NESCA’s Londonderry, NH location has immediate availability for neuropsychological evaluations. Our NH clinicians specialize in the following evaluations: Neuropsychological; Autism; and Emotional and Psychological, as well as Academic Achievement and Learning Disability Testing. Our NH clinicians also conduct evaluations for students who are at boarding schools, and two of our NH clinicians have PsyPACT authorization, allowing them to conduct evaluations out-of-state.

Visit www.nesca-newton.com/intake for more information or to book an evaluation.

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Image of an adult looking at a tablet with a child and a quote from Dr. Hernandez Medellin

Looking for the Best Holiday Gift?

By | NESCA Notes 2025

Image of an adult looking at a tablet with a child and a quote from Dr. Hernandez MedellinBy Luisa Hernandez Medellin, Psy.D., PMH-C
Pediatric Neuropsychologist, NESCA

I have three children, ages 7, 13, and 20. I have seen most consoles from the past two decades, from the Wii U to the PS5, including a couple of Nintendo DS versions and X-Boxes. I have purchased Minecraft swords, mini kitchens, baby dolls, Little People, tablets, costumes, skateboards, Rubik’s Cubes, bikes, Pokémon cards, Ninja Turtles, makeup sets, Robux, Battle passes, and phones. And every year, I get the same mixed feelings about the value of gifts, their meaning, and their purpose, especially when it comes to electronics.

As a pediatric neuropsychologist, I want my children to get toys and games that are fun and instill curiosity and creativity. I want their gifts to encourage them to learn new skills, go outside, and play with other kids, but I also understand that some of the skills they learn now will be different from the ones we learned as we grew up.

Online group games can teach kids how to play as a team, communicate with others, assign and/or accept roles, strategize, and reach a common goal. Supervised and monitored by adults, video games can also teach them discipline, limits, and boundaries. How? Because even if they are teenagers, our kids need to learn that using electronics is a privilege, not a right. They need to be monitored regarding the content of their games, their online conversations, and the impact of their actions in the digital world. To use their devices, parental controls must be enabled, and their game’s rating must be appropriate for their age. Their Discord account – if allowed one – must be accessible to the parents for them to check it as needed. The older they get, the “spicier” the conversations. But that also opens the door to having more thoughtful and meaningful conversations with them about cyberbullying, racism, discrimination, sexting, and pornography, as well as where you stand regarding family values, ethics, morals, and life in general.

The same is true of phone use and social media. Research says that having access to social media before the age of 16 has a major negative impact on self-esteem, body image, and mental health – especially in girls – as unfortunately, the algorithms feed them negative ideas and unrealistic expectations about their bodies, as well as relationships, making them more prone to depression and anxiety. While the emotional effects on boys are typically not as severe, the free access to the virtual world tends to expose them to sex, pornography, drugs, and aggressive content earlier, if social media is not supervised.

Therefore, if you ask me, and all the other concerned parents and social scientists, I would not recommend giving kids a smartphone until they are 12-13, depending on their level of maturity and the level of honest communication with each other. And once they have one, the apps downloaded to their phones must be approved by their parents (both iPhones and Androids let you create that set-up). Likewise, their access to YouTube, Instagram, Snapchat, etc., must continue to be monitored by parents until they are adults. The misuse of devices and social media should have consequences and must not be taken lightly. If, as a parent or caregiver, you would not allow certain behavior or vocabulary in person, it should not be allowed in the virtual world either.

Here are other factors to consider when deciding when your child is ready for a smartphone:

  • Child’s maturity: Assess your child’s responsibility, self-control, and ability to handle the device’s features and potential social pressures.
  • Need for communication: Consider if the child needs a phone for safety and communication due to independence (e.g., biking to school, after-school activities).
  • Alternatives to a smartphone: Before getting a smartphone, consider alternatives like a basic phone or a smartwatch with tracking and communication features but without internet access.
  • Wait Until 8th pledge: A movement called “Wait Until 8th” encourages parents to delay giving children smartphones until at least eighth grade, with the support of other families to reduce peer pressure.

Now, for the younger ones, I also have a word of caution for the use of tablets and other devices. Research shows that children under two should not be “plugged” into a tablet, as it reduces socialization time and may affect language development. With supervision, including limiting the time of use, after age four, children could use it for specific educational games and to watch videos for short periods. All tablets allow you to set up parental controls as to what they can do/watch, and for how long, so parents… learn to use them. And please, make sure you do not set up an Apple account/number with free texting or FaceTime on your child’s tablet, as it would pretty much work the same way as giving them a smartphone.

I once read that the best holiday gift a child can get is the one that comes accompanied by a caring adult – and I think that is still true for all electronics. The world we grew up in no longer exists, and this era requires involved parents who are willing to learn, guide, set limits, and model responsibility and integrity while having fun with the new technologies at hand.

 

Headshot of NESCA Pediatric Neuropsychologist Dr. Luisa Hernandez MedellinAbout the Author

As a bilingual pediatric neuropsychologist, Dr. Hernandez Medellin conducts comprehensive and culturally sensitive neurodevelopmental and neuropsychological assessments, comprehensive diagnostic evaluations, and effective care plans, providing appropriate recommendations for the client’s school, home, and the community. She specializes in the identification and assessment of neurodevelopmental disorders such as Autism Spectrum Disorders, ADHD, developmental and learning disorders, and their co-occurrence with anxiety and mood disorders. She also works with children and young adults with acquired brain injuries, epilepsy, brain tumors, strokes, general medical conditions, and genetic disorders affecting the nervous system. She is a native Spanish-speaker, passionate about serving the eclectic and vibrant South Florida community, as well as international patients looking for high-quality and compassionate care.

To book evaluation services at NESCA in Coral Gables, Florida, complete NESCA’s online intake form. 

To book a neuropsychological evaluation or other services at NESCA’s New England offices, complete NESCA’s online intake form

NESCA is a pediatric neuropsychology and related services practice with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; the greater Burlington, Vermont region; and Miami/Coral Gables, Florida, serving clients from infancy through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

Image of kids helping to cook in the kitchen and a quote from Dr. Yvonne Asher

Kids in the Kitchen

By | NESCA Notes 2025

Image of kids helping to cook in the kitchen and a quote from Dr. Yvonne AsherBy: Yvonne Asher, Ph.D.
NESCA Pediatric Neuropsychologist

Cooking Thanksgiving dinner usually takes me about 8 hours by myself. With help, it’s closer to 12. But my kids LOVE to help. They always want to mix and pour and measure and dump ingredients hour after hour, standing beside me on a wobbly kitchen chair. I’ll leave the question of safety – you know your child best in that respect – except to say that the heavily marketed “Montessori style” kitchen tools are pretty great. Instead, I want to talk about the neurocognitive benefits of helping with cooking. There are other, wonderful benefits – bonding, sharing memories and family stories, creating traditions – but those probably do not require a neuropsychologist to opine on.

