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newton massachusetts

Simple Executive Functioning Strategies When The World Is Anything But Simple

By | NESCA Notes 2020

By: Moira Creedon, Ph.D. 
Pediatric Neuropsychologist, NESCA

Whether your children have returned to school full-time, on a hybrid model or fully virtual learning, we are all juggling. Juggling work demands, family demands, household demands and educational demands in a time of remarkable uncertainty. The start of the school year typically brings the smell of fresh school supplies and our best organizational efforts, but many of us may feel hesitant to use organizing strategies to manage our lives. Why? Because our lives are unpredictable and anything but typical these days. If you’re hesitating to use pen on a calendar, I hear you!

The ability to plan and employ organizational strategies is a key task of our executive functioning system. It’s what allows us to coordinate multiple schedules, dance and sports practices, projects at work, PTO bake sale reminders, and get out the door each day on time. I have been hesitant to adopt routines because I recall vividly how all those plans imploded in March when the world stood still. I hear the buzz about how school will end up fully remote so “put it all down in pencil before it all changes.”  Maybe that will prove true, but in the meantime, let’s consider the ways that we can rally our executive systems to do what they do best: plan, organize and regulate. Some suggestions for how to do this now while the world is unpredictable:

  1. Adopt the Sunday Game Plan. Put information in a family or personal calendar once a week. Spend a few moments on Sunday night catching up on plans for the coming week. Even if we end up transitioning from “hybrid” to “remote” (or all remote), this planning routine can still be adopted. Conclude your Sunday Game Plan by previewing what may be coming the week after in the event of long-term projects. While the content of your game plan may change, the structure can remain consistent.
  2. Keep a consistent schedule for sleep for the family. When we were all in school and work, we had set times to wake up in the morning. We should adopt more consistent bed times at least from Sunday through Thursday nights. Engage kids and teens in a conversation about the plan for sleep. If there are days when children are not waking up to physically attend school, try to keep wake up times no more than an hour off to allow for more consistency in our overall sleep regulation.
  3. As part of your weekly plan, set aside time for exercise. This is particularly important for children who will have reduced physical education activities. Research about the positive impact of exercise on mood, anxiety and attention underscores how important movement is in the day.
  4. Work together with your child to identify a consistent work space. Needing a work space at home is not suddenly and dramatically forced on all of us like it was in the spring. Take the time to arrange a space that is as distraction-free as you can make it. It’s not necessary to run out and buy things as minimal distractions can allow your child to focus on their school work. Keep the supplies nearby in their own bin, basket or box top.
  5. Help your child to create visual schedules or checklists for the day. Include times for virtual school, times for completing assignments and steps to submit the work either electronically or packed for the next day in school. Keep checklists consistent throughout the week when possible.
  6. Plan and schedule breaks. For young kids, try to plan breaks from tasks for every 15-20 minutes. Incorporate movement or stretching when possible to improve focus. For older students, try to plan breaks every 30 minutes of sustained effort. Try to take a full break from screens rather than replacing a tablet/computer screen with a phone or video game.

Children and teens develop their executive functioning skills over time. Keep this in mind as you set up routines and expectations for your whole family as what is expected for a second grader should and will differ from a seventh grader. Again, the content can differ but the structure of using a checklist, planning a break, or working at a desk or table is the same.

Please remember: the pandemic has depleted our executive functioning systems, so it’s important that we are gentle and kind to ourselves. Think about simple and reasonable systems to organize yourself and your family.  And be flexible when we have to go back to the drawing board.

 

Resources:

Positive impact of exercise:

https://www.sciencedirect.com/science/article/abs/pii/S0022347612009948

Executive Functioning tips and sample schedules:

https://www.smartbutscatteredkids.com/

 

About the Author: 

Dr. Creedon has expertise in evaluating children and teens with a variety of presenting issues. She is interested in uncovering an individual’s unique pattern of strengths and weaknesses to best formulate a plan for intervention and success. With experiences providing therapy and assessments, Dr. Creedon bridges the gap between testing data and therapeutic services to develop a clear roadmap for change and deeper of understanding of individual needs.

 

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

 

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

How Do I Prepare My Child for a Neuropsychological Evaluation?

By | NESCA Notes 2020

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

Parents often ask us what they should tell their child about their upcoming neuropsychological evaluation, especially when it is their first experience with testing. I advise parents to refer to the neuropsychologist using his or her first name, as the term “doctor” can be scary and raise fears about medical exams. I might also add that the visit will not involve any shots! In order to describe the evaluation itself; here is some helpful language:

  • They are going to ask you questions, and you just need to do your best to answer.
  • They might ask you to do some drawing or writing.
  • Some activities might feel like you’re in school; for example, reading stories or doing math problems.

It may also be helpful to create a simple social story prior to the evaluation to help preview what to expect for your child.

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 everybody learns differently.
  • We are going to be “brain detectives” and figure out how your brain works!
  • This will help us identify your strengths and areas that we need to work on. That way, we can help you with things that are harder for you.
  • This will help your teachers understand your learning style so they can help you better at school.
  • Just try your best!

Testing in the age of Covid-19 is different. It can be harder to help children feel at ease when everyone is wearing masks, and we can’t offer a high five for good work. But as we are all learning, children are often more resilient than adults. Prior to coming in for an evaluation, you might want to remind your child to wear their mask, wash their hands and not approach people too closely.

