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pediatric neuropsychology Archives - NESCA

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Image of teen participating in art therapy and a quote explaining why some individuals may need different forms of therapies.

What If My Child Is Not Ready For Traditional Therapy?

By | NESCA Notes 2026

Image of teen participating in art therapy and a quote explaining why some individuals may need different forms of therapies.By: Jessica Greene, Psy.D.
Postdoctoral Fellow, NESCA

When parents receive a recommendation that their child begin therapy, it can feel overwhelming. Many people are familiar with traditional “talk therapy,” but some may not realize there are many different therapeutic approaches designed to meet children where they are at developmentally or emotionally. After receiving a recommendation for therapy, many parents immediately ask, “Do you recommend anyone?” While that is an important question, it can be just as helpful to first ask, “What type of therapy is the best fit for my child?” Not all children and adolescents are ready to sit down with a therapist and talk about their thoughts and feelings in a traditional therapy setting. Younger children, children with developmental differences, those who have experienced trauma, or children who become overwhelmed by emotions may benefit from therapies that allow them to communicate in other ways.

Fortunately, there are several therapeutic approaches that may be a better fit.

Play-based Therapy

In play-based therapy, children use play to work through challenging feelings, day-to-day stressors, and/or difficult experiences. Rather than relying on conversation, the play allows the child to express themselves in the way that comes most naturally to them. Through the child’s play, the therapist may gain insight into how the child understands experiences, relationships, or emotions. For example, a child may use toy cars to make sense of a car accident, replaying the accident as they work toward understanding and processing the experience.

It is important to know that registered play therapy is different from simply playing games with a child during a therapy session. In play therapy, play itself is the therapeutic language, and the therapist has specialized training in using play to support assessment and treatment. It is okay to ask a potential therapist about their approach.

Find a Registered Play-based Therapist: https://www.a4pt.org/search/custom.asp?id=3571

Music Therapy, Dance/Movement Therapy, and Art Therapy

Music, dance/movement, and art therapy use creative expression as the primary way children explore emotions, build coping skills, strengthen self-awareness, and process difficult experiences. For some children, creating art, moving their bodies, or making music feels safer and more natural than talking. What they may not be able to say in words, they may be able to demonstrate through one of these other forms. These therapies naturally offer rhythmic, patterned, repetitive movements that can support internal regulation while giving children an alternative avenue to express themselves.

Find a Music Therapist: https://my.cbmt.org/cbmtssa/f?p=CRTSSA:17800:1865299384:::17800::

Find an Art Therapist: https://arttherapy.org/art-therapist-locator/

Find a Dance/Movement Therapist: https://www.adta.org/find-a-dmt#/

Occupational Therapy

Occupational Therapy is another alternative that may be a better entry point for some children who are not quite ready for the above-listed therapies. Although occupational therapy is often associated with fine motor skills or handwriting, many occupational therapists also specialize in sensory processing and emotional regulation. Through movement, sensory experiences, and structured activities, children learn what helps their bodies feel calm, organized, and ready to participate in everyday activities. As children engage with swings, climbing equipment, crash pads, sensory tools, and other therapeutic activities, they begin to recognize what helps them feel better regulated. As occupational therapists can provide support for many different needs, seek an occupational therapist that focuses on sensory processing and/or emotion regulation.

To learn more about NESCA’s Occupational Therapy services, visit: https://nesca-newton.com/educational-occupational-therapy-services/

Sensory Motor Arousal Regulation Treatment (SMART)

SMART is a trauma-informed therapy that combines sensory experiences with movement, while also focusing on the importance of the caregiver/child relationship to help children feel safer and more regulated. If your child has experienced trauma, SMART therapy may be an appropriate place to begin. Similar to occupational therapy, the SMART room provides various types of therapeutic equipment to help a child regulate their body throughout the session. Sessions may include crashing into crash pads, throwing a ball back and forth, or jumping on a trampoline to help the client increase or decrease their level of arousal, depending on their needs. Caregivers are an important part of the therapeutic process, helping strengthen attachment, during sessions, while learning to recognize what supports their child’s regulation. The process also encourages caregivers to better understand their own emotional responses and how these can influence their child’s ability to feel safe and regulated.

Find a SMART-trained Therapist: https://smartmovespartners.com/find-a-smart-therapy-therapist/

Regardless of the type of therapy, one factor consistently predicts better outcomes: the relationship between the child and therapist. Children are most likely to make progress when they feel safe, understood, and connected to the person supporting them. If your child does not seem comfortable with a therapist after an appropriate adjustment period, it is okay to ask questions or explore whether another provider may be a better fit.

 

About the Author

Dr. Jessica Greene is a licensed clinical psychologist who has worked After working with Dr. Angela Currie in NESCA’s Londonderry, N.H. office from 2023-2024 as a practicum student, Dr. Jessica Greene re-joins NESCA to complete her postdoctoral fellowship in pediatric neuropsychological assessment. Dr. Greene has a particular interest in understanding clients’ strengths as well as differences, integrating a therapeutic assessment approach, when appropriate.

To book an evaluation with one of our many expert neuropsychologists or other clinicians, 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; 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.

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Image of a student going back to school along with a quote from a NESCA clinician

Helping Children with Social and Emotional Needs Navigate the Back-to-School Transition

By | NESCA Notes 2026

Image of a student going back to school along with a quote from a NESCA clinicianBy: Julie Weieneth, Ph.D.
Pediatric Neuropsychologist, NESCA

As summer winds down, many families begin shifting their focus to the upcoming school year. We start to notice store shelves filled with backpacks and notebooks. We update our calendars with orientation events and fall sports schedules. Parents also start thinking about new teachers, changing routines, and everything their children will need for a successful start.

For many children and families, the return to school brings a mix of excitement and nervousness. However, for children with diverse social, emotional, or neurodevelopmental needs – such as anxiety, ADHD, or Autism Spectrum Disorder (ASD) – this transition can be especially challenging. Sudden shifts in routines, expectations, sensory environments, and social dynamics can trigger significant stress, even when the changes are positive.

