Tag

preschool

Feb 20
3

Neuropsychological Evaluations at Different Stages of Childhood & Adolescence

By | Nesca Notes 2023

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

Having been at NESCA for more than 11 years, I have been fortunate enough to follow many clients throughout their childhood. In some cases, I have conducted two or three neuropsychological evaluations on the same student at different points in their life. After their first experience with an evaluation, parents will often ask, “Will we need to do this again?” or “How often should we get evaluations?”. As is the case for most things, the answer is different for every child depending on their needs. When determining how often to seek an evaluation, it might be helpful to think about what information you are trying to gather depending on the child’s age.

Preschool (2-5)

  • Concerns about developmental delays (not meeting milestones)
  • Concerns about autism spectrum disorder (ASD)
  • Transition from Early Intervention into preschool
  • Transition from preschool to kindergarten

Elementary School (5-10)

  • Concerns about academic skills – assess for dyslexia, dysgraphia, dyscalculia, or other specific learning disability
  • Why is the student not making expected progress in school?
  • Concerns about attention and executive functioning (possible attention-deficit/hyperactivity disorder (ADHD)
  • Concerns about ASD (if not already diagnosed)
  • For children who already have an identified disability – need to monitor progress
  • Plan for transition to middle school

Middle School (10-14)

  • If this is the first neuropsychological evaluation – it is usually because the child did okay in elementary school but is now struggling with increased demands in the areas of academics, executive functioning, and social
  • For students with a previously identified disability – need to monitor progress
  • Plan for transition to high school

Early High School (14-16)

  • Monitor progress – how is the student managing increased demands of high school?
  • Mental health – emerging concerns about anxiety and/or depression
  • Start planning for postsecondary transition
    • Is the student on track to graduate in 4 years?
    • Does the student need programming beyond 12th grade?

Late High School (16-18)

  • Heavy emphasis on postsecondary transition planning
  • Do we need to work on vocational skills?
  • If the student is college-bound – determine whether any accommodations will be needed
  • If the student is not going to college – what is next?
    • Remain at high school with ongoing special education services
    • Gap year
    • Young adult transition program for students with disabilities
  • Consult with transition specialist to help with planning

Early Adulthood (18+)

  • If the student is in college – do they need additional supports?
  • If the student is still accessing special education services – where should we be putting the emphasis?
    • Academics
    • Vocational
    • Life Skills
  • For students with developmental disabilities, need to plan for adult services
    • Should the parents seek guardianship?
    • Is the student eligible for DDS or other adult service agencies?
    • What resources are available to the family?
  • Combine with transition specialists to help navigate adult services

 

About the Author

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

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

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

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

May 20
3

Got Complicated? NESCA’s Newest Pediatric Neuropsychologist Wants to Test Your Child. Find Out Why!

By | NESCA Notes 2019

Pediatric Neuropsychologist Yvonne Asher, Ph.D., joins NESCA on June 3, servicing clients in the Londonderry, New Hampshire and Newton, Massachusetts offices, and is scheduling new clients now. We sat down with Yvonne to learn more about her, what her passions in neuropsychology are and why she joined NESCA.

 

By Jane Hauser
Director of Marketing & Outreach

NESCA has 15 neuropsychologists who test a wide range of individuals. Tell us about your past professional experience and the types of clients you most enjoy serving.

I love working with children with complex profiles where challenges and diagnoses aren’t easily made or identified. This is the group of kids I worked with most often when I was with Mass General Hospital’s Lurie Center for Autism. It’s also incredibly rewarding to work with kids who aren’t able to communicate in a traditional manner—they may be too young, too impaired or potentially non-verbal. Many people think these individuals are too difficult to work with in testing. Using data to better understand their strengths and weaknesses is my passion, and I love to help them tell their stories through the assessment process.

It sounds like you enjoy working with complex kids. Can kids who have limited verbal skills and/or behavior challenges be tested?

Yes! Sometimes these children can be labeled in a punitive or negative way, such as being “uncooperative” or “untestable.” I don’t believe that anyone benefits from these kind of labels. It’s my job as the psychologist to be creative so that we can get the necessary data to understand them. I try to ease parents’ minds by reassuring them that I’ve seen many of these children before. And, if I haven’t frequently seen a particular complex profile, I’m lucky to have wonderful colleagues and resources to collaborate with on such cases.

For example, I worked with one very sweet, four-year-old child who had severe communication issues.  The parents and his pediatrician questioned whether he had autism. Since he had incredibly limited verbal skills, we altered all of the assessment tasks, using some non-verbal assessments and creatively modifying others to complete the testing. We noted that everything in the assessments—aside from his language—was on track developmentally. Prior to testing, everyone was pointing toward autism as the diagnosis, but he actually had a severe expressive/receptive language delay. His parents had figured out some tricks to communicate with him, but the world was a very scary place to him. He didn’t understand what was going on and primarily used gestures and facial expressions to communicate. That, unfortunately, only got him so far. As you can imagine, these challenges and frustrations led to a very stressful environment for the entire family. We recommended intensive speech therapy to help develop his communication skills, providing the family with a clear path forward.

You were a teacher before becoming a neuropsychologist. How do you feel your past experience as an educator enhances your work as a pediatric neuropsychologist?

I have a lot of experience working in public and charter schools. I was also a preschool teacher before graduate school, where I found the children to be endlessly funny, creative and just awesome! This experience is, in part, what fuels my desire to work with younger children who are experiencing challenges.

Having that educational experience is so valuable for the families at NESCA. I’ve been in special education and can help parents understand the process and landscape every step of the way—from an initial concern and assessment to getting an IEP and to thinking about high school placement and transition to adulthood.

The school experience also helps me to relate to the teachers, since I’ve been one and know how to partner with them to help students. We always help our families and push for what’s needed, but it’s helpful to also understand the constraints of the school setting. Knowing the constraints won’t change our recommendations, but it’s helpful in providing recommendations that will be implemented.

Why did you opt to move from the school setting to neuropsychology?

While I loved working in the school setting, I found that I didn’t get the chance to work as closely with families as I wanted. While families were there for school meetings, I’m looking to work with and serve the whole family system. I enjoy taking a close look at why children are having particular challenges, whether there’s a diagnosis that can be identified, and determining what school or path best fits a child and their family. I like taking the time to talk with parents and educators, giving each of them the chance to talk about the child, and to ask questions and make a plan for the child and their family. With really young kids, this is often just a first step, and I am excited to work with families long-term and help them through future hurdles.

What is so special about working with young children and their families?

Being a family’s first introduction to mental health is so meaningful. I tend to work with families who may be noticing that some milestones or behaviors are a bit off, or when they may first be considering a neuropsychological evaluation or other assessments. I like to find those parents who are asking, “What do you think it could be?” I truly enjoy giving these parents insight into their child, and providing exposure to and help along their path in mental healthcare.

Why did you opt to work in a group practice, like NESCA?

During my postdoctoral work, I really came to value the consultation with and supervision from other psychologists. I thought about going back into the school setting, but school psychologists are typically the only ones in that role at their school, or even their district. I appreciate the ability to put heads and knowledge together as colleagues. Doing so, on behalf of our clients, can help us to frame a case or intervention in a different way. Being able to bounce ideas or recommendations off of each other and using the combined experiences, knowledge and referral resources of other neuropsychologists brings so much to clients, families and individuals with challenges. NESCA, in particular, offers a very supportive environment in which to work. That can be felt by co-workers as well as the families we serve.

 

About Pediatric Neuropsychologist Dr. Yvonne Asher:

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.

 

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

 

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