA’s Londonderry, New Hampshire office. Dr. Abrams joined NESCA last fall. Take a few minutes to learn more about him in today’s blog interview. 

How did you became interested in neuropsychology?

Back in the mid-80s, I worked at McLean Hospital, in the Child & Adolescent Inpatient program. They had an educational program set up for the kids that was run by psychologists who were embedded in the classrooms. There was a fair amount of test development going on at that time that used a lot of materials to build executive function and cognitive skills among the students. I was always interested in education and special education, but it was this experience that changed my career mindset toward psychology. So, I went back to school to study psychology.

Tell us about your career journey.

I always wanted to work with children and adolescents. That desire stemmed from my initial interest in special education and education in general, and I was on that path. I spent about seven and a half years at McLean, with the first couple of years working on an inpatient unit. Then I transferred to the psychologist-run education program, where I was a classroom educator.

After switching to psychology, my original clinical interest was with children who had experienced abuse and neglect and those who were involved in children’s eyewitness testimony. The focus was on how the experiences they had been through affected their memory, attention, and cognitive development. The more I worked with children and adolescents, the more I recognized how these neuropsychological factors impacted all aspects of their lives. It became much more than what I saw in the context of a legal case; instead, I saw how their experiences affected the management of themselves, their image of themselves, their hopes and aspirations, etc. I became really interested in how their neuropsychology intersected with their opportunities and experiences.

What segment of children and adolescents do you primarily work with? What is your specialty area?

I am particularly interested in working with children from age eight through 14, when their cognitive development is really taking off and they are trying to master this whole new set of skills. This time is filled with questions and challenges concerning self-esteem, mood, relationships, family relationships, etc. It’s a time when they are asking themselves what they are good at, where they struggle, and what those strengths and challenges say about them as a person. There is a great opportunity to have a big impact on kids in this age range. It’s such a gift to allow them to see themselves as successful and have that lead to future success.

What do you find most rewarding and most challenging about your profession?

The rewarding part is two-fold. The first is the interpersonal emotional piece. On a personal level, it’s rewarding to be able to contribute to other peoples’ success, whether it’s the clients, the practice, or the field overall. The second piece is more personal and intellectual. It’s intellectually stimulating to be able to integrate all of the information we gather or identify about a person, and to be able to communicate those findings or revelations to a child and their parents or caregivers. The intellectual reward lies in the ability to effectively communicate a child’s cognitive complexity in a way that they understand and can use to help reach their goals.

The challenging part has to do with the mental health landscape overall. As someone who is involved in neuropsychological assessments, it can feel like operating within a silo in the overall landscape. So many of the systems, such as insurance and education, are not set up for seamless collaboration with psychology practices or other areas of behavioral health. Unfortunately, this can make getting the appropriate mental health care or educational/therapeutic interventions a cumbersome, sometimes adversarial process. It’s the frustration that accompanies the much larger, more overarching need to develop a genuine collaboration among all the pieces within the health and mental health care settings.

What interested you about NESCA?

I was drawn to the opportunity NESCA provides to interact with other psychologists and affiliated clinicians on an ongoing basis. Professionally, I am not operating in a silo. At NESCA, there is more regular consultation and collaboration on how to put together a comprehensive and coherent plan for these kids. I was very excited to have a team of highly qualified, very experienced professionals, within the same organization, who can provide a range of supports and services for the kids we work with. Having this as a resource is a great opportunity for our clients and our staff, alike.

 

About Pediatric Neuropsychologist J. Michael Abrams, Ph.D.

Dr. J. Michael Abrams has over 30 years of experience in psychological, educational, and neuropsychological assessment and psychotherapy in various settings. A significant aspect of Dr. Abrams’ continuing interest and experience also includes the psychological care and treatment of children, adolescents, and young adults with a broad variety of emotional and interpersonal problems, beyond those that arise in the context of developmental differences or learning-related difficulties.

 

To book a neuropsychological evaluation with Dr. Abrams in Londonderry, NH, or to book with another expert NESCA neuropsychologist, 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, Londonderry, New Hampshire, and Burlington, Vermont, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

6

Why are Some Youths More Susceptible to Anxiety and Anxiety Disorders?