Fortunately, with proactive planning and preparation, families can make the transition smoother and reduce anticipatory anxiety before the first day of school arrives.

Why the Back-to-School Transition Can Be Difficult

Children with anxiety, ADHD, or ASD often rely on predictability, structure, and familiar environments to feel secure and regulated:

  • For children with anxiety, the unknown can trigger a cycle of worry. This may include apprehension about academic performance, social acceptance, or simply not knowing the daily schedule.
  • For children with ADHD, the transition from the relatively relaxed pace of summer to the high executive functioning demands of the classroom – which requires sustained attention, organization, and self-regulation – can feel overwhelming.
  • For children with ASD, differences in social communication and a strong preference for sameness mean that new teachers, different peer groups, and novel sensory environments require significantly more cognitive effort to manage.

Helping children understand exactly what to expect before these changes occur builds confidence and makes unfamiliar situations feel manageable. Below are some practical steps that families can take to help reduce this stress:

  1. Visit the School Before Classes Begin

One of the most effective ways to reduce first-day anxiety is to make the new environment feel physically familiar. This sensory and spatial familiarity benefits anxious, hyperactive, and sensory-sensitive children alike. Replacing uncertainty with physical familiarity significantly lowers anxiety on the first day of school.

If possible, arrange a visit to the school before classes officially start. Many schools host orientation days or can accommodate a brief walk-through during teacher preparation week. During the visit, your child can:

  • Meet their new teacher to establish an early, positive connection.
  • Locate their classroom, desk, and cubby or locker.
  • Walk the routes to key locations like the cafeteria, gym, library, and bathrooms.
  • Identify a “safe space” or a designated staff member they can access if they feel overwhelmed during the day.
  1. Use Social Narratives and Visual Schedules

Social narratives are personalized, step-by-step stories that help children understand what to expect in specific situations and outline helpful coping strategies. While originally developed for children with autism, these narratives are highly effective for children with ADHD and anxiety, as they clarify expectations and reduce executive functioning demands.

Using photos taken during your school visit can make the story even more meaningful. For example:

Tomorrow is my first day of fifth grade. I will walk into my classroom and see my teacher, Mrs. Smith. I will put my backpack in my cubby and find my desk. The classroom might be loud, or I might feel nervous, and that is okay. I can take deep breaths or ask to use my sensory tool. At the end of the day, I will take the bus home, and my family will be waiting for me.

Reading this narrative together several times before school starts allows children to mentally rehearse the day, reducing anxiety and boosting their sense of control.

  1. Utilize Video Modeling and Visual Walkthroughs

Many neurodivergent children are strong visual learners who process information more effectively through images and video than through verbal explanations alone.

Before school begins, consider recording a brief video on your phone during your school visit. Narrate the steps as you walk through the building: entering the front doors, finding the classroom, opening a locker, or navigating the cafeteria. Watching this video repeatedly at home allows your child to familiarize themselves with the sights and sounds of the school layout from the safety of a comfortable environment.

If you cannot visit the school in person to record, check the school’s website or reach out to the principal – many schools now host virtual tours or welcome videos recorded by staff that you can watch together at home. Video modeling is a highly versatile tool; it can also be used to prepare children for other transitions, such as medical appointments, family gatherings, or community outings.

  1. Gradually Shift Routines Before Day One

The transition from the relaxed schedule of summer to the highly structured routine of the school year can be a shock to a child’s internal clock. For children with ADHD and ASD, sleep disruption directly impacts daytime attention and emotional regulation.

About two weeks before school starts, begin incrementally shifting bedtimes and wake-up times by 15 minutes each day. Additionally, start practicing the morning routine – waking up, getting dressed, and having breakfast in the same sequence they will on school mornings. This gradual shift prevents first-week sleep deprivation and makes the first real school morning feel like a routine they have already mastered.

  1. Share a “One-Page Profile” with the New Teacher

Teachers receive a significant amount of paperwork at the start of the year, but a brief, personalized “One-Page Profile” (or “About Me” sheet) can be incredibly helpful. Before the first day, email a simple, bulleted summary to your child’s teacher. Consider including:

  • My Strengths: What your child loves and what motivates them (e.g., “loves space science,” “highly creative”).
  • What Helps Me: Strategies that work well (e.g., “needs a visual timer,” “benefits from sitting near the front”).
  • What I Struggle With: Early warning signs of distress (e.g., “fidgets when overwhelmed,” “may shut down if confused”).

This quick-reference guide helps the teacher understand your child’s unique profile from day one, fostering a collaborative home-school partnership.

  1. Plan for the “After-School Letdown”

For children with diverse needs, holding it together during a highly structured school day requires immense cognitive and emotional effort. When they finally return to their safe haven at home, it is incredibly common for them to release that built-up tension. This often looks like sudden irritability, meltdowns, or extreme fatigue right after school – a very normal reaction often referred to as the “after-school letdown” or decompression.

To help your child gently decompress at the end of the day:

  • Keep the transition quiet: Avoid immediately asking, “How was your day?” as they get in the car or walk through the door. Give them time to transition in comfortable silence.
  • Provide a comforting snack: Have a favorite snack ready immediately to address any hunger-related irritability.
  • Schedule quiet downtime: Allow for 30 to 60 minutes of unstructured, low-demand time (like quiet play, outdoor movement, or relaxing screen time) before starting homework or chores.

Small Steps Make a Big Difference

Transitions naturally involve uncertainty, which can fuel anxiety and behavioral challenges. Providing opportunities to preview and practice what lies ahead helps children feel more secure and confident.

Whether it is visiting the school, reading a personalized narrative, watching a video walkthrough, or gradually adjusting routines, these proactive strategies can help children with diverse needs approach the new school year with greater ease. While every child’s profile is unique, thoughtful preparation can make the transition back to school a more positive experience for the entire family.

Wishing you and your family a smooth transition back to school. Please feel free to reach out with any questions, or to share your own transition strategies with the NESCA community!