It is also important to understand that a neuropsychological evaluation is a lot of work for your child! Finding a way to reward them for their effort will go a long way in helping them stay motivated and positive. This could be as simple as swinging by the drive-thru for a donut or something more extravagant, like a new video game. Whatever you choose to do, create a plan with your child and let the neuropsychologist know. When I have a child in my office who is starting to fatigue, it’s always a great motivator to remind them of the special prize they’ll get at the end of the visit!

 

About the Author: 

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

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

 

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

 

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

The Next Pandemic: Mental Health Issues

By | NESCA Notes 2020

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

The return to school, whether remotely or in person, will be a transition that is bound to be stressful for many children and adolescents as well as their parents and teachers. Coming on the heels of five stressful months of lockdown, remote learning, loss of social contact and so many other changes,  children will be meeting this challenge with depleted resources for coping with stress and may show new signs of anxiety or mood issues. This will be particularly true for children and adolescents who have underlying issues with mental health, attention or learning. Prioritizing the mental health of students and focusing on providing emotional support will be key to helping children manage the transition back to school. “When children feel connected, they’re going to learn better, do better, stay on track,” commented Dr. Nadine Kaslow, professor of psychiatry at Emory School of Medicine and past president of the American Psychological Association, in this article. She emphasized that “loving warm interactions need to take precedence” over struggling with them about behavior or about schoolwork.”   Remembering that undesirable behaviors are often driven by emotional distress and are a form of communication can be helpful for parents in responding in a positive and supportive manner. As we continue through this period of unprecedented levels of stress and change, children need to feel connected to and supported by their parents even more than is usual; maintaining this connection is far more important than any academic goals, no matter how far behind parents fear their child is as a result of the interruption to regular schooling.

If you have concerns about your child’s mental health, clinicians at NESCA are available for expert consultation or evaluation of your child’s emotional functioning so that the appropriate supports can be put in place. This work can be done either through teletherapy or in-person through contactless evaluations in all three of our locations (Newton and Plainville, MA and Londonderry, NH). NESCA has several suites in which there is a large plexiglass panel in the shared wall between two offices so that the child/parent and evaluator/therapist are in separate offices but have the benefit of full visibility and communication through headphones. For more information, please view, “Testing in the Age of COVID-19” on our Video Resources page.

If you have questions about your child’s mental health and would like professional help, please reach out to Dot Lucci, M.Ed., CAGS: dlucci@nesca-newton.com for an intake and screening.

 

About the Author: 

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

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

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

To book an evaluation with Dr. Helmus, NESCA Founder and Director, or one of our many other expert neuropsychologists or therapists, complete NESCA’s online intake form

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

Preparing our Kids to Reenter the Community

By | NESCA Notes 2020

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

For many children, new experiences are frightening and anxiety-provoking. Children thrive on routine and predictability; when these get interrupted, it can be hard for them to understand what is happening. As we all know, the last few months have been fraught with unpredictability and change. Now, we are starting to go back to work, eat at restaurants and visit retail stores. As adults, we might have mixed feelings about this – relief to get out of the house but also fear about the ongoing pandemic. For our children, we are expecting them to reenter their communities with a new set of “rules” after months of being in the safety of their homes. This is going to be a difficult process, especially for children with special needs.

So how do we prepare children for all of the new experiences they are about to face?

One method that has been found to be effective is the use of Social Stories™. Social Stories were first developed in 1990 by Carol Gray, a special education teacher. In essence, Social Stories are used to explain situations and experiences to children at a developmentally appropriate level using pictures and simple text. In order to create materials that are considered a true Social Story, there are a set of criteria that must be used. More information can be found here: https://carolgraysocialstories.com/social-stories/what-is-it/.

While special educators or therapists are expected to use this high standard in their work, it is also relatively easy for parents to create modified versions of these stories to use at home. I was inspired by one of my clients recently who made a story for her son with Down syndrome to prepare him for the neuropsychological evaluation. During her parent intake, she took pictures of me and the office setting. At home, she created a short book that started with a picture of her son, a picture of their car, a picture of my office, a picture of me and so on. On each page, she wrote a simple sentence:

  • First we will get in the car
  • We will drive to Dr. Gibbons’ office
  • We will play some games with Dr. Gibbons
  • We will go pick a prize at Target
  • We will drive home

Throughout the evaluation, she referred to the book whenever her son became frustrated by the tests or needed a visual reminder of the day’s schedule. Something that probably only took a few minutes to create played an important role in helping her son feel comfortable and be able to complete the evaluation.

The options for creating similar types of stories are endless, giving parents a way to prepare their children for a scary experience.

Some examples of stories to create during the ongoing pandemic:

  • Wearing a mask when out of the house
  • Proper hand washing
  • Socially distant greetings (bubble hugs, elbow bumps, etc.)

Some examples of more general stories include:

  • Doctor’s visits
  • Going to the dentist
  • Getting a haircut
  • Riding in the car
  • First day of school

You can use stock photos from the internet or pictures of your child and the actual people/objects they will encounter. If you have a child who reads, you can include more text; if your child does not read, focus on pictures only. Read the story with the child several times in the days leading up to the event. For ongoing expectations (e.g., wearing a mask) – you can review the story as often as needed. Keep it short and simple. And have fun with it!