By | Nesca Notes 2023

By: Ferne Pinard, Ph.D.
NESCA Pediatric Neuropsychologist

Anxiety disorders are one of the most commonly diagnosed disorders in childhood and adolescence. According to the Centers for Disease Control and Prevention (CDC), 9.4% of children aged 3-17 years (approximately 5.8 million) were diagnosed with anxiety between 2016-2019. These numbers have increased significantly during the COVID-19 pandemic. Some studies estimate that the prevalence of child and adolescent anxiety disorders nearly doubled during the pandemic.

Why are some individuals more susceptible to anxiety than others? The development of anxiety and anxiety disorders during youth is not simple or straightforward but involves complex interactions among the following variables:

  • Temperament: Children with the behavioral inhibition temperamental style described as timidity, shyness, and emotional restraint when with unfamiliar people and or in new places are more likely to develop anxiety disorders.
  • Parent-child Attachment: Children who did not experience a trusting and secure parental bond, but received inconsistent responses from caregivers and are preoccupied with the caregiver’s emotional availability (Ambivalent attachment) are at increased risk for developing an anxiety disorder.
  • Parental Anxiety: Children with anxious parents are at higher risk of developing an anxiety disorder. This relation is partly influenced by genetics. The risk of developing specific anxiety disorders has been associated with various genes. These can be passed to the child, thereby increasing their genetic vulnerability to anxiety disorders. However, parental behavior and practices are also important in understanding this link.
  • Parenting Behavior/Practices: When parents model anxious, overcontrolling, or demanding behavior, their children are more reluctant to explore new situations and display more avoidance behaviors.
  • Adversity: Trauma, negative/stressful life events as well as low socio-economic status are also risk factors for childhood anxiety. The more adverse life events an individual experiences in childhood, the greater the likelihood that they will develop an anxiety disorder. They also experience higher levels of anxiety.
  • COVID-19: The combination of social isolation and lack of support networks increased anxiety among youth during the COVID-19 pandemic.
  • Bullying: Being the victim or perpetrator of bulling is also associated with anxiety symptoms later on in life
  • Externalizing Disorders: Adolescents with early externalizing disorders are at increased risk for later anxiety disorders. Attention Deficit/Hyperactivity Disorder (ADHD), in particular, is a significant risk factor.
  • Sleep: Sleep disturbance often predicts the emergence of anxiety disorders.
  • Cognition: Maladaptive cognitive responses (e.g., inability to tolerate distress, negative beliefs about uncertainty, avoidance of new/unfamiliar people/things, and repetitive negative thinking) are associated with impaired emotion regulation and a greater risk of developing anxiety disorders.

Supportive relationships with family and peers as well as problem-focused coping strategies can guard against anxiety disorders. Problem-focused coping refers to strategies that directly address the problem to minimize its effect.

Parents, caregivers, and other adults involved can also help by:

  • being aware of the signs of anxiety
  • being mindful of expectations set for children and teens
  • encouraging participation in sports teams, clubs, community- or religious-based groups
  • supporting a healthy lifestyle, including a nutritious diet, exercise, and adequate sleep
  • providing access to support services

 

References:

Donovan, C. L., & Spence, S. H. (2000). Prevention of childhood anxiety disorders. Clinical psychology review, 20(4), 509-531.

Vallance, A., & Fernandez, V. (2016). Anxiety disorders in children and adolescents: Aetiology, diagnosis and treatment. BJPsych Advances, 22(5), 335-344. doi:10.1192/apt.bp.114.014183

Warner, E. N., & Strawn, J. R. (2023). Risk Factors for Pediatric Anxiety Disorders. Child and Adolescent Psychiatric Clinics. Published: February 26, 2023 DOI: https://doi.org/10.1016/j.chc.2022.10.001

 

 

About Pediatric Neuropsychologist Ferne Pinard, Ph.D.

Dr. Pinard provides comprehensive evaluation services for children, adolescents, and young adults with learning disabilities, attention deficit/hyperactivity disorders (ADHD), and psychiatric disorders as well as complex medical histories and neurological conditions. She has expertise in assessing children and adolescents with childhood cancer as well as neuro-immunological disorders, including opsoclonus-myoclonus-ataxia syndrome (“dancing eyes syndrome”), central nervous system vasculitis, Hashimoto’s encephalopathy, lupus, auto-immune encephalitis, multiple sclerosis (MS), acute disseminated encephalomyelitis (ADEM), and acute transverse myelitis (ATM), and optic neuritis.

To book a neuropsychological evaluation with Dr. Pinard or another expert neuropsychologist at NESCA, complete NESCA’s online intake form. 