 

About the AuthorJulie Weineth headshot

Dr. Weieneth is a licensed clinical psychologist who has worked with children and families with complex diagnostic and treatment needs for the last twenty years. Her areas of specialty include ADHD, autism spectrum disorders, anxiety, mood disorders, learning disabilities, executive functioning, and school-related challenges. That being said, Dr. Weieneth also understands that not all individuals fit cleanly into diagnostic groups or labels. Her goals for each evaluation are to help families feel comfortable with the process, use all the tools available to best understand each individual’s unique strengths and needs, and to write a clear and comprehensive report that will guide educational and treatment planning.

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

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

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Image of a reward chart and quote from NESCA

“I’ve tried a sticker/reward chart, and it does not work!” – Strategies to Make Incentive Plans Actually Work

By | NESCA Notes 2026

Image of a reward chart and quote from NESCABy: Alison Burns, Ph.D.
Pediatric Neuropsychologist, NESCA

Behind the simple sticker chart or reward chart is decades of solid science. Psychologists and brain researchers have found that these charts work because they tap into how the human brain naturally learns and stays motivated. When a child gets a sticker or a point towards a reward immediately after doing a good job, their brain releases a tiny splash of dopamine, the “feel-good” chemical that helps us focus and feel successful. Decades of research, especially with kids who have ADHD, shows that rewards make boring or difficult tasks feel achievable. By focusing on positive rewards rather than nagging or punishment, these charts help shape behavior through slowly motivating changes which become habits or routines.

Incentive charts are highly versatile tools. While most commonly associated with young children, they are effective for anyone, including elementary-aged students and teenagers, who need help changing behaviors, building new habits, or staying motivated.

Despite these benefits, many parents I work with share the same frustration: “I’ve tried a sticker/reward chart, and it just didn’t work.”

When I dig a little deeper, I usually find that the incentive system wasn’t set up in a way that allowed the child, and the family, to succeed. I provide the following guidance to make their incentive plans more effective:

  1. Pick Your Battles: Focus on just 2 to 3 goals at a time (or even just one for very young kids). Ask yourself: What is the most pressing behavior change we need right now? Is it brushing teeth without an argument? Getting out the door on time for school? Stopping hitting or food-throwing? Trying to change too many things at once is a major reason why these charts fail. Think of it like New Year’s resolutions: when we try to overhaul our diet, go to sleep early, start a daily workout routine, complete a gratitude journal, and read a book a week all at the same time, we quickly burn out. It is simply too hard to maintain that much change long enough for new habits to stick. The same is true for your child. Keep it simple. Once your child masters one specific goal, you can “graduate” them from that goal and introduce a new one.
  2. State Goals Clearly and Positively: Tell your child exactly what you want them to do, rather than what you want them to stop doing. Instead of “Don’t be late for school,” phrase the goal as “Be ready with your shoes on and backpack packed by 7:20 AM.”
  3. Start with “Easy Wins”: Incentive plans often fail when parents set the bar too high right away; if a child goes several days without earning a reward, they will lose motivation and give up. Instead, start with an easy, highly achievable version of your goal and slowly raise the bar. For example, if your ultimate goal is for your child to have their shoes on and backpack packed by 7:20 AM, start by rewarding them just for having their shoes on by 7:20. Once that becomes a habit, you can raise the bar to include the backpack. Slowly shaping the behavior in these small, manageable steps keeps your child winning, building the momentum they need to succeed rather than setting the bar out of reach and causing them to throw in the towel.
  4. Reward the Behavior Immediately: Timing is everything. To help your child’s brain connect the good behavior with the reward, hand over the incentive right away. For timed tasks (like being ready by 7:20 AM), give the sticker, token, or point the second they finish. For all-day goals (like keeping hands to themselves), have a set time every day (like right after dinner) to hand out the reward. Connect the dots for them by saying: “Because you kept your hands to yourself today, you earned your sticker!” The more immediate or consistent the reward process is, the more likely the incentive system will be a success.
  5. Let Your Child Choose the Rewards: Children are far more motivated by rewards they actually care about. Sit down together and make a list of prizes. Remember, rewards do not have to be toys or cost money. Kids are highly motivated by quality time and special privileges, such as an extra bedtime story, 10 minutes of one-on-one time with a parent, choosing what’s for dinner, or picking the movie for family night.
  6. Make the “Exchange Rate” Clear: Make sure your child knows exactly what their stickers/points can buy. For young kids: Keep it simple. Placing the sticker on the chart might be enough, or they can “cash in” 3 stickers for a reward (like 10 minutes of screen time). For older kids, let them save up. They can earn points daily, but saving up 5 points might earn them a larger weekend reward (like a trip to get ice cream).
  7. Never Take Stickers Away: This is the golden rule of incentive charts. Once a sticker or point is earned, it is locked in. If your child has a great morning and earns a sticker/point, but has a meltdown in the afternoon, do not peel the morning sticker off or take away a point. Taking away earned rewards feels unfair to kids and ruins their motivation to keep trying. If they have a tough afternoon, simply say: “You didn’t earn your sticker/point for this afternoon, but you can try again tomorrow.”

Why Summer is the Perfect Time to Start

Summer is a fantastic time to introduce an incentive plan because it provides a light, predictable structure to those otherwise unstructured summer days. Furthermore, behavior change can be easier to accomplish when kids are relaxed and free from the daily stress of the school year. Making small, positive changes over the summer months can pay large dividends and set your family up for a smooth transition back to school in the fall. Not only will your child be accustomed to using a reward system by then, but they will also have already established several positive habits that will make the start of the school year much easier for everyone!

 

About the Author

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

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

NESCA is a pediatric neuropsychology practice and related services practice with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; 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.

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Image of a child doing an obstacle course and a quote by Julie Weieneth, Ph.D.