First and foremost, cooking is science and math. Actually, a ton of math. Addition, subtraction, multiplication, division, fractions, and more. Having company? We probably need to double our usual brownie recipe. Only Aunt Sue and Jimmy like cranberry sauce? Let’s halve that one. We need one and a half cups of flour for this pie crust, but only the one-quarter cup measure is clean. How many quarter-cups will we need? For science, we have states of matter, heat transfer, and chemical reactions. Why do carrots turn green in carrot cake? How do baking soda and vinegar get a chocolate cake to rise? What makes those dinner rolls so fluffy? The age of your child is (almost) irrelevant – younger children are intrigued by more basic concepts, and older ones can understand more complex and nuanced ideas. When I was a preschool teacher (long before my current career), I can still remember the wide eyes of my barely 3-year-old pupils when watching heavy cream turn into butter, yeasted dough turn into bread, and disparate ingredients turn into delicious cookies.

There is also a tremendous amount of executive functioning in cooking and food preparation. As anyone who has hosted a meal or, frankly, just tried to get dinner on the table before 9pm, will know, planning is crucial. Holding information in mind (working memory), organizing, setting smaller goals in the service of larger ones, tracking progress through multiple tasks, and checking one’s work are all vital to ending up with a special meal (did you remember to put the butter in the mashed potatoes???). If anyone in your crowd has particular eating requirements (babies learning solids, allergies, vegan/gluten-free diets, etc.), the executive functioning demands are ratcheted up by a lot. And, if you are the kind of person who sets an elaborate table with décor and such (my kids are lucky if I remember to grab a tablecloth), you have even more planning, organizing, and task management to do.

Last, but most certainly not least, learning to plan menus, shop, prepare food, cook, and bake are phenomenal life skills. Life skills are vital for everyone, but especially for individuals with developmental disabilities. Strong, confident mastery of life skills is critical for adolescents and young adults to achieve independence. I’m still patiently awaiting the day that one of my kids can cook dinner all by themselves, but I will be immeasurably pleased and proud when they do.

It is a commitment to have kids help in the kitchen. They make unbelievable messes (I never knew how many places powdered sugar could end up), ruin dishes with expensive ingredients, and most certainly introduce germs into food (even with the best of handwashing practices and “DON’T TOUCH YOUR FACE” admonishments). But this is the space between ideal and real that we can inhabit in service of teaching. Yes, it will take longer. Yes, things you envisioned may absolutely not happen (or not happen the way you hoped). Yes, it will be a crazy amount of work for you. Yes, you may need an extra grown up to actually help while your child “helps.” (You can, of course, designate certain dishes or elements of dishes as appropriate for “help” and others “just for grownups.”) But this is an incredible opportunity to help your kids learn math, science, executive functioning, and life skills in ways that are meaningful, filled with love, and built in to the fabric of their lives.

 

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 and related services practice with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; Coral Gables, Florida; and staff in the greater Burlington, Vermont region, serving clients from infancy 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 a NESCA clinician, please complete our Intake Form today. For more information about NESCA, please email info@nesca-newton.com or call 617-658-9800.

 

Image of a child appreciating nature around them along with a quote from Dr. Manning

Growing Grateful Kids

By | NESCA Notes 2025

Image of a child appreciating nature around them along with a quote from Dr. ManningBy Madeline Manning, Ph.D.
Pediatric Neuropsychologist, NESCA Hingham

Growing Grateful Kids: Tips for Fostering Resilience Through Gratitude

Gratitude, or the quality of being thankful and the readiness to appreciate the good in life, is especially important for youth today. It helps promote resilience, emotional well-being, and positive relationships in an increasingly complex and fast-paced world. By fostering gratitude, young people can develop a stronger sense of self-worth and perspective, empowering them to navigate challenges with optimism and empathy. Parents and caregivers play a vital role in helping children and teens develop the practice of gratitude. Research in resilience and positive psychology consistently shows that practicing gratitude helps individuals overcome adversity, enhances everyday well-being, improves mood, and strengthens interpersonal relationships. Cultivating gratitude can also enhance emotional regulation, social skills, and academic performance.

Why Gratitude Matters for Resilience

Our brains adapt and change in response to what we consistently notice and value in our environments. Encouraging youth to attend to and emphasize positive experiences helps strengthen neural pathways that make it easier for them to recognize the positives and protective factors in their lives. This supports well-being and contributes to better mental and physical health (improved immune function, better sleep, reduced cortisol levels).

Studies show that children and teens who practice gratitude regularly experience increased happiness, life satisfaction, and positive emotions. They also report fewer negative emotions and lower rates of depression and anxiety. By focusing on what is present and positive, rather than what is missing, gratitude helps youth cope with challenges and stress in healthier ways.

How Gratitude Builds Resilience and Well-being

  • Emotional regulation: Practicing gratitude engages brain regions involved in emotional processing, helping children manage difficult feelings and recover from disappointment more efficiently.
  • Social connection: Gratitude strengthens empathy and prosocial behavior, making it easier for children to form and maintain relationships with others.
  • Coping skills: Focusing on positive aspects of situations, particularly during tough times, helps children find meaning and hope, buffering against stress and adversity.

Evidence-Based Ways to Build Gratitude in Daily Life

Incorporating gratitude practices into everyday life does not need to require a major time commitment or dramatic changes to your schedule. Gratitude can be woven into everyday routines through simple, meaningful shifts in daily practices:

  • Mealtime gratitude: During meals, take turns sharing one thing each family member is grateful for, big or small. Regular sharing of gratitude strengthens family bonds and increases positive emotions.
  • Finding silver linings: During challenges or setbacks, gently help children identify a lesson learned, a person who helped, or a small comfort. This reframing fosters adaptive coping.
  • Mindful moments in nature: Encourage children to pause and notice something pleasant in their environment, such as a flower in bloom or a bird chirping. Bringing attention to the present moment and combining mindfulness with gratitude can help reduce anxiety and improve mood.
  • Expressing thanks: Encourage thank-you notes, drawings, or messages to teachers, friends, or relatives. Expressing appreciation and being thoughtful of others builds empathy and fosters deeper social connection.
  • Bedtime reflections: End the day by naming three good things that happened. This simple habit can improve sleep quality and increase optimism.

Modeling Gratitude: The Parent’s Role

Children learn gratitude best by observing adults around them. Consistently expressing appreciation and integrating these or similar practices into the daily routine helps make gratitude a family value.

Research-backed strategies include:

  • Verbalizing appreciation: Let children hear adults thank others and explain why their actions mattered to them.
  • Acknowledging effort: Thank children for their hard work, kindness, or cooperation, not just when positive outcomes have been attained.
  • Sharing personal gratitude: Reflect openly on moments from the day that inspire thankfulness.

These small acts show children that gratitude is an everyday mindset, not something reserved for special occasions or major achievements.

Tools to Record and Share Gratitude

Making gratitude tangible can help children and teens integrate it into their lives. A few examples of simple ways to record what we are grateful for include:

  • Gratitude journals: Writing down daily reflections has been linked to increased happiness and decreased depressive symptoms in youth.
  • Digital apps: Online apps like Grateful or Happyfeed can make it easy for teens to track positive moments throughout the day and reflect back on moments of gratitude over time.
  • Gratitude jars: Fill a jar with notes of things that went well, things you appreciate, or things you are looking forward to. Read them together as a family at the end of the week or month.
  • Photo projects: Encourage older kids (and help younger kids) to capture one photo a day of something they appreciate.
  • Family gratitude boards: Post sticky notes with moments of thanks for everyone to see.