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

10

How Can a Neuropsychological Evaluation Help?

By | Nesca Notes 2023

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

Recently I met with a family seeking a neuropsychological evaluation for their daughter. After talking about their reasons for pursuing testing, the parents asked me, “So…do you think this will help? Is this type of testing what our child needs?” It’s an important question and one I’m sure many families wonder about but don’t always ask. A comprehensive neuropsychological evaluation can be of tremendous value, but the process requires time and energy as well as a financial investment, so it makes sense to consider this question carefully.

Though it may be surprising to hear this coming from a neuropsychologist, the answer to the question of whether to have a child evaluated is not always clear-cut. For instance, parents sometimes wonder if there is practical benefit to seeking testing when a child or adolescent already has a diagnosis but there are questions about its accuracy. Consider the following scenario as an example. A child with issues regulating attention and with weaknesses in social skills has a diagnosis of Attention-Deficit/Hyperactivity Disorder (ADHD). Her therapist has raised the question of whether a diagnosis of Autism Spectrum Disorder (ASD) might better explain the issues the child is facing. Inattention can be present in both ADHD and ASD, and both conditions can result in social difficulties. Especially if a child is already receiving appropriate services, does the diagnostic label matter, and is it worth pursuing formal assessment?

There are valid arguments to be made in favor of seeking an evaluation in this type of situation and valid arguments to support choosing not to invest in an assessment.  In such a scenario, I would encourage a family to consider the following questions:

  • Will diagnostic clarification address unanswered questions that previous diagnoses have not fully addressed?

Sometimes an established diagnosis partially explains a child’s issues but there are lingering questions about other aspects of a child’s presentation. If a different or additional diagnosis could fill in the gaps, it may be worth assessing.

  • Could testing help identify your child’s unique pattern of strengths and weaknesses?

Especially when an existing diagnosis has been made without testing (for instance by a therapist or physician), there may be important aspects of a child’s neuropsychological profile that have not yet been identified. For instance, individuals with Autism Spectrum Disorder share certain key features, but they also differ in significant ways. A diagnosis alone cannot capture the nuances of an individual child’s strengths and weaknesses, while a full neuropsychological evaluation can more fully describe a child on an individual level.

  • Will understanding the root of the problem help guide recommendations?

NESCA’s clinic director compares a child’s observable difficulties to the “tip of an iceberg.” There are inevitably hidden underlying factors, and discerning these can be important in determining how to address the issues that are visible on the surface. For example, problems with social interactions can arise from deficits in social communication (e.g., difficulty interpreting facial expressions), as seen in Autism. Alternatively, a child with ADHD may encounter social challenges because they have trouble paying attention to relevant social cues or because impulsivity leads them to behave inappropriately. Someone with social phobia may have few relationships because their anxiety drives them to avoid social interactions. Effective intervention in each of these cases requires a nuanced approach that targets not just the surface issue but the factors underlying it.

  • Will establishing a particular diagnosis open up opportunities for additional support and resources that may be important?

In some cases, there are specific resources that are available to individuals with particular diagnoses. For instance, in Massachusetts, individuals with a diagnosis of Autism Spectrum Disorder or Intellectual Disability may be eligible to receive services through the Department of Developmental Services. If qualifying for such services could be beneficial, diagnostic clarification may be important.

More broadly, the internet and social media have allowed people with shared diagnoses to connect in new ways. The opportunity to connect with others experiencing similar difficulties can be invaluable, and online communities can provide a sense of support, educational information, and practical resources for children and parents alike.

The answers to these questions and to the bigger question of whether to seek neuropsychological evaluation will be different for different families. There are many factors to weigh in making the decision to seek testing. If you are considering an assessment for your child and need additional information to make an informed decision, answers to frequently asked questions about neuropsychological evaluation can be found on NESCA’s website.

 

About the Author

Maggie Rodriguez, Psy.D., provides comprehensive evaluation services for children, adolescents, and young adults with often complex presentations. She particularly enjoys working with individuals who have concerns about attention and executive functioning, language-based learning disorders, and those with overlapping cognitive and social/emotional difficulties.