 

About the Author: 

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

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

 

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

 

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

Testing at NESCA during COVID-19

By | NESCA Notes 2020

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

I’m sure you can agree, it’s been an interesting time due to the onset of COVID-19. Our worlds, livelihoods and professional lives have been turned upside down. At NESCA, where our entire business revolves around the in-person evaluations, assessments, coaching and treatment of children, adolescents and young adults, much of our “In Real Life (IRL)” activity had to be put on hold to prevent the risk of infection among our clients and staff.

After making the decision to temporarily close our physical offices, our clinical and administrative staff swiftly geared up to provide as many services as possible remotely. While we were considered an “essential” business by the State of Massachusetts, we opted to pause our neuropsychological testing for the safety of all involved while initiating research into how we could conduct this critical service to our families. We are keenly aware of the long wait times for testing and the associated stress that puts on parents while they seek out answers about their children’s behavior or learning differences—all the while making children who need supports earlier than later wait in the wings as well. We also knew there would be an increased need for testing because of the impact COVID-19 was and is likely to have on the mental health of children and teens; schools would eventually be inundated with a back-log of evaluations already in the works as well requests for new evaluations that, by law, have to be conducted within a specific time period; and to help fulfill the ever-present need to assist schools and parents in providing support to children with special needs.

Knowing our pause of testing was not a long-term, viable option, after careful consideration and much intense research, we identified several options on how we could bring our neuropsychological evaluation services back to the NESCA community. The options we identified as possibilities included conducting teletherapy, using a partial plexiglass screen (akin to what you would see protecting a store cashier), observing social distancing and constructing a two-office model. We examined the risk to both clients and clinicians, privacy and technology constraints, ethics surrounding the validity of the test findings and legal issues concerning the credibility of evaluation findings/diagnosis among other topics.

While we determined that teletherapy has a role in the testing process, including parent intake and feedback sessions, we ultimately decided that it would not be a solution for NESCA to adopt for the actual evaluation of a child. Next, the partial plexiglass shield did not provide enough risk mitigation for the child or evaluator, and it may not have been a secure enough physical barrier for some of the more aggressive children we test to keep both parties properly distanced.

So, where does that leave us? We do have social distancing in the mix as a potential option. While it does not provide maximum risk reduction, some families see it as the most natural option. The child, and if necessary, a parent helper, are at one end of a long conference table, and the evaluator is at the other end, at least six feet away at all times. All people in the room wear masks to further reduce risk. All testing materials are set up in advance for the child or parent helper. Most tests can be conducted on an iPad, which is controlled by the evaluator’s computer.

Since we were very aware that some parents would not be comfortable with this model, we continued our exploration and education, landing on an innovative two-office model. The two-office set-up involves a four foot by eight foot clear plexiglass window to be installed between two offices. This allows for clear observation of the child by the evaluator, the ability for the child and evaluator to communicate with each other via a high-quality intercom system and for the evaluator to visually demonstrate activities that the child is asked to perform during testing. A parent helper can be allowed in the room with the child should they need support during the session. Again, many of the tests would be administered via an iPad, which is controlled by the evaluator in the adjoining room. All additional test materials are organized and arranged in the office where the child is prior to testing.

NESCA’s two-office approach was piloted in our Londonderry, N.H. office by Dr. Angela Currie. Due to its maximum risk reduction for all parties and its similarity to the standard testing experience, NESCA expanded its testing capabilities with this model to the Newton office, where there are currently two of these testing areas available. While it does have some limitations, it is working very well with our families.

Along with the new testing models implemented, NESCA is, of course, taking all precautions available to reduce risk of exposure. We require risk assessment questionnaires, temperature checks and hand sanitizing; implemented a “touchless” check-in process; limit the number of people to a total of eight at one time in the 7,000 square foot Newton office, with testing being done at opposite ends of the office; provide private waiting rooms for parents who are not involved in the child’s testing; and sanitize all equipment and rooms used both before and after every appointment. We continue to follow the CDC and State’s guidelines for re-opening requirements.

We are very proud of our ability to continue to serve parents, children, families and schools during this extremely difficult time. I am once again so grateful to the cohesive and collaborative team we have in place here at NESCA and for its creativity, innovation, determination and dedication. The needs of families with children who have special needs never stop. While we may be forced to pause, NESCA will do everything in its power not to stop either.

Resources/Notes:

  • To view the Federation for Children with Special Needs webinar with Dr. Ann Helmus, visit Testing in the Age of Remote Learning
  • Dr. Helmus will present, “Testing in the Time of Covid,” to the Massachusetts Urban Project, a statewide network of special education leaders from 15 urban school districts across the state, on June 9.
  • Dr. Helmus will present on this topic in conjunction with Massachusetts Advocated for Children in June TBD.

 

About the Author: 

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

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

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

To book an evaluation with Dr. Helmus, NESCA Founder and Director, or one of our many other expert neuropsychologists, complete NESCA’s online intake form

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

New Decade; New Director’s Update

By | NESCA Notes 2019

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

Welcome to the new year and a new decade! It’s a perfect time to take a look in the mirror and determine who we are. We reflect on what’s taken place in our lives and ask questions about what’s next. What do we want to keep in our lives or discard? What motivates us? What drives us to accomplish the plans we make?