Planting Seeds of Resilience for the Future

Much like strengthening a muscle, gratitude is a skill that grows stronger with practice. Creating opportunities to notice and name what is good and supportive builds happier, healthier children and nurtures resilient, thoughtful young adults who can find meaning and hope even in difficult times.

Gratitude does not mean ignoring life’s challenges. Rather, it is about recognizing the positive, fostering connection, and building the emotional strength to navigate whatever comes their way.

Integrating gratitude practices into daily life gives children a lifelong gift: the ability to find joy, connection, and resilience, no matter what the world may bring.

 

References:

Basit, A., Ali, R., Rahman, S., & Shah, A. A. (2024). Exploring how the practice of gratitude can strengthen interpersonal relationships, enhance mental well-being, foster emotional resilience, and promote greater social connectedness and cooperation. Review of Education, Administration & Law, 7(4), 427-441.

Bohlmeijer, E. T., Kraiss, J. T., Watkins, P., & Schotanus-Dijkstra, M. (2021). Promoting gratitude as a resource for sustainable mental health: Results of a 3-armed randomized controlled trial up to 6 months follow-up. Journal of happiness studies22(3), 1011-1032.

Klibert, J., Rochani, H., Samawi, H., Leleux-LaBarge, K., & Ryan, R. (2019). The impact of an integrated gratitude intervention on positive affect and coping resources. International Journal of Applied Positive Psychology, 3(1), 23-41.

Kurian, R. M., & Thomas, S. (2023). Gratitude as a path to human prosperity during adverse circumstances: a narrative review. British Journal of Guidance & Counselling, 51(5), 739-752.

Zainoodin, N. N., Hutasuhut, I. J., & Bakar, M. A. A. (2021). Gratitude and its relationship to resilience and academic performance among university students. Journal of Cognitive Sciences and Human Development. Vol, 7, 2.

 

About Dr. Madeline Manning

Dr. Madeline Manning is committed to providing comprehensive, collaborative evaluations that helpMadeline Manning, PhD Headshot families better understand their child’s unique neurocognitive, developmental, learning, and social-emotional profiles. She specializes in the assessment of toddlers, school-aged children, adolescents, and young adults. Her expertise involves working with youth exhibiting a diverse range of clinical presentations, including neurodevelopmental disorders, such as autism spectrum disorder, attention and executive functioning deficits, learning disabilities, developmental delays, intellectual disabilities, and associated emotional challenges. Dr. Manning is also trained in the assessment of children with medical complexities, recognizing how health conditions can impact a child’s development and functioning. She partners closely with families to develop practical, personalized recommendations that support each individual’s success and growth at home, in school, and within the community.

To book a neuropsychological evaluation at NESCA, complete NESCA’s online intake form

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

school student frustrated over the work

Navigating the Post-Honeymoon Phase: Signs Your Child May Need Support This School Year

By | NESCA Notes 2025

school student frustrated over the workBy Miranda Milana, Psy.D.
Pediatric Neuropsychologist

With the start of the school year well underway, we are beginning to see students and teachers settling into their classroom routines. Along with this increase in familiarity and comfortability, parents often start to see bits and pieces of challenges arise around this time of year that may have gone unnoticed during the initial “honeymoon period.” You may be wondering what challenges you should be looking out for and when those challenges warrant an evaluation to determine further supports and services. Let’s take some time to explore what to keep an eye on, and when it might be time to reach out to schedule an evaluation to dive a bit deeper into what is going on.

Academics

No matter their age, if you ever feel your child is inundated and overwhelmed with schoolwork, it is a great idea to reach out to their teachers; ask how long homework should be taking and whether it should feel like review vs. new material. If homework starts to consistently become a battle, it might be worth taking a closer look into why. It could be because it’s a new and appropriately challenging course. It could also be because there are underlying language-based learning disabilities, a nonverbal learning disability, executive function challenges, or increasing symptoms of anxiety or depression. Some specific things to watch for:

  • Frequent tears during homework that appear to be getting worse instead of better
  • Not appearing to “get it” even after review and repetition
  • Difficulty studying/holding information in memory
  • Dysfluent reading or not understanding what they’ve read
  • Challenges understanding math concepts or memorizing math facts
  • Difficulty applying and generalizing concepts
  • Opposition to handwriting tasks or when asked to compose a writing assignment
  • Poor penmanship that is illegible and/or immature for age
  • Not meeting benchmarks on assessments

Social Skills

At this point in the school year, children are typically starting to be interested in other peers within their classrooms. For younger kids, they are likely to feel more comfortable interacting with other children in their play. Common social concerns can include:

  • Not remembering any names or faces of kids in their class
  • Preferring to play alone; hesitant to join in with a group
  • Appearing unaware of social cues or how to initiate conversation with others
  • Rigidity in play – always wanting to play their own game by their own specific rules
  • Frequent peer conflicts and feeling rejected or left out

Emotional Functioning

A new school year often elicits feelings of anxiety in kids no matter how outgoing and social they may be! When might it be a sign that there is something more?

  • Continued and persistent resistance to going to school
  • Frequent somatic complaints with no apparent cause (e.g., headaches, stomachaches)
  • Change in sleeping patterns – not being able to fall asleep at night or waking up frequently
  • Difficulty with regulating their emotions/frequent tantrums
  • Changes in appetite
  • Negative statements about themselves
  • Increase in irritability
  • Withdrawal from others or previously preferred activities
  • Always wanting to know what is happening next and struggling with changes in routine (i.e., Does a substitute teacher derail their whole day? If a friend is out sick, is there a perseveration on where they are? Do you wait to tell them about changes in plans so they don’t worry in advance?)

Attention/Focus

Have you ever found yourself feeling restless and distracted when sitting through a work meeting? Kids are no different! Sitting still and paying attention for extended periods of time can be really tough – especially after being on summer break! Here are a few things to keep an eye on:

  • Frequently fidgeting in their seat or needing a fidget item to increase concentration
  • Difficulty with multi-step directions
  • Not remembering information presented during lectures
  • Acting impulsively
  • Easily distracted/daydreaming
  • Acting as if running by a motor
  • Blurting out thoughts, interrupting conversations
  • Teacher feedback that they are interrupting other students or not able to sit quietly and attend to class discussions

As always, you know your child best! If you feel like this year is off to a rocky start, or you’re starting to have questions regarding their functioning, do not hesitate to reach out and schedule an evaluation. A comprehensive neuropsychological evaluation is designed to look at ALL aspects of a child to determine what is getting in their way of reaching their potential. We are always here to help!

 

About the Author

Dr. Miranda Milana provides comprehensive evaluation services for children, adolescents, and young adults with a wide range of concerns, includingMiranda Milana Headshot 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.​

To book an appointment with Dr. Miranda Milana or another expert NESCA neuropsychologist, please complete our Intake Form today. 