Summer Treatment Ideas for Children with ADHD

By | NESCA Notes 2025

Image of a child doing an obstacle course and a quote by Julie Weieneth, Ph.D.By: Julie Weieneth, Ph.D.
Pediatric Neuropsychologist, NESCA

For many families with children who have ADHD, the end of the school year brings both relief and anxiety. While the break is welcome, the sudden loss of routine can be daunting, leading to unstructured days and endless requests for screen time. But what if this summer could be different? The season’s freedom presents a powerful opportunity to build new skills, strengthen family bonds, and explore creative ways to manage ADHD symptoms. To help you begin, we have gathered summer treatment and planning ideas for every age, including preschoolers, elementary schoolers, middle schoolers, and young adults preparing for college. If any of these ideas resonate with you, try one out this summer and let us know how it goes. We would love to share your experiences with other families!

Preschool (Ages 3-5)

For the little ones, learning through play and interaction is key.

  1. Parent-Child Interaction Therapy (PCIT): PCIT is a hands-on approach that helps parents build better relationships with their kids using play and clear discipline strategies, with real-time coaching from a therapist. It focuses on boosting positive behaviors and reducing the tough ones to create a happier home life. For more information, check out PCIT.org or reach out to NESCA for provider recommendations.
  2. Occupational Therapy (OT): OT can support young children with ADHD by targeting sensory processing, self-regulation, and fine motor skills.
  3. Academic Readiness through Play: Head to a local craft, school supply, or thrift store, or a learning store, like Lakeshore Learning, to find games and activities that build fine motor skills, counting, sorting, and creativity. Here are some additional fun ideas to try out:
    • Treasure Hunts: Create simple treasure hunts with clues to improve attention, focus, and listening skills.
    • Storytime with Puppets: Use puppets to act out stories, encouraging participation and retelling to boost language skills.
    • Craft Projects: Try out different crafts involving cutting, gluing, and coloring to strengthen fine motor skills and creativity.
    • Obstacle Courses: Set up indoor or outdoor courses to enhance physical coordination and follow instructions. If you have an older sibling, get them involved in setting up and running the obstacle course.
    • Cooking Together: Involve your child in cooking simple recipes to improve focus, following directions, and fine motor skills.
    • Memory Games: Play memory games with cards or objects to boost attention and recall.
    • Building Challenges: Use blocks or LEGO sets to encourage planning and problem-solving.
    • Dance and Movement Games: Play games, like freeze dance or follow-the-leader, to help with self-regulation and listening skills.

Elementary School (Ages 6-10)

Kids in this age group thrive with structured activities that enhance social skills and organization.

  1. Behavioral Therapy: Enroll your child in therapy sessions targeting goals including impulse control and organization.
  2. ADHD Summer Camps and Social Skills Groups: These camps/group programs offer structured environments tailored for kids with ADHD, focusing on social skills, self-esteem, and executive functioning.
  3. Bibliotherapy or Self-Help: Summer is a great time to read books on parenting children with ADHD, like “Taking Charge of ADHD” by Russell A. Barkley. There are also many children’s books, such as “The Secret Superpowers of ADHD” by Jennifer Everly. Explore resources on CHADD and ADDitude for more ideas.

Middle School (Ages 11-13)

As your child enters adolescence, focus on fostering independence and self-awareness.

  1. Cognitive Behavioral Therapy (CBT): CBT helps middle schoolers learn strategies to manage impulsivity and improve attention, with summer sessions focusing on real-life situations, such as managing social conflict and academic stress.
  2. Mindfulness and Relaxation Techniques: Introduce mindfulness practices –  meditation or yoga – to improve focus and reduce stress. Many apps can help integrate these into daily routines.
  3. Volunteer Opportunities: Encourage community service projects to boost self-esteem, teach life skills, and reinforce social skills and early vocational skills.

Young Adults Transitioning to College/Vocational Endeavors (Ages 14-18)

For these young adults, it is all about preparing for college or vocational work, and managing academic, social, and daily living demands more independently.

  1. Executive Function Coaching: Consider hiring a coach to work on time management, organization, and goal setting, which are key skills for college and career success. NESCA offers transition-related assessments and coaching services tailored to transition-age youth. Explore NESCA Transition Services to help determine if college or a different path is right for you, and NESCA Coaching Services to build and practice skills that will be needed for all future paths.
  2. Medication Management: Check in with your healthcare provider to review medications and make any necessary changes before college starts. Learn more about what they are, what they are for, how to refill them, and when a new prescription is needed.
  3. Transition Workshops and College Immersion Programs: Look for workshops or programs that focus on transitioning to college or postsecondary life, covering self-advocacy, stress management, academic strategies, and social problem-solving.
  4. Updated Neuropsychological Evaluation: Ensure updated testing within three years of starting college or work to receive accommodations. If you have relied on accommodations in high school, have a support plan in place before your first college semester in order to ensure your success. Get to know more about on-campus resources to support you. If you are interested in learning about neuropsychological evaluations, please check out our website or contact us by filling out an Intake Form for more information.

We hope that you have a relaxing, fun, and rewarding summer! Feel free to reach out with any questions or concerns, or if you have any additional ideas to share with the NESCA community!

 

About the AuthorJulie Weineth headshot

Dr. Weieneth is a licensed clinical psychologist who has worked with children and families with complex diagnostic and treatment needs for the last twenty years. Her areas of specialty include ADHD, autism spectrum disorders, anxiety, mood disorders, learning disabilities, executive functioning, and school-related challenges. That being said, Dr. Weieneth also understands that not all individuals fit cleanly into diagnostic groups or labels. Her goals for each evaluation are to help families feel comfortable with the process, use all the tools available to best understand each individual’s unique strengths and needs, and to write a clear and comprehensive report that will guide educational and treatment planning.

To book a consultation with Dr. Weieneth or one of our many other expert neuropsychologists or other clinicians, 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; 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.

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image of a child receiving summer services

Why Summer Is the Perfect Time to Start Services for Your Child

By | NESCA Notes 2026

image of a child receiving summer servicesBy: Rebecca Dautoff, Psy.D.
Pediatric Neuropsychologist, NESCA

For many families, summer is a welcome break from the busy routines of the school year. Without homework, early morning schedules, and packed extracurricular calendars, children often have more flexibility and downtime. While summer is commonly viewed as a season for relaxation and fun, it can also be an ideal time to begin therapeutic, educational, or developmental services.