At NESCA, we started this reflection early in the fall by dedicating a full day to a company-wide workshop to define who we are as a group practice and what our core values are. The main question to ourselves was, “What makes NESCA different?”.

Throughout the exercise, we outlined our mission and—as a values-driven organization—what our core values are. It’s not that we didn’t regularly follow them before our workshop, but we now had them down on paper to help guide us on a daily basis and as we forge ahead in the new decade. We shared our views on being so much more than evaluators who write neuropsychological reports and came to a consensus on what our bigger purpose is. We create the game plan, the roadmap that helps people rewrite the script of their lives, tell a new story and create a new path forward.

Throughout the workshop day, one unanimous theme emerged from NESCA’s team of clinicians, consultants, transition specialists, wellness providers and administrative staff is that we are a community of lifetime learners who are dedicated to collaboratively helping the families we work with, both now and as they develop throughout their life.

While each one of us at NESCA is smart, we know we are smarter together. NESCA clinicians are experienced professionals, veterans of their respective domains, who truly enjoy what they do and seek opportunities to collaborate, all so we can deliver the best possible recommendations for the individuals and families we work with. Many of us have worked together for decades. We understand SPED laws and the myriad of available services from preschool to adulthood. We work in a supportive environment where the perspectives and experiences of all employees are valued, respected and counted—whether that experience comes from our formal education, decades of work with families, conversations with our colleagues, being parents of children with special needs or other areas. This knowledge allows us to create plans that accommodate the services that are appropriate now as well as create a window for what an individual may need in the future.

As a team, we continually and proactively seek the expertise of each other as well as external professionals to enhance and strengthen our perspectives and consequently shape our individualized recommendations to those we work with. We don’t just do this on an ad hoc basis. We dedicate untouchable time on a weekly basis to our case conferences where we meet as a team, share resources and new evidence-based research and discuss challenging cases, with each clinician or practitioner offering insight and expertise from their vast past experience and body of connections to provide stronger and more worthwhile guidance and recommendations to families and schools.

Because of this group collaboration, we are highly equipped to take on complex cases. As the largest group of neuropsychologists and complementary clinicians in Greater Boston/New Hampshire, we bring a broad range of skills, perspectives and unique tools and approaches to the complex issues that are often presented to us.

During our workshop, we stated our core values—what motivates us every day to do what we do. We created them together and re-examine them regularly to ensure they reflect our mission, our commitment to children, young people and families, and our overall vision. Collaboration is just one of the core values that drives us. Throughout the year, we will bring you more of the outputs from our workshop, sharing what makes NESCA different.

About the Author: 

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

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

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

To book an evaluation with Dr. Helmus, NESCA Founder and Director, or one of our many other expert neuropsychologists, complete NESCA’s online intake form

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

Acupuncture for the Treatment of Specific Conditions

By | NESCA Notes 2019

By: Meghan Meade, L.Ac, MAOM, MS PREP, CYT

Licensed Acupuncturist, NESCA

A Primer on Acupuncture

While the insertion of needles into the skin to provoke a healing response is a hallmark characteristic of acupuncture, the practice actually involves the potential use of a number of other tools and techniques, including cupping, magnets and other non-insertive tools, and moxibustion, the topical application of a heated herbal substance designed to improve circulation and reduce inflammation.

Chinese medicine approaches healing by seeking to restore balance in the body; in so doing, it evaluates the patient as a complex and ever-changing ecosystem, a composite of multiple interrelated and mutually interdependent systems. Though a patient may be seeking relief from anxiety, for example, acupuncture addresses the issue within the context of a wider landscape, as there are often other symptoms and imbalances accompanying a primary imbalance. To that end, treatments will, of course, take into account a patient’s reported symptoms, but they are rarely the main driver of an acupuncturist’s treatment decisions. Acupuncturists additionally rely on observation of patients’ mannerisms, the sound and qualities of their voices, how they carry themselves and perhaps most importantly – the use of palpation techniques to elicit feedback from the body that guide treatment decisions. What an acupuncturist feels in a patient’s pulse or palpates on a patient’s abdomen or acupuncture channels is immensely influential to the diagnostic and treatment processes.

Implicit in this process is the notion that despite the fact that a patient may be seeking relief from a particular condition, that patient is not the same person he is today as he was yesterday, nor the same as he will be tomorrow. The treatment aims to address the nuances of a patient’s presentation within the present moment, guided by the knowledge of the patient’s health history and health objectives for the future.

Put into a biological context, we humans are continually and necessarily affected by our innate biochemistry as well as by our surroundings – both our mental-emotional and physical environments. Chinese medicine does not reduce a condition down to its primary symptoms, but rather considers all symptoms that are overtly or seemingly less-directly related. If the immune system is affected by a virus, for example, because of its cross-talk with the nervous and endocrine systems, all systems will be influenced in some way, shape or form. Though the rest of this article will discuss the ways in which acupuncture can impact specific conditions that commonly affect the pediatric population, it is predicated on this concept of mutual inter-relatedness and interdependence of the body’s systems.

Acupuncture’s Impact on Mental and Emotional Conditions

The incidence of anxiety, depression and behavior disorders has increased markedly in recent years, with data from the CDC indicating that anxiety and depression incidence among children aged 6-17 has grown from 5.4% in 2003 to 8.4% in 2011-2012. Currently, incidence rates among children aged 3-17 are 7.4% for behavior problems; 7.1% for anxiety; and 3.2% for depression. These afflictions do not occur in isolation and often accompany each other, as 73.8% of children aged 3-17 with diagnosed depression also have anxiety and 47.2% also have behavior problems.