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

 

Dr. Luisa Hernandez Medellin evaluating a child

NESCA’s Heading South to Care for Children and Empower Families

By | NESCA Notes 2025

Dr. Luisa Hernandez Medellin evaluating a childBy Jane Hauser
Director of Marketing & Outreach, NESCA

Dr. Luisa Hernandez Medellin Discusses NESCA’s Miami Launch

NESCA recently opened its latest pediatric neuropsychology office in Coral Gables/Miami, Florida, headed up by Dr. Luisa Hernandez Medellin. I had the opportunity to speak with Dr. Luisa Hernandez Medellin to get to know more about her background, the current evaluation landscape in South Florida, Latin America, and the Caribbean, and to hear from her what unmet needs NESCA addresses in bringing its expertise to that region.

Tell us about your background and how you chose to become a pediatric neuropsychologist.
I was born and raised in Mexico City in a family that valued service and helping others. As a teen, I considered becoming a missionary nun because I wanted to travel to deliver services and support to children in need. During those years, I spent time in Cuba, Nicaragua, Guatemala, and Costa Rica, where I witnessed numerous disparities in the way people lived. That experience shaped my commitment to serving children and families.

When I returned to Mexico, I explored different careers, including teaching and medicine, as my father was a doctor, and eventually landed in psychology almost by chance—but it felt like home as soon as I discovered it. Later, when I moved to Miami, I completed my bachelor’s degree and entered a doctoral program in child psychology. During my training, I discovered neuropsychology, and it was a perfect fit: a way to combine psychology with the medical world, caring for both the mind and the body of an individual.

I trained at Jackson Memorial Hospital, where I fell in love with pediatric neuropsychology, working with children with neurodevelopmental disorders in both inpatient and outpatient settings. That experience set the foundation for my career. Since then, I’ve worked in hospitals, private practice, and now with NESCA, where I get to provide high-quality evaluations in a compassionate way that will help children and their families have a path to move forward on.

What is your philosophy when working with children and families?
I treat every child as I would my own. I’m a mother of three, all neurodivergent in different ways, so I understand how hard it can be to navigate the challenges of having children with disabilities while also loving them so deeply. My role is to get to know each child who comes in for an evaluation—what makes them unique, what’s important to them—and to help uncover what’s happening so they can flourish.

How do you feel neuropsychological evaluations benefit individuals and families?
Evaluations give us a deeper, objective understanding of a child’s strengths and challenges. Parents often come to me worried that they’ve done something wrong that caused their child’s struggles. I reassure them that no one is at fault. The goal is not to find problems or identify something or someone to blame; rather, it’s to identify the root cause of a child’s challenges while also highlighting each child’s strengths. It’s about finding the “lights AND the shadows.” For example, if a child struggles in math but loves music, we lean into music as a source of joy and growth for the child while knowing how to  properly provide support in areas like math, that may be more stressful.

How do you approach parents or caregivers who are resistant to the evaluation process or the possibility of their child receiving a diagnosis from it?
In Miami, many families are hesitant about their child receiving a diagnosis(es). I take the time during the intake process to listen to their concerns and gently plant seeds about the types of issues we may be seeing. That way, parents aren’t shocked during the feedback session where they learn the findings from the evaluation, which may include one or more diagnosis(es). It helps them process the information and reduces their fears. I emphasize that neurodivergence isn’t caused by parenting choices or styles, screen time, or the Covid experience. It’s just how a child is wired. My focus is on supporting families and children and building hope with new information from the evaluation.

How did you connect with NESCA, and what excites you about bringing NESCA to Miami?
While considering a move to Boston, I met NESCA’s founder and director, Dr. Ann Helmus, and our conversation felt like meeting a kindred spirit. She reminded me of my attending supervisor from Jackson Memorial Hospital in that they both expect very high quality evaluations, really care about their patients, and truly value the quality of the training provided to their trainees. That’s not always the way with providers, so that was very important to me.

She shared that NESCA was planning to open a Miami office, which felt like the perfect match. Now, I get to help NESCA bring its 30 years of expertise to our region, while I’m also contributing my own 20 years of experience right here in Miami. Together, we’re offering high-quality, culturally-sensitive evaluations in both Spanish and English.

Why does Miami need a practice like NESCA?
The system here in South Florida often creates delays in the identification of developmental, emotional, or learning disabilities. Pediatricians sometimes use a “wait and see” approach; bilingualism is sometimes mistaken for a speech delay when it’s really a sign of autism; and schools often face huge, lengthy backlogs for testing students.

It can be tricky to find the right resource or professional to help identify challenges early on. Neurologists tend to be trained in the brain as “hardware,” whereas we examine the brain’s operating system and how it functions when there is a brain injury, a developmental disorder, or other issue. More often, they look to scans and imaging for answers, where we look at the child’s wellbeing and growth, especially when there is a more complex presentation that may lead to several diagnoses, like ADHD, autism, and anxiety, all co-occurring. And due to productivity pressures in large Miami hospitals, they are only able to see patients for 15 minutes or so and often via telehealth.

And again, with our medical system not being optimized, there is a lot of overwhelm among pediatricians who are forced to operate in a factory-like system. Many people here in South Florida don’t actually have a dedicated pediatrician who knows them and their families. It’s more of a walk-in urgent care system, and that means there is no follow-up in six months or even a year to see how a child is progressing or not. No one is tracking them and is dedicated to their developmental well-being. This is another reason for the frequent delays in diagnosis here.

Because of all of these issues, too often, families don’t receive timely or comprehensive evaluations, and diagnoses and services are delayed. NESCA offers an alternative: in-depth, individualized assessments that consider the whole child—what their lives look like and how they do in school, at home, and in the community. NESCA coming to Miami is filling a very large gap in getting families the answers they are looking for and getting children the support they need to thrive.

What do you evaluate at NESCA in Coral Gables?
I focus primarily in pediatric neurodevelopmental disorders, ADHD, Autism Spectrum Disorders, and learning disabilities, providing evaluations and highly tailored recommendations for interventions. I have also been training practicum students in the Miami area, which we will continue to do as part of the NESCA practice in Coral Gables. There are currently only two sites in Miami where doctoral-level students can train at a practicum level in pediatric neuropsychology, and one of them is now NESCA.

What are your plans for working with schools and international families?
International families and private schools are actively seeking support for their students. Many families from Latin America and the Caribbean face limited resources in their home countries. They come to NESCA for specialized, highly personalized evaluations and recommendations on how to support their child or student at home or in school, in their country. NESCA in Miami will provide these families with the guidance and expertise they need—tailored to their cultural context and delivered with compassion.

Any final thoughts?
NESCA offers families in South Florida, Latin America, and the Caribbean the best of both worlds. We’re bringing NESCA’s legacy of excellence from 30 years of practice in New England, along with my decades of experience living and practicing in Miami, to serve families in this diverse, multicultural community. My goal is simple: to help every child be understood, supported, and given the guidance and tools necessary to thrive.

Headshot of NESCA Pediatric Neuropsychologist Dr. Luisa Hernandez MedellinAbout the Author

As a bilingual pediatric neuropsychologist, Dr. Hernandez Medellin conducts comprehensive and culturally sensitive neurodevelopmental and neuropsychological assessments, comprehensive diagnostic evaluations, and effective care plans, providing appropriate recommendations for the client’s school, home, and the community. She specializes in the identification and assessment of neurodevelopmental disorders such as Autism Spectrum Disorders, ADHD, developmental and learning disorders, and their co-occurrence with anxiety and mood disorders. She also works with children and young adults with acquired brain injuries, epilepsy, brain tumors, strokes, general medical conditions, and genetic disorders affecting the nervous system. She is a native Spanish-speaker, passionate about serving the eclectic and vibrant South Florida community, as well as international patients looking for high-quality and compassionate care.