As a psychologist, I often hear parents wonder whether they should wait until the fall to start services. In most cases, my recommendation is simple: if a child would benefit from support, summer is one of the best times to begin. Schedules are more open, and you may even be able to meet more often and make as much progress in the summer as you would over the course of an entire semester. I personally have two children getting services this summer, and here is why:

Reduced Academic Demands Create More Capacity for Growth
During the school year, children are balancing academics, social expectations, extracurricular activities, and family responsibilities. Adding a new service can sometimes feel overwhelming for both children and parents. Summer offers a different environment. With fewer academic pressures and more flexible schedules, children often have greater emotional and cognitive bandwidth to engage in learning new skills, and parents may have more bandwidth to take on the scheduling of yet another thing. Whether they are working on emotional regulation, social communication, executive functioning, speech and language development, or motor skills, children may be more receptive to intervention when they are not simultaneously managing the demands of a full school day.

Time to Build Relationships Before School Starts
One of the most important factors in successful intervention is the relationship between the child and the provider. Trust and comfort take time to develop. Starting services during the summer allows children to establish rapport with therapists, specialists, or support providers before the school year begins. By the time fall arrives, many children feel more comfortable, confident, and familiar with the therapeutic process, allowing them to make more meaningful progress when academic demands increase.

Opportunities to Practice Skills in Real-Life Settings
Summer often provides more opportunities for children to practice new skills in everyday situations. Family outings, camps, playdates, vacations, and community activities create natural opportunities to apply what they are learning.

For example:

  • Children working on social skills can practice initiating conversations and maintaining friendships.
  • Children receiving counseling can use coping strategies during new experiences and transitions.
  • Children developing executive functioning skills can practice planning, organization, and independence.
  • Children receiving speech or occupational therapy can apply newly learned skills across a variety of environments.

This real-world practice helps strengthen learning and promotes generalization of skills beyond the therapy setting.

Preventing the “Wait and See” Delay
Parents sometimes hope that a challenge will improve on its own over time. While development naturally occurs as children grow, delaying support can sometimes mean missing valuable opportunities for intervention. Summer provides a proactive window to address concerns before they potentially become more significant during the school year. Beginning services early allows professionals to assess needs, develop goals, and implement strategies that can help children start the school year with greater confidence and support.

Easing School-Year Transitions
Transitions can be challenging for many children. Starting a new school year often brings changes in routines, teachers, expectations, and social dynamics. When children begin services during the summer, they can enter the school year with established supports already in place. They may have stronger coping skills, increased confidence, and a clearer understanding of their strengths and challenges. This foundation can make the transition back to school smoother and less stressful for both children and parents.

More Opportunities to Participate
Parent involvement is one of the strongest predictors of successful outcomes in many therapeutic and educational interventions. The school year in our house often feels hectic. With two working parents and three kids in school, our day-to-day is fast-paced and complicated, to say the least. During the summer, families like ours often have more flexibility to attend appointments, participate in consultations, and implement recommended strategies at home. This increased bandwidth and collaboration allows providers and families to work together more effectively, creating consistency between sessions and daily life.

Progress Before the Next School Year Begins
Perhaps one of the greatest advantages of starting services during the summer is the opportunity to make meaningful progress before school resumes. A few months of targeted support can help children develop new skills, increase confidence, and establish positive routines. Rather than beginning services while already managing the demands of a new school year, children can start the fall with momentum and a stronger foundation for success.

 

About the Author

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

 

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

 

NESCA is a pediatric neuropsychology and related services practice with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; and the 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.

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Image showing a student concentrating in class; quote from Dr. Sean Hyde O'Brien

Hearing Loss and Neuropsychological Development

By | NESCA Notes 2026

Image showing a student concentrating in class; quote from Dr. Sean Hyde O'BrienBy: Sean Hyde O’Brien, Psy.D., ABPdN 
Pediatric Neuropsychologist, NESCA

As the husband of a pediatric audiologist, I often hear stories of children referred for audiological evaluations that end up having normal hearing but are thought to have other conditions that fall within the purview of neuropsychology, including Language Disorder, Autism Spectrum Disorder, Intellectual Disability, and Attention-Deficit/Hyperactivity Disorder. It made me think about the way that children typically referred for neuropsychological evaluations can be potentially impacted by hearing loss, particularly in terms of their cognitive, academic, and social-emotional functioning. Review of the literature indicates the following:

  1. Language Acquisition and Communication:

Children with hearing loss may experience delays in development of communication skills including speech articulation and receptive-expressive language. This can make it difficult to for children to understand instructions, participate in discussions, and express ideas.

  1. Literacy Skills:

Development of reading and writing skills are closely tied to language abilities. Hearing loss can lead to difficulties in phonological awareness, decoding, and comprehension, resulting in lower literacy achievement in children with otherwise intact cognitive profiles.

  1. Executive Functioning:

Hearing loss may affect executive functioning skills such as attention, organization, and task completion due to difficulties in following multi-step instructions or classroom routines.

  1. Cognitive Load:

Increased effort required to listen and comprehend spoken information can lead to cognitive fatigue, reducing the capacity for learning and retention.

  1. Classroom Engagement:

Students with hearing loss may struggle to follow lessons, especially in environments with significant background noise or when teachers are not facing the class. They may miss important information, instructions, or peer interactions, leading to reduced participation and engagement.

  1. Academic Achievement:

Studies have shown that children with hearing loss are at greater risk for lower academic achievement, particularly in subjects that rely heavily on verbal instruction and interaction (language arts, social studies, etc.).

  1. Access to Curriculum:

Without appropriate accommodations (e.g., hearing assistive technology, preferential seating, captioning, sign language support), students may not have equitable access to curriculum content.

  1. Social-Emotional Functioning:

Finally, hearing loss can contribute to feelings of social isolation, frustration, and decreased self-esteem if communication barriers lead to difficulties in making friends or participating in group activities.