Though we should keep in mind that enhanced awareness of these conditions among children as well as improved assessment and detection in recent years may paint a more dire picture of afflictions that have never in actuality been absent from the pediatric population, the data do represent a critical need to help children in their formative and impressionable years feel more at ease in their bodies as they navigate growth and development.

A dysregulation of the stress response is characteristic of chronic depression, anxiety and behavior disorders. The HPA (hypothalamic-pituitary-adrenal) axis is responsible in part for regulating the body’s response to stress, whether that stress be mental, emotional or physical. When stress becomes chronic, the ability of the HPA axis to allow for functional communication between the brain and body to keep a person feeling safe and calm becomes impaired, resulting in altered activity of stress hormones, such as cortisol, and neurotransmitters such as serotonin and dopamine. Cortisol is of particular interest in this context, as it not only plays a significant role in the stress response but also modulates immune system activity. When cortisol is elevated due to chronic stress, the body ultimately becomes resistant to it, and the immune system is not kept in check, resulting in a proliferation of inflammation. Acupuncture has demonstrated the capacity to modulate HPA axis function to alleviate stress-related symptoms by restoring the body’s responsiveness to cortisol so that its roles in nervous and immune system function can be maintained appropriately. Dysregulated HPA axis function has been implicated in a number of allergic conditions, such as asthma and dermatitis; somatic conditions, such as Fibromyalgia and Chronic Fatigue Syndrome; psychiatric conditions such as PTSD and depression; and numerous immune and autoimmune diseases, underscoring the importance of maintaining proper function of the HPA axis.

Another component of the body’s response to stress involves the autonomic nervous system, comprised of two branches – the sympathetic nervous system and the parasympathetic nervous system. Where the sympathetic branch of the nervous system is responsible for the ‘fight, flight or freeze’ response that alerts us to and helps us remove ourselves from danger, the parasympathetic branch of the nervous system represents the ‘rest and digest’ state, which we’re biologically designed to occupy the majority of the time. Dysfunction of the autonomic nervous system is thought to underlie a number of prevalent mental, developmental and behavioral disorders, such as depression and anxiety, ADHD, and autism. Acupuncture has been shown to activate and modulate the function of brain regions involved with the autonomic nervous system through a number of mechanisms, including increasing concentrations of endogenous opioids, regulating the function of amino acids, such as GABA and glutamate, and enhancing the activity of neurotrophins, such as nerve growth factor (NGF) and brain derived neurotrophic factor (BDNF).

While depression and anxiety are highly heterogeneous in their presentations, and are driven by numerous mechanisms in the central and peripheral nervous systems, increases in inflammation are thought to play a correlational – if not at least partly causative – role in their development. Depression and anxiety have been associated with elevated levels of inflammatory markers, such as C-reactive protein (CRP), Interleukin 6 (IL-6) and Tumor Necrosis Factor-alpha (TNF-alpha), all of which have been shown to be reduced through acupuncture.

Acupuncture and ADHD

ADHD, as defined by the DSM-IV, has a prevalence of 5.9% – 7.1% among children. Characterized by inattention, hyperactivity and impulsivity, ADHD is commonly treated pharmacologically with stimulant medications, such as methylphenidate. While little is known about the long term effects of stimulant medication in this population, and short-to intermediate-term effects include anxiety, depression, weight loss and insomnia, 12% – 64% of parents of children with ADHD have sought out complementary and alternative (CAM) therapies, including acupuncture. In a study of children aged 7-18 diagnosed with ADHD, twice weekly acupuncture treatments for six weeks demonstrated improved attention and memory function among children not taking medication. Another study explored the potential for acupuncture to improve school performance among children aged 7-16; following a series of 10 acupuncture sessions over the course of eight weeks, study subjects showed significant improvements across all three school subjects: math, social studies and Turkish language. Aside from the capacity of acupuncture to improve the stress response through modulation of the HPA axis and autonomic nervous system, acupuncture’s effects on attention and memory and on learning and perception are thought to be mediated in part by its regulation of the neurotransmitters dopamine and serotonin, respectively.

Acupuncture and Autism

With prevalence reports ranging from as low as 1 in 500 to as high as 1 in 50, Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that affects social communication and interaction, language and behavior. Standard treatment of ASD includes pharmacological therapy and behavioral/educational therapy, though reports from a wide sampling of children with ASD indicate that approximately 88% had utilized CAM therapies to address symptoms such as hyperactivity, inattention, poor sleep and digestive issues. In a study of boys with autism, a treatment regimen of five daily acupuncture sessions over the course of eight weeks demonstrated improvements in speech, self-care and cognition. Significant increases in glucose uptake were shown within the intervention group (vs. control), with improved glucose metabolism in areas of the brain involved in visual, auditory and attentional functioning being thought to underlie the improvements seen in language, attention and cognition. An analysis of 13 studies on acupuncture for autism indicated that the most effective treatment regimen entailed 12 sessions within four weeks, each using a minimum of four acupuncture points, and went on to associate individual acupuncture points with specific effects, from improved language comprehension to enhanced self-care abilities. A meta-analysis of 27 randomized controlled trials found that acupuncture in combination with behavioral and educational interventions (BEI) was more effective than BEI in improving symptoms as determined by a number of evaluation scales (CARS, ABC1, ATEC), suggesting the potential for acupuncture to yield an additive positive effect when utilized with standard of care therapy.