Prior to joining NESCA, Dr. Rodriguez worked in private practice, where she completed assessments with high-functioning students presenting with complex cognitive profiles whose areas of weakness may have gone previously undiagnosed. Dr. Rodriguez’s experience also includes pre- and post-doctoral training in the Learning Disability Clinic at Boston Children’s Hospital and the Neurodevelopmental Center at MassGeneral for Children/North Shore Medical Center. Dr. Rodriguez has spent significant time working with students in academic settings, including k-12 public and charter school systems and private academic programs, such as the Threshold Program at Lesley University.

Dr. Rodriguez earned her Psy.D. from William James College in 2012, where her coursework and practicum training focused on clinical work with children and adolescents and on assessment. Her doctoral thesis centered on cultural issues related to evaluation.

Dr. Rodriguez lives north of Boston with her husband and three young children.  She enjoys spending time outdoors hiking and bike riding with her family, practicing yoga, and reading.

 

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

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

5

Why a Task is Never “Just a Simple Task” – a compassionate perspective on executive functioning difficulties

By | Nesca Notes 2023

By Jasmine Badamo, MA
Educational Counselor; Executive Function Tutor

I’ve often experienced the frustration of a student being given a task–whether it be at home or school–and struggling to complete it. Teachers and parents alike have said to me, “I just don’t understand why they can’t get it done. It’s a simple task.” I’d like to challenge the concept of a “simple task.” Once we begin to dig beneath the surface, we start to see all the hidden demands that every task requires of us and our brains.

As a trained Special Education teacher and executive function coach, I was taught to search for the hidden demands in the academic tasks I give my students. For example, asking a student to write a story about a time they were sad involves a multitude of mini-tasks that present varying levels of challenge depending on the student and their learning needs:

  • Recognize what sad feels like to you
  • Activate your memories to recall a time you felt what sad feels like to you
  • Remember the order of events of a memory that may be more visceral than cerebral
  • Determine which details are important vs. less important to include in your story
  • Decide who your audience is, and remember what the purpose of this story is
  • Perspective take and infer what would make your story interesting to your audience
  • Identify words that will accurately convey your experience to your audience
  • Utilize your knowledge of grammar, spelling, and punctuation to craft intelligible writing
  • Understand and implement a proper story arc so that your story flows

All of this is not even including the related emotional demands:

  • Decide if you’re even motivated to do this, and if your relationship with your teacher is worth all this headache
  • Manage the frustration that comes up at every.single.step.along.the.way.
  • Self-soothe when your insecurities bubble up and you start to question your identity as a writer, student, and/or good person

Oh wait, you thought we were done? There is also a myriad of executive function demands such a task places on a student:

  • Understanding the steps you needs to take, and determining where to start
  • Motivating yourself to take the first step despite feeling extremely stuck
  • Deciding which parts of the writing process to prioritize and spend more time on
  • Knowing how long this will take you, and managing your time respectively
  • Maintaining focus on a task that involves doing the most laborious and LEAST interesting thing a teacher could ask you to do…write
  • Managing the impulse to turn to your friend next to you and talk about what you’re really interested in, which is obviously Minecraft

The above lists are far from comprehensive, and even so, they help demonstrate how a “simple” task is in fact a much more complex–and demanding–series of mini-tasks to complete. Depending on the student, they may easily breeze through these mini-tasks, hardly experiencing them as demands, or they may acutely feel the weight of each mini-task. Students with executive function struggles are more likely to fall into the latter category.

While the best way to support your student or child will vary, the first step is the same for everyone: awareness. The more aware teachers and parents can be about the hidden demands involved in the tasks we assign, the better prepared we can be to support students in overcoming those demands. Acknowledgement and compassion go a long way. Start by reflecting on all the mini-tasks involved in each of your own daily activities, and your ability to identify hidden demands will steadily improve. You can extend this new self-awareness to your students or child, helping them to understand that every task contains a series of smaller steps to follow, and all these steps can make a task feel complicated and draining. Soon, both you and your child will be pros at seeing what lies beneath the surface, and you’ll never label something “a simple task” again!

If today’s post resonates with you or your child, consider reaching out to NESCA; we’re here to help with life’s “simple” tasks! For more information about NESCA’s executive function coaching, visit: https://nesca-newton.com/coaching-services/detailed/#coaching-executive-function.

 

About the Author

Jasmine Badamo, MA, is an educational counselor and executive function coach who works full-time at NESCA supporting students ranging from elementary school through young adulthood. In addition to direct client work, Ms. Badamo provides consultation and support to parents and families in order to help change dynamics within the household and/or support the special education processes for students struggling with executive dysfunction. She also provides expert consultation to educators, special educators and related professionals.