Based on the various ways that hearing loss can impact the cognitive, academic, and social-emotional development of your child, it is important that their hearing be evaluated at the first signs of concern. Paired with a comprehensive neuropsychological evaluation, this can result in early identification and treatment (e.g., speech-language therapy, hearing assistive technology, and classroom accommodations) that leads to the optimal outcome for your child.

For more information, please visit the American Speech-Language-Hearing Association (ASHA) website at https://www.asha.org/public/hearing/effects-of-hearing-loss-on-development/

 

About the Author

Dr. Sean O’Brien has been providing comprehensive neuropsychological evaluations in the GreaterSean Hyde O'Brien Boston area since 2006. He specializes in the assessment of children and adolescents who present with a wide range of developmental conditions, such as  Attention-Deficit/Hyperactivity Disorder, Specific Learning Disorder (reading, writing, math), Intellectual Disability, and Autism Spectrum Disorder; as well as children whose cognitive functioning has been impacted by medical, psychiatric, and genetic conditions. He also has extensive experience working with children who were adopted both domestically and internationally.

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

NESCA is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; the greater Burlington, Vermont region; and 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.

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Image of a signpost with the words Wait and See" and "Check It Out" on it and a quote from Dr. Rebecca Dautoff

When In Doubt, Check it Out

By | NESCA Notes 2025

Image of a signpost with the words Wait and See" and "Check It Out" on it and a quote from Dr. Rebecca DautoffBy: Rebecca Dautoff, Psy.D.
Pediatric Neuropsychologist, NESCA

As a child psychologist, I regularly advise parents that our job is not to eliminate their children’s frustration, anxiety, and disappointment. Instead, our goal is to help kids process and tolerate these emotions. In fact, it’s critical that children face obstacles so they can learn to navigate and endure challenges throughout their life. But what happens when a child has a particularly tough time at school or a really difficult year? What are the next steps?

Deciding what to do can be a hard decision for concerned parents. Some parents question whether they should  “do something” to help the child, or to relieve their own anxiety and guilt. Other parents feel that their child’s issues are due to “a bad fit” with a particular teacher or classroom structure. This can be even harder when the school tells parents that everything is okay, or it’s just a phase that they see all the time. In some cases—such as a child grieving or adjusting to a new school—a short observation period (a few weeks) with close monitoring and open communication can be appropriate. However, this should always come with a clear plan to seek help if things don’t improve, because the “wait and see” approach can pose real risks to a child’s development, mental health, and emotional well-being. Here’s why:

First, childhood is full of developmental windows. These are essentially periods of time or opportunity when the brain is especially receptive to learning a specific skill. If a child is struggling in one of these areas and we wait too long, we risk missing this period of optimal learning. Language delays are a clear example. There is a critical period of language development before the age of 3, meaning that intervention for speech and language challenges are most effective before this age.

Second, children are incredibly perceptive. Kids are highly attuned and hyper aware when they feel like something is harder for them than it is for their friends and classmates. Often, kids internalize their struggles as personal failures. This can lead to frustration, anxiety, withdrawal, or behavioral problems/acting out. These outcomes are even more likely if a child is late to learn a skill. Take reading as an example. If a child is learning to read more slowly than their peers in first or second grade, they are less likely to internalize this as a problem because most of their classmates are also learning to read. It might come more easily to their friends, but they are all learning to read. If we wait to intervene, and a child is still having difficulty with reading in fourth grade, they are more likely to internalize their difficulty as a personal failure because they are no longer surrounded by peers who are also working on the same skill.

Taking a wait and see approach with your child’s mental health can feel like a cautious or hopeful strategy—especially when you’re unsure if something is truly wrong. Unfortunately, mental health conditions are often progressive, and waiting to treat them can allow symptoms to worsen, which makes them harder to treat. Undiagnosed mental health issues can lead to poor academics, social withdrawal, bullying, or acting out. The child may fall behind developmentally or struggle to make or keep friendships, which will impact their self-esteem and exacerbate their mental health issues. In older children and adolescents, we also see untreated mental health issues lead to more dangerous problems, like substance use, self-harm, eating disorders, or suicidal thoughts.

Instead of waiting, parents should proactively communicate with teachers, seek professional help when needed, and consider the child’s overall well-being when making decisions about their education.

What to Do Instead Of “Wait and See”:

  • Talk to your child: Open the door to conversation and let them know you’re there.
  • Keep track of behaviors, moods, or changes.
  • When in doubt, check it out: Even a single consultation with a pediatrician, school counselor, or therapist can provide guidance without committing to long-term treatment. If you suspect there is a deeper learning, emotional, developmental, or behavioral issue, a neuropsychological evaluation can also determine the root cause of the issues and set you and your child on a better path forward.

 

About the Author

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

 

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

 

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

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Image of someone who could head in multiple directions; quote from Dr. Jessica Greene about where to start with recommendations from neuropsychological evaluations

What to Do with All the Recommendations?

By | NESCA Notes 2026

Image of someone who could head in multiple directions; quote from Dr. Jessica Greene about where to start with recommendations from neuropsychological evaluationsBy: Jessica Greene, Psy.D.
Postdoctoral Fellow, NESCA

Your child’s neuropsychological evaluation is complete, and your family now has a greater understanding of your child – and a long list of recommendations. After you review the list, it can feel as though every recommendation is the most important one. How do you know where to start? The steps outlined below are general guidance; your team may recommend a different timeline based on your child’s needs.

Prioritize

Recommendations are meant to provide a roadmap for the next two to three years. Step back and ask yourself, “What is most important for my child and for my family right now?” Choose one to two recommendations that make the most sense and gradually find ways to work them into your routine. Making intentional changes, at a reasonable pace, gives everyone time to adjust. Also, it is much easier to tell whether a strategy, intervention, or service is helping when you try one thing at a time.

Reflect

After you have tried the chosen recommendations for a reasonable amount of time, take a moment to consider your child’s progress. Day-to-day life can make growth easy to overlook, particularly when there are still other pressing needs. But, before returning to your list of recommendations, consider the changes that have occurred. Growth is not always linear, so perhaps your child has made growth in one area, but something new has presented itself. On the other hand, perhaps things have moved forward for the better and there is time to focus on recommendations that were less pressing.