Ultimately, though research supports the use of acupuncture for specific conditions among children and adolescents, it is important to remember that the approach of an acupuncturist is generally not solely protocol-driven as it would be in a research setting. While research findings can and certainly do inform treatment decisions, acupuncturists also rely to a great extent on what is observed and felt during the treatment – they listen to patients’ reported symptoms and experiences, observe how patients speak and carry themselves, palpate acupuncture channels and reflex areas, and feel the pulse to determine imbalances in the body. In this way, Western and Eastern science and medicine are invited to work together to treat imbalances in an informed, patient-centric, holistic way.

References

Almaali, H. M. M. A., Gelewkhan, A., & Mahdi, Z. A. A. (2017, November 11). Analysis of Evidence-Based Autism Symptoms Enhancement by Acupuncture. Retrieved from https://www.sciencedirect.com/science/article/pii/S2005290117301395.

Data and Statistics on Children’s Mental Health. (2019, April 19). Retrieved from https://www.cdc.gov/childrensmentalhealth/data.html.

Duivis, H. E., Vogelzangs, N., Kupper, N., Jonge, P. de, & Penninx, B. W. J. H. (2013, February 8). Differential association of somatic and cognitive symptoms of depression and anxiety with inflammation: Findings from the Netherlands Study of Depression and Anxiety (NESDA). Retrieved from https://www.sciencedirect.com/science/article/pii/S0306453013000073.

Hong, S.-S., & Cho, S.-H. (2015, November 22). Treating attention deficit hyperactivity disorder with acupuncture: A randomized controlled trial. Retrieved from https://www.sciencedirect.com/science/article/pii/S1876382015300585.

Lee, B., Kim, S.-N., Park, H.-J., & Lee, H. (2014, April 1). Research advances in treatment of neurological and psychological diseases by acupuncture at the Acupuncture Meridian Science Research Center. Retrieved from https://www.sciencedirect.com/science/article/pii/S2213422014000237.

Lee, B., Lee, J., Cheon, J.-H., Sung, H.-K., Cho, S.-H., & Chang, G. T. (2018, January 11). The Efficacy and Safety of Acupuncture for the Treatment of Children with Autism Spectrum Disorder: A Systematic Review and Meta-Analysis. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/29552077.

Li, Q.-Q., Shi, G.-X., Xu, Q., Wang, J., Liu, C.-Z., & Wang, L.-P. (2013). Acupuncture effect and central autonomic regulation. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3677642/.

Musser, E. D., Backs, R. W., Schmitt, C. F., Ablow, J. C., Measelle, J. R., & Nigg, J. T. (2011, August). Emotion regulation via the autonomic nervous system in children with attention-deficit/hyperactivity disorder (ADHD). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3112468/.

Wong, V. C.-N., Sun, J.-G., & Yeung, D. W.-C. (2014, December 19). Randomized control trial of using tongue acupuncture in autism spectrum disorder. Retrieved from https://www.sciencedirect.com/science/article/pii/S2095754814000064.

 

About the Author

Meghan Meade is a licensed acupuncturist practicing part-time at NESCA.

Having suffered from anxiety, digestive issues, hormonal imbalances and exercise-induced repetitive stress injuries throughout her adolescence and twenties, Meghan first sought out acupuncture as a last ditch effort to salvage some semblance of health and sanity during a particularly stressful period in her life. It worked. Remarkably well. So palpable was the influence of acupuncture on her well being that she was compelled to leave a career in advertising to study Chinese medicine so that she could help others benefit from its effects.

Meghan earned her masters degree in Acupuncture and Oriental Medicine from the New England School of Acupuncture at Massachusetts College of Pharmacy and Health Sciences (MCPHS) and a masters degree in Pain Research, Education and Policy from Tufts University Medical School. She is licensed by the Massachusetts Board of Medicine and is a Diplomate of Oriental Medicine, certified by the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM).

In her clinical practice, Meghan integrates both Eastern and Western perspectives to provide treatments unique to each patient’s needs and endeavors to empower patients to move forward on their paths to not just feeling good, but feeling like their true selves. In addition to her work as a licensed acupuncturist and herbalist, Meghan serves as adjunct faculty at MCPHS and is a certified yoga teacher.

 

To learn even more about Meghan and acupuncture, visit her alternate web site or read her blog: https://meghanmeadeacu.com/Meghan is practicing at NESCA during the following hours. Appointments at NESCA can be booked by reaching out to me directly at meghan@meghanmeadeacu.com.

Monday: 10am – 6pm

Thursday: 9am – 7pm

 

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

We’re All “Perfection Pending”

By | NESCA Notes 2019

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

I recently came across a raw and powerful blog post on Perfection Pending by Meredith Ethington. It’s a worry-filled, heartfelt and all-too-familiar account of a mother dropping her child off at school in tears, questioning her parenting skills after a tough, embattled morning with her struggling child. We can all relate to her fears, questioning and self-doubt.