To book evaluation services at NESCA in Coral Gables, Florida, complete NESCA’s online intake form. 

To book a neuropsychological evaluation or other services at NESCA’s New England offices, complete NESCA’s online intake form

NESCA is a pediatric neuropsychology practice with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; the greater Burlington, Vermont region; and Miami/Coral Gables, Florida, serving clients from infancy through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

Engineered for Excellence

By | NESCA Notes 2025

Image of NESCA clinicians conferring with each other and a quote from Dr. Ann HelmusBy Ann Helmus, Ph.D.
Founder & Director, NESCA

NESCA supports your clinician—so your clinician can support you and your child

When you choose NESCA, you’re not just hiring an individual clinician—you’re accessing an entire organization built to deliver excellence to each family who works with us. From the first intake call to the final report, every step of our process is designed to ensure quality, accuracy, and the best outcomes for your family. Parents invest in this process to resolve complex questions about their child’s learning, development, or emotional well-being—questions that can only be addressed by a thoughtful, thorough evaluation leading to recommendations that will truly make a difference.

At NESCA, we believe that the best way to provide this level of care is to take extraordinary care of our clinicians. Our equation is simple:

Lower Case Volume + High Clinician Support =

Exceptional Evaluations + Better Outcomes

Supporting Clinicians in Doing Their Best Work
In some practices and settings, clinicians face heavy caseloads, which can make it difficult to dedicate as much time to each child as they’d like. With larger caseloads, clinicians are often left with little time for reflection, professional growth, or collaboration. At NESCA, we intentionally structure things differently. We greatly value our clinicians as highly educated professionals with many years of training and provide them with the support, environment, and opportunity to produce their most thorough and careful work.

From the beginning, NESCA was intentionally designed for clinicians to typically work with six or fewer clients each month—a low volume compared to many other practices or settings. This structure ensures that every child’s evaluation receives the time, attention, and individualized analysis it deserves.

We Care for Our Clinicians—So They Are Able to Care for Your Child
Behind the scenes, our clinicians are supported in ways that are uncommon in many private practices:

  • Professional Development: Weekly seminars, ongoing mentorship, and access to senior clinical directors to ensure that every clinician is continually learning and growing.
  • Collaboration: Regular case conferences provide a forum for discussing complex cases and drawing on the expertise of their NESCA colleagues who specialize in multiple disciplines, providing well-rounded and forward-looking perspectives. Your child’s clinician is never working in isolation.
  • Dedicated Support Staff: Psychometricians handle test scoring, and administrative staff manage scheduling and logistics. This frees clinicians to focus entirely on the heart of their work—understanding your child.
  • Quality over Quantity: Because we are not driven by volume, clinicians can invest the time needed to observe your child carefully, analyze test results holistically, speak with educators and providers on your team, and craft thoughtful recommendations.

What This Means for Families
We know that clinicians do their best work when they feel secure, valued, and engaged. That’s why NESCA provides stability, top notch administrative support, and a professional community. When challenges arise, we work with our clinicians to resolve them, offering mentorship and guidance rather than leaving them to struggle and produce work that doesn’t meet NESCA’s high standards.

This culture of care is not just good for our staff—it’s essential to the families we serve. It means that when you come to NESCA, you are working with professionals who are deeply committed, well supported, and fully equipped to provide the highest quality evaluations and recommendations.

We take care of our clinicians so that they can take the best possible care of your child.

 

About the Author

NESCA Founder and Director Ann Helmus, Ph.D., is a licensed clinical neuropsychologist who has beenAnn Helmus headshot practicing neuropsychology for 35 years and has been director of NESCA’s Neuropsychology practice for nearly three decades, continuously training and mentoring  neuropsychologists to meet the highest professional standards.

To book a neuropsychological evaluation at NESCA, complete NESCA’s online intake form

NESCA is a pediatric neuropsychology practice with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; the greater Burlington, Vermont region; and Miami/Coral Gables, Florida, serving clients from infancy through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

young child undergoing a neuropsychological evaluation

Early Childhood Evaluations, Lifelong Impact: Why Acting Early Can Make All the Difference

By | NESCA Notes 2025

young child undergoing a neuropsychological evaluationBy Madeline Manning, Ph.D.
Pediatric Neuropsychologist, NESCA Hingham

Early childhood is a time of rapid development, marked by significant growth in physical, cognitive, social, and emotional domains. While every child develops at their own pace, sometimes parents, caregivers, or healthcare providers may notice certain behaviors and developmental patterns that raise questions or cause concern. In such scenarios, a neuropsychological evaluation can serve as a powerful tool to better understand a child’s specific needs and guide interventions to promote their overall growth and well-being.

Common Signs That a Neuropsychological Evaluation May Be Warranted

Identifying the need for a neuropsychological evaluation can be challenging, particularly for young children between the ages of 2 and 6, as this is a time when developmental milestones vary widely. The following signs may indicate that consulting with a qualified professional would be beneficial:

1. Developmental Delays

Children typically reach certain developmental milestones within specific age ranges. Delays in areas such as speech and language, fine and gross motor functioning, adaptive/self-care skills, or social interactions may signal the need for further evaluation. For example:

  • Absence of babbling or only making a few sounds by age 1
  • Not using word combinations by age 2 or speaking in simple sentences by age 3
  • Difficulties with walking, running, or grasping objects
  • Limited eye contact or lack of interest/engagement with peers
  • Unresponsive to their name being called
  • Limited use of gestures (pointing, waving) or facial expressions
  • Difficulties interpreting social cues in others (personal space, tone of voice, body language)

2. Behavioral Challenges

While tantrums and emotional outbursts are common in young children, persistent or extreme behavioral issues may require closer attention. These might include:

  • Frequent, intense, prolonged meltdowns that are difficult to soothe
  • Aggressive behaviors toward others or self-harm
  • Frequent property destruction
  • Unusual rigidity or resistance to transitions and changes in routine

3. Attention and Focus Issues

Young children have naturally short attention spans and are often very active; however, indicators such as an inability to engage with toys or activities for any length of time, or frequently seeming to be in their “own world,” might suggest underlying difficulties.

Attention deficits do not always stem from an attention-deficit/hyperactivity disorder, and may have a myriad of different etiologies, including anxiety, sleep problems, trauma, learning problems, impairment in vision or hearing, or other underlying medical conditions. Neuropsychological evaluations can help to better understand the cause of inattention, which can provide a crucial roadmap to helping address the behaviors.

4. Sensory Sensitivities

A child who is unusually sensitive to sounds, textures, lights, or smells (or in contrast, seems under-responsive to sensory input) may benefit from an evaluation. Sensory sensitivities can impact daily routines and interactions.

5. Regression in Skills

If a child starts to lose previously acquired skills, such as language, motor, or adaptive abilities, this could be a red flag that warrants close attention and prompt assessment.