Review

When ready, return to recommendations and consider what to implement next. Again, choose one or two items, so as not to overwhelm yourself or the family system.

Set Boundaries with Others (if needed)

Caregivers often tell me they feel flooded with opinions from everyone they know. While outside input can be helpful at times, it’s also okay to set boundaries. You might simply thank people for their advice and say you have a plan you intend to follow. That response acknowledges their concern without letting you get derailed.

Need Help Choosing a Next Step?

If you are unsure where to start or what to focus on next, reach out to a trusted provider that understands your child’s needs. That may be the NESCA neuropsychologist who completed the evaluation, an outside provider (occupational therapist, counselor, speech-language pathologist), your pediatrician, or a school contact (special education teacher or school counselor). They can help you plan next steps.

If you’d like more details about next steps and who to share the report with, see Dr. Maggie Rodriguez’s post, which outlines practical actions to take after a neuropsychological evaluation. Read her full article here: https://nesca-newton.com/navigating-life-after-a-neuropsychological-evaluation-what-comes-next/.

 

About the Author

Dr. Jessica Greene is a licensed clinical psychologist who has worked After working with Dr. Angela Currie in NESCA’s Londonderry, N.H. office from 2023-2024 as a practicum student, Dr. Jessica Greene re-joins NESCA to complete her postdoctoral fellowship in pediatric neuropsychological assessment. Dr. Greene has a particular interest in understanding clients’ strengths as well as differences, integrating a therapeutic assessment approach, when appropriate.

To book an evaluation with one of our many expert neuropsychologists or other clinicians, 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; 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.

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Image of a road sign with College ahead on it portraying the topic of the blog about college planning with ADHD

College Planning for Families of Students with ADHD

By | NESCA Notes 2026

Image of a road sign with College ahead on it portraying the topic of the blog about college planning with ADHDBy: Julie Weieneth, Ph.D.
Pediatric Neuropsychologist, NESCA

The transition from high school to college brings stress for most families. As a parent of a high school junior, I am currently helping my teen juggle schoolwork, extracurriculars, and all the “must-do’s” for college planning. At times, it feels very overwhelming for me, so I can only imagine how it feels for my daughter. As a neuropsychologist, I often reflect on how neurodiversity, especially ADHD, shapes this journey.

Over the years, I have worked with many bright students with ADHD who have successfully navigated the college planning process. These teens bring unique strengths to the table. When families are able to recognize these strengths, support ongoing areas of need, and seek professional guidance as needed, college planning can become a process of growth for both teens and their parents.

ADHD Strengths in College Planning

  • Creativity and Problem-Solving: Many students with ADHD naturally think outside the box. They approach challenges from fresh angles, which can help them identify colleges, majors, or support services that might otherwise be overlooked. Their creative solutions can make the search process more dynamic and tailored to their needs.
  • Energy and Enthusiasm: Students with ADHD often bring a high level of energy and excitement to new experiences. This enthusiasm motivates them to explore a wide range of colleges, participate in campus tours, and engage with student groups. Their passion can help them stand out in interviews and application essays.
  • Hyperfocus on Interests: While ADHD is often associated with distractibility, many students experience periods of intense focus, especially on topics that truly interest them. This hyperfocus can be a tremendous advantage when researching colleges, preparing application materials, or delving into extracurricular opportunities that align with their passions.
  • Resilience and Adaptability: Navigating the ups and downs of ADHD often builds resilience. Many students learn to adapt quickly, bounce back from setbacks, and persist in the face of challenges. These qualities are invaluable during the college search and application process, which can involve rejection, waitlists, or unexpected changes.

How Parents Can Help

Parents play a key role in supporting their teens’ transition to college. Here are some practical steps:

  • Foster Self-Advocacy: Encourage your teen to understand their needs and practice asking for help. Role-play conversations about accommodations and celebrate their efforts.
  • Find the Right Fit: Focus on colleges that match your teen’s needs, not just prestige. Visit campuses, meet with disability services, and consider factors like class size and available supports.
  • Secure Accommodations: Keep neuropsychological testing up to date, as colleges require documentation. Encourage early use of academic supports and check in regularly.
  • Build Executive Function Skills: Practice time management and organization before college. Gradually let your teen take the lead and consider executive function coaching if needed.
  • Plan for Medication and Health: Help your teen set up prescription management and health routines. Practice independence with gentle reminders.
  • Support Social and Emotional Well-being: Encourage involvement in clubs and normalize seeking help from campus resources. Keep long-term supports in place, and encourage booster sessions with therapists, executive function and real-life skills coaches, tutors, during breaks or through virtual sessions as needed.

Also, it is important to remember to care for yourself! This transition is significant for parents, too. Seek support for yourself as needed.

At NESCA, in addition to neuropsychological evaluations, we offer consultations and executive function and real-life skills coaching. Please feel free to reach out to us if we can help you and your child navigate this process.

 

About the AuthorJulie Weineth headshot

Dr. Weieneth is a licensed clinical psychologist who has worked with children and families with complex diagnostic and treatment needs for the last twenty years. Her areas of specialty include ADHD, autism spectrum disorders, anxiety, mood disorders, learning disabilities, executive functioning, and school-related challenges. That being said, Dr. Weieneth also understands that not all individuals fit cleanly into diagnostic groups or labels. Her goals for each evaluation are to help families feel comfortable with the process, use all the tools available to best understand each individual’s unique strengths and needs, and to write a clear and comprehensive report that will guide educational and treatment planning.

To book a consultation with Dr. Weieneth or one of our many other expert neuropsychologists or other clinicians, 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; 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.

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Image of a person's brain with gears working in sync, representing Executive functioning

Executive Functioning: What is it and how do we address weaknesses?