At NESCA, I often meet with parents, just like the mom in the blog post, who question the decisions they’ve made as well as the indecision they’ve allowed on behalf of their children. They blame themselves for the challenges their child has at home and/or in school and frequently ask themselves and me what they could have done better. Many times, the answer is nothing. These are normal emotions for any parent, but when there are special needs present, these emotions are intensified.

Recently, our staff across NESCA’s three offices met as a team to get to know new staff  better, discuss what’s going on in the field of pediatric neuropsychology and hone in on what makes NESCA different. After lots of insightful discussions throughout the day, we were struck by the consistent theme that emerged—when families come to NESCA, they don’t just get a cookie cutter neuropsychological report about their child’s learning style, diagnosis and rote recommendations. At NESCA, not only do families get a thorough, individualized report with an accurate diagnosis and highly customized, realistic recommendations, but they get—sometimes even more importantly—an entire team of experts in their field all contributing ideas and resources to support families in the quest help their child.

Our expert neuropsychologists and providers don’t arrive at the label of “expert” solely by their degrees, years of experience and broad networks of resources who may help the children and young adults we see. Many of our clinicians and providers also have children or relatives they care for—a large number with their own identified challenges and special needs. We see things from both sides, can relate to the ongoing struggles and are there alongside the parents and caregivers during the testing process and over the long haul. We work side by side with parents, families, schools and children throughout a person’s development, not just the hours or days of testing and observation. Our jobs are not done when we deliver that final report to families. We serve as teammates throughout your journeys.

So, to the parents and caregivers crying tears of worry, doubt and blame, we hear you and we support you.

Additional reading:

Perfection Pending by Meredith Ethington

Mom Life: Perfection Pending

 

About the Author: 

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

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

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

 

To book an evaluation with Dr. Helmus, NESCA Founder and Director, or one of our many other expert neuropsychologists, complete NESCA’s online intake form

 

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

 

 

Introduction to Acupuncture with Licensed Acupuncturist Meghan Meade

By | NESCA Notes 2019

 

By: Meghan Meade, L.Ac, MAOM, MS PREP, CYT

Licensed Acupuncturist, NESCA

Acupuncture is one of eight branches of Chinese Medicine that dates back over 3,000 years and involves the insertion of hair-thin needles into the body to provoke a healing response.

The body registers needling as a microinjury to which it responds by summoning the immune, nervous and endocrine systems to increase circulation, produce endorphins and other pain-relieving substances and flips the switch on the stress response.1,2,3 The treatment itself effectively assesses the internal imbalance and sends a signal to the body to address it; for this reason, acupuncture’s effects are often described as regulating – reducing elevations in inflammatory markers, enhancing the production and function of essential neurotransmitters, and so on. 1,2,3

Because acupuncture is so regulating to the body’s internal environment, the effects experienced by the patient can be both targeted and systemic2 – while pain relief could be achieved for a specific injury such as a sprained ankle, a patient might also noticed improved sleep or reduced anxiety, for example.

As a practitioner of Japanese style acupuncture, a style that is particularly reliant on using the body’s feedback to guide treatment decisions (though not to the exclusion of a patient’s verbal feedback about their health concerns and experiences), I incorporate pulse diagnosis and palpation into my overall diagnosis and treatments. Because an individual is considered to be the ever-changing reflection of their environment and experiences – physical, mental and emotional – my treatments for a given patient and a given condition will never look the same; each day the body is slightly different than the day prior, and treatments are designed with this principle in mind.

Another important theme within Chinese Medicine is that of duality; acupuncturists consider mutually opposing and complementary elements, such as heat and cold, internal and external, male and female, and yin and yang to be crucial in both assessment and treatment. Whereas yang represents heat, energy, masculinity, day time and light, yin, by contrast, represents coolness, substance, femininity, night time and darkness. When we are born, we are at our peak state of yang, which progressively gives way to yin throughout the lifetime. Because children are by nature more yang, their energy is ample and at the surface; accordingly, treating children and adolescents with acupuncture requires less stimulation to yield a desired response. Often needling is not involved, and non-insertive tools and techniques are preferred for their gentle, effective and often expedient results. Pediatric treatments may involve the use of magnets placed on acupuncture points, as well as brushing and tapping techniques using stainless steel, copper and/or silver tools. Because acupuncture points exist along 14 channels that run up and down the body, an acupuncturist can effect change both in a given channel/organ system and systemically by stimulating a channel through brushing and tapping techniques. While the above statement is true that inserting needles into the skin triggers an extensive sequence of immune, nervous and endocrine system events, so, too, does the more superficial work that acupuncturists perform for their pediatric patients.

The goal of acupuncture is always to harmonize, reducing what is in excess and restoring what is deficient. On a biomedical level, this typically entails a shift in the autonomic nervous system from a sympathetic dominant state – fight or flight mode – to a parasympathetic state – the calmer and more productive – though elusive – ‘rest and digest’ mode.2,3 Similarly, acupuncture regulates the function of hormones, neurotransmitters and immune mediators to achieve this balance. While many feel a positive response from a single treatment, acupuncture is generally not a ‘one and done’ therapy; instead, the response to acupuncture becomes stronger and more lasting over the course of several treatments, as a cumulative signal is often required for the body to carry out the work of regulating imbalances. Often after an initial series of treatments, a patient can enter a maintenance mode of treatment, spacing treatments out in increasingly longer windows and eventually receiving treatment on a maintenance or as-needed basis.