6. Medical Complexities

A child who has a known history of medical complications (e.g., premature birth, low birth weight, chronic illness, neurological insult, such as stroke or seizures, in utero substance exposure, head injury) may require a neuropsychological evaluation early in life to identify potential developmental challenges and to guide timely interventions that support their growth and learning.

7. Family History

Parents and caregivers of children with a family history of neurodevelopmental disorders, such as autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and/or learning disabilities, should closely monitor their child’s developmental progress, as these children are at increased risk for developmental challenges.

It’s important to remember that every child learns at their own pace, and variations in reaching milestones are often a normal part of development. Noticing delays or differences does not always mean there’s a major cause for concern. However, if you do have questions or observations you’d like to explore further, speaking with your child’s primary care provider or consulting with a pediatric neuropsychologist can be a helpful step in understanding whether a neuropsychological evaluation may be beneficial.

Families may find the following resource helpful as a detailed guide to understanding the key milestones to watch for at various stages of development:  https://www.cdc.gov/ncbddd/actearly/milestones/index.html

The Benefits of Neuropsychological Evaluations for Young Children

Neuropsychological evaluations are comprehensive assessments that examine how a child’s brain development impacts their behavior, learning, communication, and overall functioning. For children aged 2 to 6, these evaluations are particularly beneficial for several reasons:

1. Early Detection and Intervention

When detection of developmental delays and appropriate intervention begins during these formative, early years, children are set up with the best opportunity to develop essential skills during their most receptive learning period. The earlier challenges are identified, the sooner targeted interventions can begin, which is critical as early intervention has been shown to lead to better long-term outcomes, aiding in the child’s future cognitive, social-emotional, and academic success.

2. Comprehensive Understanding, Guidance, and Coordinated Support

Neuropsychological evaluations offer a thorough understanding of a child’s cognitive strengths and challenges, emotional well-being, and social skills. This holistic approach enables caregivers and professionals to gain insight into the child’s unique learning style, allowing for tailored interventions that address their specific needs.

For parents and educators who may feel overwhelmed or uncertain about how to best support children with developmental delays or dysregulation, these evaluations can provide clear guidance and practical recommendations. These may include strategies to implement at home and in the classroom, therapeutic options, or referrals to specialized services. Additionally, neuropsychological evaluations serve as a roadmap for coordinating essential therapies, such as speech, occupational, physical, behavioral, or parent-child interaction therapies, while facilitating communication among the various professionals involved. This collaborative approach ensures that adults across different settings can work together effectively to support the child’s overall development and well-being.

3. Tracking Progress

Early childhood neuropsychological evaluations establish a baseline to understanding a child’s early cognitive, emotional, and social functioning. These assessments provide a starting point from which progress can be accurately tracked over time. Once children begin receiving developmental support, regular neuropsychological re-evaluations, typically every 2 to 3 years, may be essential in monitoring progress, assessing the effectiveness of interventions, and making timely adjustments to treatment plans as needed.

Embracing the Journey Towards Greater Understanding

The idea of a neuropsychological evaluation may initially feel daunting to some parents, yet it’s important to view an evaluation as a proactive step toward better understanding and nurturing a child’s potential. Every child deserves the opportunity to thrive, and sometimes that journey begins by asking questions, seeking answers to potential barriers in their development, and embracing the valuable insights a neuropsychological evaluation can offer.

By recognizing the signs early and accessing the appropriate resources, caregivers can help to empower their children with the tools and support they need to flourish. Ultimately, the goal is not merely to address identified challenges, but to celebrate, embrace, and amplify the countless ways in which a child can grow and excel.

 

About Dr. Madeline Manning

Dr. Madeline Manning is committed to providing comprehensive, collaborative evaluations that helpMadeline Manning, PhD Headshot families better understand their child’s unique neurocognitive, developmental, learning, and social-emotional profiles. She specializes in the assessment of toddlers, school-aged children, adolescents, and young adults. Her expertise involves working with youth exhibiting a diverse range of clinical presentations, including neurodevelopmental disorders, such as autism spectrum disorder, attention and executive functioning deficits, learning disabilities, developmental delays, intellectual disabilities, and associated emotional challenges. Dr. Manning is also trained in the assessment of children with medical complexities, recognizing how health conditions can impact a child’s development and functioning. She partners closely with families to develop practical, personalized recommendations that support each individual’s success and growth at home, in school, and within the community.

To book a neuropsychological evaluation at NESCA, complete NESCA’s online intake form

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

Madeline Manning Headshot and quote

NESCA Welcomes Neuropsychologist Madeline Manning, Ph.D., to its Hingham Location

By | NESCA Notes 2025

Madeline Manning Headshot and quoteBy Jane Hauser
Director of Marketing & Outreach, NESCA

I recently had the opportunity to get to know the most recent clinician to join NESCA’s neuropsychology practice, Madeline Manning, Ph.D. Dr. Manning is a wonderful addition to NESCA’s Hingham location, where she joins Dr. Moira Creedon in serving families on the South Shore. I hope you can take the time to get to know more about her as well.

Tell us about your background.

My background in pediatric neuropsychology has been shaped within academic medical centers, where I’ve had the privilege of working with children and families navigating complex medical and developmental challenges. During my doctoral training at Northeastern University, my clinical experiences focused primarily on understanding neurocognitive, behavioral, and social-emotional functioning in children with medical complexities—such as epilepsy, brain tumors, cardiac conditions, and genetic disorders—and how these health conditions impact a child’s overall well-being and day-to-day life.

This foundation led me to an APA-accredited internship at Nicklaus Children’s Hospital in Miami, Florida, where I received rich and diverse training in both neuropsychological assessment and therapeutic modalities. It was there that I deepened my understanding of neurodevelopmental disorders and how they often co-occur with complex medical and psychiatric presentations.

From there, I completed a two-year clinical post-doctoral fellowship at Massachusetts General Hospital/Harvard Medical School. At MGH, I gained extensive experience assessing youth with a wide range of neurodevelopmental presentations—including autism spectrum disorder, ADHD, learning disabilities, and complex profiles where psychiatric, neurological, and socioecological factors all play a role.

Throughout this journey, I’ve been incredibly fortunate to learn from and be supported by dedicated mentors, supervisors, and colleagues. Their guidance has been instrumental in shaping the clinician I am today, and I’m excited to bring that training and experience into my work with children and families at NESCA.

You mentioned your experience working with patients with medical complexities. Can you tell us more about who you worked with?

During my internship at Nicklaus Children’s Hospital, I had the opportunity to work closely with medically complex pediatric populations. I provided neuropsychological assessments for children with epilepsy undergoing Phase 1 pre-surgical evaluations, helping to inform surgical planning and overall treatment decisions. I also assessed patients referred through the oncology, hematology, and neurogenetics clinics, which gave me valuable insight into how medical conditions and treatments, such as chemotherapy, can affect cognitive, emotional, and behavioral functioning.

During my postdoctoral fellowship at MGH, I continued to build on this foundation. While many of the presenting concerns for patients were centered around neurodevelopmental and psychiatric symptoms, I also had the opportunity to work with young patients navigating complex medical conditions—including pediatric stroke, epilepsy, and a range of genetic disorders.