By | NESCA Notes 2026

Image of a person's brain with gears working in sync, representing Executive functioningBy: Alison Burns, Ph.D.
Pediatric Neuropsychologist, NESCA

Although the concept of executive functioning has existed since the 19th century, it began to gain significant attention in the fields of psychology, education, and neuroscience in the late 1990s and early 2000s. Executive functioning can be thought of as the brain’s “management system.” It enables us to plan ahead, stay organized, remember important information, initiate tasks, control impulses, adapt to changes, and manage our emotions. These skills help us get started on homework or chores, remember what we need to buy at the store, keep track of our schedules, stay calm when upset, switch gears when plans change, and finish tasks without getting distracted. When executive functioning skills are strong, individuals are able to juggle responsibilities, solve problems, and cope effectively with everyday challenges.

Executive functioning difficulties can arise from a variety of causes. Neurodevelopmental disorders such as Attention Deficit Hyperactivity Disorder (ADHD), Autism Spectrum Disorder, and learning disabilities frequently involve challenges with executive skills. Neurological conditions – including brain injury or stroke, particularly those affecting the frontal lobes – can impair executive functioning. Mental health disorders such as depression, anxiety, bipolar disorder, and schizophrenia may also impact these skills, making it harder to plan, organize, or regulate emotions. Environmental factors, including chronic stress, lack of sleep, poor nutrition, or substance use (alcohol or drugs), can temporarily or permanently weaken executive functioning. Additionally, some individuals may have a genetic predisposition to weaker executive functioning, and developmental delays due to prematurity, or early childhood adversity can further contribute to difficulties in these areas.

Fortunately, executive functioning weaknesses can be improved through targeted interventions. Direct interventions may include cognitive-behavioral therapy to enhance skills such as self-regulation, cognitive flexibility, and self-monitoring. Executive function coaching can also be beneficial, focusing on skills like planning, organization, and time management by identifying barriers and providing practical strategies for implementation.

In addition to direct intervention, accommodations can be provided to help individuals compensate for areas of challenge. Accommodations should be matched to an individual’s specific executive functioning weaknesses. Below are examples of accommodations for specific areas of challenge. This is not meant to be an exhaustive list, but rather to provide examples of the types of accommodations that may be recommended depending on an individual’s specific profile.

Planning & Organization

  • Use a paper planner, wall calendar, or smartphone app to record assignments, appointments, and deadlines. Review these tools daily to clearly see what needs to be done and when.
  • Divide complex assignments or larger projects into smaller, more manageable tasks, and set individual deadlines for each one. This approach will make the overall project less overwhelming and easier to tackle.
  • Use visual tools such as graphic organizers, outlines, or flow charts to organize ideas and information before beginning an assignment or task.
  • Use folders, color-coding, and binders to organize physical belongings. Use trial and error to identify what works best and take time every day to maintain organizational systems (i.e., put it away before it piles up and feels overwhelming).

Working Memory (the brain’s “scratch pad” where we hold and manipulate information)

  • Use detailed checklists for tasks that require memory of several steps to reduce the burden on working memory. Check off each step when completed. Apply this strategy to recurring tasks, such as morning or bedtime routines, but also schoolwork or chores that have multiple steps or components.
  • Give the individual verbal instructions more than once and ask them to repeat the instructions back to ensure they understand what needs to be done. Instructions should be provided in in small chunks, rather than all at once, so the individual can focus on one step before moving to the next.
  • Permit individuals to use audio recorders or AI technology to capture information during lectures or meetings, so they can replay and review content as needed.

Task Initiation

  • Define the first action required for a task, such as “open your book to page 10,” so it is clear exactly how to begin.
  • Sentence starters or example problems can be helpful in clarifying task expectations, and, in turn, improving task initiation.
  • Establish regular routines and schedules, such as starting homework at the same time each day, to make it easier to get started on tasks.

Inhibition (Impulse Control)

  • Have a teacher, supervisor, or caregiver nearby to provide quick feedback or reminders when impulsive behaviors occur.
  • Provide items like fidget spinners, putty, or doodling pads to give individuals a safe way to channel their energy and reduce impulsive actions. Allow individuals to take short movement breaks to help manage restlessness or impulsivity.
  • Provide praise or rewards when individuals demonstrate restraint or appropriate behavior, encouraging them to continue using impulse control strategies.

Cognitive Flexibility

  • Inform individuals ahead of time about changes in plans or schedules so they can mentally prepare and reduce stress. Give warnings ahead of transitions (e.g., “You have five minutes to finish up that essay) to assist in the transition from one activity to the next, particularly when shifting from a preferred to non-preferred task.
  • Using written or visual stories that describe upcoming events and expected behaviors will help individuals anticipate and cope with new experiences.
  • Teachers or supervisors should preview any partner and group work ahead of time, including carefully outlining roles and expectations.

Emotional Regulation

  • Offer designated quiet areas or allow breaks for individuals to calm down when feeling overwhelmed or upset.
  • Use charts, cards, or other visual tools to help individuals recognize and communicate their emotions.
  • Allow individuals a few minutes to reflect or calm down after an emotional incident before discussing their behavior or asking them to resume work or activities.

Self-Monitoring

  • Provide tools that allow individuals to evaluate their own work against specific criteria and track their progress over time. For example, an editing checklist for a writing assignment should include specifics such as a review of content, spelling, punctuation/capitalization, and grammar/run-ons. This would help shift the vague task of “check your work” into a more actionable task with greater success of being beneficial.
  • Schedule frequent reviews and provide constructive feedback to help individuals stay on track and make adjustments as needed.
  • Allow individuals extra time to double-check their work for errors or improvements before turning it in or finishing a task.

This vast network of skills, collectively referred to as executive functioning, plays a critical role in an individual’s ability to function in daily life. Comprehensive neuropsychological evaluations can provide valuable insight into specific areas of weakness and how they impact an individual’s functioning. This understanding allows for tailored, targeted recommendations that are more likely to be effective than implementing broad, non-specific executive functioning supports.

If your child or student can benefit from executive function coaching, complete NESCA’s online inquiry/intake form to receive additional information or book sessions.

 

About the Author

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

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

NESCA is a pediatric neuropsychology practice and related services practice with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; 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.

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