Ms. Badamo is a New York State Certified ENL and Special Education teacher. She has more than 10 years of teaching experience across three countries and has worked with students and clients ranging in age from 7 to adulthood. She earned her bachelor’s degree in Biological Sciences from Cornell University and her master’s degree in TESOL from CUNY Hunter College. She has also participated in graduate coursework focusing on academic strategies and executive function supports for students with LD, ADHD, and autism as part of the Learning Differences and Neurodiversity (LDN) certification at Landmark College’s Institute for Research and Training. In addition to being a native English speaker, Ms. Badamo is also conversationally fluent in verbal and written Spanish.

Having worked in three different New York City public schools, Ms. Badamo has seen firsthand the importance of executive function skills in facilitating student confidence and success. Her coaching and consultation work focuses on creating individualized supports based on the specific needs and strengths of each client and supporting the development of metacognition (thinking about one’s own thought processes and patterns), executive function skills, and independence. She will guide clients to generate their own goals, identify the barriers to their goals, brainstorm potential strategies, advocate for support when needed, and reflect on the effectiveness of their applied strategies.

Ms. Badamo is a highly relational coach. Building an authentic connection with each client is a top priority and allows her to provide the best support possible. Additionally, as a teacher and coach, Ms. Badamo believes in fostering strong collaborations with anyone who supports her clients including service providers, classroom teachers, parents, administrators, and community providers.

 

To book executive function coaching with Jasmine Badamo or another EF or Real-life Skills Coach at NESCA, complete NESCA’s online intake form. 

 

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

8

Individualized Education Program or 504 Plan? How do I Know which is Right for My Child?

By | Nesca Notes 2023

By: Alissa Talamo, PhD
Pediatric Neuropsychologist, NESCA

Both an Individualized Education Program (IEP) and a 504 Plan can provide supports for students in grades K-12 who are struggling in school, to ensure the student is able to receive “free and appropriate public education (FAPE).” However, not all students who are struggling will qualify for these supports.

An IEP provides a plan for students who require special education supports and direct related services to meet their unique needs, and these supports need to be provided at no cost to the family.

There are two requirements a child must meet to qualify for an IEP. The student must have one or more of the 13 disabilities noted in The Individuals With Disability Education Act (IDEA), which is the federal special education law for children with disabilities. Some of the disabilities listed include a Specific Learning Disability, autism (ASD), other health impairment (e.g., AD/HD), speech or language impairment, or an intellectual disability (for a full list of the 13 disabilities, see https://www.doe.mass.edu › sped › definitions). The second requirement is that the disability must affect the child’s educational performance and/or ability to learn and benefit from the general education curriculum, meaning the child must need specialized instruction to make progress in school. The IEP sets learning goals and describes the services the school will provide. Some components the IEP must include are: how the child is currently performing in school (e.g., academic and functional performance) along with annual education goals and services the child will receive. Additionally, the school will track progress toward those goals and the IEP team must review the IEP at least once a year.

A 504 Plan stems from Section 504 of the Rehabilitation Act of 1973. This is a federal civil rights law to stop discrimination against people with disabilities and requires the school to provide support and remove barriers for a student with a disability. A 504 Plan provides services and changes to the learning environment to enable students to learn alongside their peers. As with an IEP, a 504 plan is provided at no cost to families. There are two requirements to be eligible for a 504 Plan. A child has any disability, and the disability must interfere with the child’s ability to learn in a general education classroom. According to Section 504, the disability must substantially limit one or more basic life activities. Because the definition of disability is broader on a 504 Plan, a child who does not qualify for an IEP might still be eligible for a 504 Plan. In general, a 504 Plan is a good option for students with disabilities who do not require specialized instruction but do need specific accommodations to receive FAPE (e.g., extended time on tests, larger print text, priority seating close to the front of the classroom).

To determine if your child would qualify for an IEP or 504, it is important that they receive a thorough evaluation (cognitive, educational, functional, social/emotional, etc.) to determine their level of need. This evaluation can be completed through the public school system or an independent evaluator.

Sources:

www.understood.org

https://www.mpgfirm.com/back-to-basic-rights-iep-vs-504/

 

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 college-aged daughter.

 

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 and Plainville, Massachusetts, Londonderry, New Hampshire, and Burlington, Vermont, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

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