These experiences further strengthened my understanding of how neurodevelopmental, medical, and psychiatric factors interact in shaping a child’s development. They also enhanced my ability to conduct comprehensive, individualized evaluations that consider the whole child—not just the diagnosis—and offer tailored recommendations to support them across settings.

What made you explore a new opportunity?

I’m someone who truly values lifelong learning, which in large part is why I’ve appreciated working in hospital settings—they’re often centered around collaboration, teaching, and tackling complex clinical questions as a team. That environment has been incredibly formative for me. At this point in my career, I feel ready—and genuinely excited—to transition into a group practice setting, and NESCA felt like the perfect fit. Their strong commitment to teamwork, continued education, and high-quality, individualized care really stood out to me.

On a more personal note, I recently became a mom, and embracing this new season of life has been so meaningful. Finding a role that allows me to continue growing as a neuropsychologist in a supportive, mission-driven environment, while also being closer to home and more present for my family, is something I feel incredibly grateful for.

Why were you interested in joining NESCA?

NESCA’s mission is closely aligned with my values—both as a clinician and as a person. I’ve long admired NESCA’s reputation for providing the highest level of care to families, and that made me eager to learn more about the organization. When I met Dr. Ann Helmus, NESCA’s founder and director, I was deeply impressed by her dedication to fostering a positive team culture, while also holding an unwavering commitment to clinical excellence. I’ve felt that same sense of respect and appreciation in the way everyone I’ve spoken to during my transition has been incredibly welcoming and clearly proud to be part of this team.

What also excites me about joining NESCA is how it offers the best of both worlds—an organization with the flexibility of a group practice that also emphasizes collaboration and continued learning, similar to a hospital setting. The weekly case conferences and team meetings create a space for discussing clinical questions, sharing resources, and learning from one another, which fosters professional growth and ultimately allows us to provide exceptional care to the families we support. I feel so fortunate to be joining the team at NESCA, and I can’t wait to get started!

What do you think you will be able to bring to NESCA?

What I look forward to bringing to NESCA is my strong foundation in both clinical assessment and developmental psychology, as well as my passion for supporting children and their families with empathy and care. My training has equipped me to evaluate youth across developmental stages—from as young as 2 years old through young adulthood— experiencing a wide range of challenges. I approach each case with a commitment to understanding the whole child and place a strong emphasis on collaboration—with families, schools, and medical providers—to ensure that my evaluations translate into meaningful, practical recommendations. My goal is also to empower families with the knowledge and tools they need to support their child’s growth, and I strive to bring a warm, patient, and culturally sensitive approach to every case.

You will be joining NESCA’s Hingham office? Who will you be seeing there?

At NESCA’s Hingham office, I’ll be seeing a diverse range of children, adolescents, and young adults who are navigating complex neurodevelopmental, social-emotional, and/or medical challenges. This includes children with autism spectrum disorder, ADHD, learning disabilities, developmental delays, executive functioning difficulties, and those managing health-related conditions that impact cognitive and emotional development.

I’m especially looking forward to supporting families who may be seeking clarity around a diagnosis, looking for school-based recommendations, or working through transitions—whether that’s entering preschool, kindergarten, middle school, or preparing for high school and post-secondary life. I’m excited to collaborate with NESCA’s talented team of clinicians and to contribute to the high-quality, comprehensive evaluations that NESCA is known for.

You live on the South Shore. Why is it important to serve families in the South Shore communities?

As a South Shore native, I know there is a high level of need in this area for quality neuropsychological services. Families here are often traveling long distances in order to obtain the level of care their children need, which adds stress and limits access to services, especially for younger children or those with complex needs. That’s why it’s so exciting that NESCA has expanded its practice to Hingham!

There’s a real gap in local resources on the South Shore, and NESCA’s decision to meet families where they are at reflects a deep understanding of both the clinical and practical needs of this community. I’m thrilled to be part of that effort and to contribute to making high-quality neuropsychological care more accessible to families in this region.

Is there anything else you would like the NESCA community to know about you?

I’d love for the NESCA community to know that I’m deeply passionate about helping youth and families feel seen, understood, and supported every step of the way. I take a collaborative approach and aim to make the evaluation process not only informative, but also empowering, compassionate, and grounded in each child’s strengths.

Outside of clinical work, I am someone who values community, connection, and balance. I love being outdoors, spending time with family, and staying active—which helps keep me grounded and present in the work I do.

I’m truly honored to be joining the NESCA team, and I’m excited to grow alongside such an experienced and thoughtful group of professionals while contributing to the care of families in my own community.

 

About Dr. Madeline Manning

Dr. Madeline Manning is committed to providing comprehensive, collaborative evaluations that helpMadeline Manning, PhD Headshot families better understand their child’s unique neurocognitive, developmental, learning, and social-emotional profiles. She specializes in the assessment of toddlers, school-aged children, adolescents, and young adults. Her expertise involves working with youth exhibiting a diverse range of clinical presentations, including neurodevelopmental disorders, such as autism spectrum disorder, attention and executive functioning deficits, learning disabilities, developmental delays, intellectual disabilities, and associated emotional challenges. Dr. Manning is also trained in the assessment of children with medical complexities, recognizing how health conditions can impact a child’s development and functioning. She partners closely with families to develop practical, personalized recommendations that support each individual’s success and growth at home, in school, and within the community.

To book a neuropsychological evaluation at NESCA, complete NESCA’s online intake form

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

Map of Hingham, MA and quote by Dr. Moira Creedon

Strengthening the South Shore Community: Supporting Our Children, Teens, and Adults

By | NESCA Notes 2024

Map of Hingham, MA and quote by Dr. Moira CreedonBy: Moira Creedon, Ph.D. 
Pediatric Neuropsychologist, NESCA

It was an exciting dream realized when our NESCA South Shore office in Hingham opened in November 2023. As a resident of the South Shore, I was looking forward to connecting to my community closer to home. I was expecting to enjoy a shorter commute and great location. Pausing to reflect after 16 months with our doors open in Hingham, I realize that it is so much more.

I am grateful for how quickly we were welcomed by pediatricians, therapists, psychiatrists, tutors and executive functioning coaches, attorneys, advocates, and public and private schools. We have all quickly aligned on the needs of our communities. There are many children, teens, and adults struggling with gaps in learning, trouble with social connections, high anxiety, depressed mood, and behavioral troubles. Many of these collaborations have also communicated the frustration and sense of burnout facing families who feel like they have been working hard and trying to make changes. Teachers feel discouraged when they have dedicated their hearts and minds to support students, and yet students continue to struggle. Adults are also going through this in record numbers. The experience in our community is universal – it’s so hard to watch our kids, teens, young adults, and our contemporaries struggle.

This can leave many wondering if neuropsychological testing is just one more “hoop” to jump through. Within the trenches of the daily struggle, it can be hard to see how testing might help – especially when change is so slow. I do all that I can to explain why neuropsychological testing is way more than a hoop; it can be a roadmap. How?