I hope this introductory conversation provides some insight as to how acupuncture works. I will be back with a follow-up post to shed some light on the effect of acupuncture on specific conditions commonly seen among NESCA’s client base.

  1. Cheng, Kwokming James. “Neurobiological Mechanisms of Acupuncture for Some Common Illnesses: A Clinician’s Perspective.” Journal of Acupuncture and Meridian Studies 7.3 (2014): 105-14. Web.
  2. Carlsson, C. “Acupuncture Mechanisms for Clinically Relevant Long-term Effects – Reconsideration and a Hypothesis.” Acupuncture in Medicine 20.2-3 (2002): 82-99. Web.
  3. Cheng, K. J. “Neuroanatomical Characteristics of Acupuncture Points: Relationship between Their Anatomical Locations and Traditional Clinical Indications.” Acupuncture in Medicine 29.4 (2011): 289-94. Web.

 

About the Author: 

Meghan Meade is a licensed acupuncturist practicing part-time at NESCA.

Having suffered from anxiety, digestive issues, hormonal imbalances and exercise-induced repetitive stress injuries throughout her adolescence and twenties, Meghan first sought out acupuncture as a last ditch effort to salvage some semblance of health and sanity during a particularly stressful period in her life. It worked. Remarkably well. So palpable was the influence of acupuncture on her well being that she was compelled to leave a career in advertising to study Chinese medicine so that she could help others benefit from its effects.

Meghan earned her masters degree in Acupuncture and Oriental Medicine from the New England School of Acupuncture at Massachusetts College of Pharmacy and Health Sciences (MCPHS) and a masters degree in Pain Research, Education and Policy from Tufts University Medical School. She is licensed by the Massachusetts Board of Medicine and is a Diplomate of Oriental Medicine, certified by the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM).

In her clinical practice, Meghan integrates both Eastern and Western perspectives to provide treatments unique to each patient’s needs and endeavors to empower patients to move forward on their paths to not just feeling good, but feeling like their true selves. In addition to her work as a licensed acupuncturist and herbalist, Meghan serves as adjunct faculty at MCPHS and is a certified yoga teacher.

 

To learn even more about Meghan and acupuncture, visit her alternate web site or read her blog: https://meghanmeadeacu.com/Meghan is practicing at NESCA during the following hours. Appointments at NESCA can be booked by reaching out to me directly at meghan@meghanmeadeacu.com.

Monday: 10am – 6pm

Thursday: 9am – 7pm

 

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

What Does Autism Look Like? Exploring the Differences among Girls and Boys

By | NESCA Notes 2019

 

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

In 2018, the Centers for Disease Control and Prevention (CDC) determined that approximately 1 in 59 children is diagnosed with Autism Spectrum Disorder (ASD). Boys are still four times more likely be diagnosed with ASD; however, research indicates that the diagnosis is often missed in girls, especially those who have average intelligence and “milder” forms of ASD. To understand why ASD is more often missed in girls, let’s explore the differences between boys and girls with ASD. This discussion will focus on children with average to above average intelligence (about 50% of all children diagnosed with ASD).

 

Boys Girls
Poor impulse control, more acting out Likely to be quiet and withdrawn
Disruptive behaviors in the classroom setting Tend to be reserved and cooperative at school
Frequent repetitive motor behaviors that are directly observable Lower frequency of these motor behaviors
Lack of interest in imaginary play Very much engaged in imaginary play
Restricted interests may seem unusual – e.g., train schedules, maps, windmills Restricted interests may seem “age appropriate” – e.g., horses, unicorns, ballet
Trouble making friends Might have a few friends
Likely to exhibit angry outbursts when frustrated/anxious Likely to engage in self-harm or other behaviors that are not observed by others when frustrated/anxious
Lack of awareness of being different or not fitting in More motivated to fit in and “hide” social difficulties – might try to imitate the behavior of a peer that is perceived as popular

 

Due to these differences, the diagnosis of ASD is often missed in young girls. Adults might agree that a girl is “odd” or “quirky,” but dismiss these concerns because she has good eye contact, has some friends, and does not engage in hand flapping or other unusual behaviors. Unfortunately, other girls might be misdiagnosed, which could lead to ineffective or inappropriate treatment interventions. Most commonly, they might be misdiagnosed with ADHD or Anxiety Disorder.

In many cases, girls with ASD have increasing difficulties with social interactions as they get older and demands get higher. A young girl with ASD might be able to “get by” in social interactions but by the time she reaches adolescence, she is not able to navigate the intricacies of the social milieu. This can lead to social isolation and high risk of being bullied or rejected by peers.

Unfortunately, a missed diagnosis of ASD for a young girl can have long-reaching ramifications. She might experience depression, anxiety and/or low self-esteem, wondering why she doesn’t “fit in” and “feels different” from other girls. She might start to struggle in school or disconnect from activities that she used to enjoy. Moreover, missing the diagnosis in childhood means that she did not receive services to support her social and peer interaction skills during her formative years.

As always, when parents or other caregivers have concerns about a child’s development, it is important to seek an evaluation from a professional. And if the findings do not feel quite right, parents should never feel uncomfortable about seeking a second opinion.

 

About the Author: 

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

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

 

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

 

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