  1. Even if you or your child has had “evaluations before,” neuropsychological testing is a chance at an integrated and comprehensive evaluation. What does that mean? It means that if you have had pieces of testing before, you still have a pile of pieces – an educational evaluation from school, a private OT evaluation, an early speech evaluation, a diagnostic interview with a therapist, etc. My goal is to take all of those pieces, plus the new ones I add, and put them together into one cohesive puzzle demonstrating how a child or teen thinks and learns.  This is one of the reasons NESCA does academic testing as part of its testing batteries, because these pieces are essential for diagnostic clarity, to see how the profile impacts a person’s real life skills/functioning, and because being a student is a kid or teen’s full time job. It’s not a piece to be overlooked.
  2. Neuropsychological testing can be a chance to understand the “why” when there are many complicated layers. When an individual is struggling, we often start in the middle of the process. Often, parents and/or schools want to try to solve the problem with school support, or interventions such as a referral to a therapist or connection to a social skills group. When those efforts stall, the impulse is to try a different solution.  Neuropsychological testing lets us step back, learn about a larger profile or picture of all aspects of a child’s learning or thinking to make meaning of what is happening. Then, we can choose a path for intervention that has the best chance of success. When a child is struggling, trying to see what works in a way that’s not fully informed or that addresses the child as a whole, is often not the best use of time and resources. The same goes for adults who seem to be missing a piece of their own puzzle.
  3. Neuropsychological testing uses the data collected from the testing to outline the steps for what to do next. Any good plan needs a detailed understanding of a problem. Oftentimes, it’s a combination of services that are needed – in the community, at home, and/or at school. It can be hard to figure out how to prioritize the steps, and it’s important to consider what is realistic and feasible. Neuropsychological evaluation can help make those steps clearer.
  4. Neuropsychological testing can give us a good baseline and measure of progress. Caretakers know their children best, so they can often spot subtle issues before they bloom into the bigger issues. Neuropsychological testing can be proactive, and it can help to track how a student responds to interventions. We can also use neuropsychological testing to maximize potential, including how students find their strengths, build their “academic diet” of courses in high school and college, and build stronger study skills along the way.
  5. At NESCA, neuropsychological testing involves important collaboration, perspective, and insight. The reason I mention the community that I’ve met through our South Shore office is because collaboration is key. The observations and insight offered by anyone who comes in contact with a child or teen is invaluable. Standardized test measures are a critical piece of the puzzle, but it’s one part of the critical triad of history, observations, and testing. These collaborations are also helpful to keep the neuropsychological test report “alive” as the community putting the recommendations into action works best through communication.

In the upcoming year, we set many goals for NESCA as a leader in our field. I want to pledge to my community that we will continue to provide the highest quality care and to respect and value our clients and families.  We will continue to build connections to our community members to join the efforts in supporting children, teens, and young adults. I am thrilled for upcoming opportunities to learn and grow alongside you all.  I am deeply grateful to be part of the South Shore community supporting children, teens, and young adults.

 

About the Author

Dr. Creedon offers her expertise in evaluating children and teens with a variety of presenting issues. SheMoira Creedon headshot is interested in uncovering an individual’s unique pattern of strengths and weaknesses to best formulate a plan for intervention and success. She tailors each assessment to address a range of referral questions, such as developmental disabilities, including Autism Spectrum Disorder, learning disabilities, attention challenges, executive functioning deficits, and social-emotional struggles. She also evaluates college-/grad school-age/adult individuals with developmental issues, such as ASD and ADHD, particularly when there is a diagnostic clarity or accommodation question.

 

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

 

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

Image of clinicians collaborating around a conference table

Why I Started a Group Pediatric Neuropsychology Practice

By | NESCA Notes 2024

Image of clinicians collaborating around a conference tableBy Ann Helmus, Ph.D.
Founder and Director, NESCA

In the field of pediatric neuropsychology, the complexities of child development and the wide array of diagnoses children may face can often be overwhelming for any one practitioner to fully grasp. With this in mind, I chose to open NESCA’s doors as a group practice back in 2007. The advantages of a group practice model were clear to me then and have become even more critical in today’s environment – and with today’s challenges facing children – particularly when it comes to addressing the varied and intricate needs of our young clients and their families.

When I was creating NESCA, I was a mother with much younger children than they are now and thought about the concept of breaking out as a solo practitioner. I was skilled and had plenty of years of education and experience by that time. I knew I could have done it – and likely had much more flexibility and far less stress in my life at a time when that was hard to come by – but, I loved (and still do) the concept of “group think” far too much to go that route.

Group think – or today’s “hive mind” – to me meant bringing together multiple minds to tackle a problem. A group allows for different perspectives to come together, often leading to creative, outside-the-box solutions for families that may not have been considered by me alone, even after seeking outside consultation with another practitioner. My decision to build NESCA as a group practice has since led to a constant cross-pollination of ideas among our group of expert clinicians, through scheduled weekly seminars and case conferences as well as the more casual in-office discussions. All of this collaboration enhances the care we provide and ensures that the recommendations we make are as comprehensive, vetted, and tailored as possible.

From the beginning, we have been and remain committed to offering the highest level of care, and one of the key ways we do this is by nurturing the collaborative environment that NESCA was founded on. We started out as a small group practice with several colleagues who had been working together in a separate organization. Since then, we have grown into a larger team of diverse clinicians and specialists who together have expertise in every diagnosis that presents itself. Each NESCA clinician has their own strengths and areas of focus, allowing our entire team to draw from this collective pool of knowledge. No matter what challenge a child is facing – whether it’s ADHD, autism, a specific learning disorder, or an emotional regulation issue – we can pair them with a clinician who has in-depth experience and a keen understanding of that particular diagnosis.

In addition to specialized knowledge, working as part of a group also provides the invaluable opportunity to check our thinking. Even as highly seasoned professionals who have been assessing and evaluating clients for decades, we still benefit from feedback and fresh perspectives of our colleagues and their own networks. And in a group setting, colleagues are available to consult, offer second opinions, and share resources and recommendations. This collaborative approach ensures that our evaluations and recommendations are not only thorough but also well-rounded, and likely discussed among our team, leading to more accurate diagnoses and more effective interventions and treatment plans.

Ultimately my choice to develop and grow a group practice means that our clients receive the benefit of our individual and collective expertise, collaboration, and shared insights. I’m so grateful that families who come to NESCA are able to benefit from our many minds working together toward the same goal: helping each child or individual reach their full potential. This level of care is why we believe so deeply in the group practice model.

 

About the Author

NESCA Founder/Director Ann Helmus, Ph.D. is a licensed clinical neuropsychologist who has been practicing for almost 30 years. In 1996,Ann Helmus headshot she jointly founded the Children’s Evaluation Center (CEC) in Newton, Massachusetts, serving as co-director there for almost 10 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.

She is an active participant in the Trauma and Learning Policy Initiative, a collaborative effort between Massachusetts Advocates for Children and Harvard Law School’s Education Law Clinic, a project involving a multi-disciplinary group of professionals working together to better define and meet the educational needs of children who have been traumatized.

She received her undergraduate degree in Neural Science from Brown University and earned her doctorate at Boston University School of Medicine. Her postdoctoral fellowship in pediatric neuropsychology was completed at Children’s Hospital in Boston, where she remained on staff for seven years. Concurrently, she served as neuropsychologist to the Pediatric Brain Tumor Clinic at Dana-Farber Cancer Institute in Boston.

To book an appointment with NESCA’s expert neuropsychologists, please complete our Intake Form today. 

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

 

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