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processing speed deficit

Processing Speed Deficits and College – Part 2 – Finding a Fit

By | NESCA Notes 2020

By: Kelley Challen, Ed.M., CAS
Director of Transition Services; Transition Specialist

In my last blog, Processing Speed Deficits and College – Part 1 – The Dilemma, I discussed specialized instruction for students who have processing speed deficits in high school in comparison to the accommodations process in college. Below is a list of some of the accommodations and instructional modifications that are often afforded to students with processing speed deficits in high school, and if/how that support can be replicated in college as well as how hard a student may need to work to bridge gaps in support. One of the most important things to remember when reviewing this list is that modifications to the course of study or workload in a college course are typically not available in college. Students with processing difficulties must be able to keep up with the same instruction provided to every student in the class through a combination of accommodations, self-help strategies and use of supports (tutoring, academic coaching, office hours, study groups, etc.) outside of the classroom.

In the classroom

  • Reduced pace for instruction – High school educators may be used to heavily modifying their instruction (i.e., providing instruction at a slower pace, in manageable “chunks,” sometimes even with breaks between content) when they are teaching a class that includes students with reduced processing speeds. This is a typical methodology for many private special education schools and for special education classes in public schools. However, this is not the typical instructional style at a traditional college. With that said, there is great variety in the pacing of classes from one institution to another, and even from one teacher to another within the same institution. For students who have received specialized instruction in high school, it is important to consider the pace of available instruction and to sit in on college classes when considering this transition. Depending on the student’s learning profile, it may be necessary to seek out a college or support program that is specifically designed for students with learning disabilities or has had targeted programming for students with learning disabilities—especially those with processing speed deficits—for many years.
  • Copies of teacher notes or fill-in-the-blank notes – Note-taking is an important skill for life, and even students who receive accommodations to enhance their note-taking need to build skills for retaining instruction and oral direction. However, some students exit high school without note-taking skills. Upon request, colleges often have one or more ways that they can accommodate students who are unable to effectively take their own notes in class. Students may be able to get copies of teacher notes/slides, copies of notes taken by another designated student or professional note taker, recordings of class or opportunities to use other technologies in class, such as a Livescribe Smartpen. When note-taking is a challenge, it is important to understand what accommodations are typically available at a particular college, including what support might be provided for assistive technology training and usage.
  • Follow-up questions and review of learning – Students who have difficulty processing classroom learning in real-time are often provided lengthy opportunities to ask questions about materials outside of class and/or provided with copies of the teacher’s lecture materials and study guides for separate review. When thinking about college, easy access to course information and resources from outside of the classroom is an important consideration. While many universities and professors use learning management system (LMS) technologies like Blackboard, Canvas, Google Classroom, etc., there are still some professors who have not made the shift to using these systems for the majority of their coursework or student communication. Getting a sense of technology use is important if a student expects to preview and review course materials outside of the classroom (independently or with support). Understanding how easy it is to get ahold of professors outside of class (e.g., percentage of faculty who work full-time at the school, have offices, have office hours), and how to schedule brief times for individual communication with the instructor is also useful.

Managing assignments

  • Reduced writing – In high school, students who struggle with processing speed may be expected to complete fewer assignments or have longer deadlines than typical peers. In college, students are expected to complete the same number of assignments and to have all of their work for each course completed by the end of the semester. It is possible at some colleges to request extensions on assignments as an accommodation or on a case-by-case basis. However, extensions on assignments should be something that are needed as an exception rather than a rule or students may find themselves unable to keep up toward the end of a semester. Instead of extending deadlines, students who struggle with writing demands may benefit greatly by taking a reduced course load (i.e., fewer classes per semester) or by diversifying the types of classes they enroll in during one semester—for example, taking a kinesiology class at the same time as an English Composition class. If these types of accommodations are important, students will need to carefully understand a school’s policies on underloads as well as how much control/flexibility a student is able to have when managing their course of study.
  • Grading based on quality not quantity – Just as described above, it is important to remember that every student in a college course is expected to complete the same quantity of work and same course requirements. Both quality and quantity matter in college and for those reasons it is important to pick a school that is well suited for your pace and style of learning as well as a major that will enable you to fulfill course requirements using your learning strengths.
  • Support with reading fluency – Specialized instruction during K-12 education may have focused on helping a student to increase their reading pace. Reading intervention and readers are not typical in college. However, technology can be a lifesaver in supporting a student’s independent reading fluency. Students may benefit from audio books or from text-to-speech technology so that they can take in information in multiple modes and a faster pace. Practicing with technologies and understanding the related accommodations that will be available in college are important for continued reading success. Some high school students have additionally needed tutoring support because they learn best when discussing aloud content that they have read in a supportive setting—for those students, it has been important to seek out schools or learning disability programs that can provide this type of tutoring (a less common support) or to pay privately for tutoring in addition to college-based learning supports.

Testing

  • Extra time – This is one accommodation that is fairly common in both high school and college settings. One major change is that many high schools provided unlimited extra time to students, even those with no identified learning disabilities. In college, students will typically receive 50% or 100% extended time based on their needs as demonstrated in diagnostic testing. Good executive functioning can be helpful if you are a student who uses extra time on exams, because you may need to schedule your exams in a separate testing setting each time they occur.
  • Shorter length/Reduced writing requirements – As a college student, you are required to meet the same testing requirements as every student in your class. If you are accustomed to reduced writing requirements on tests, you will need to consider some of the other available accommodations (e.g., extra time, assistive technology, etc.) to successfully manage. You may also need support building your test taking strategies so that you can use your time most efficiently on tests.
  • Separate testing space – Taking a test in a reduced distraction environment, or possibly a private room, is another accommodation that is common in both high school and college. Similar to students who receive extra time on tests, there can be a high degree of planning and organization involved in scheduling one’s exams in a separate setting according to school guidelines. Students may want to inquire about the level of support that college personnel will provide to a student when they are first learning to organize and implement their testing accommodations.

Social and daily life

  • Two additional factors that may have been important in high school include Smaller school/class size and Similar peer cohort. Matriculating from a small homogenous class or school environment, where all of your peers have similar learning styles and accommodation needs, can be a shock. When researching and visiting schools, it will be extremely important to get a sense of who the other students on campus are, how common processing speed deficits are among students with learning disabilities on campus, how diverse the school is and how tolerant students generally are, etc. Sitting in on classes and taking part in accepted student days can be critical activities for students who are looking for a college that will meet them where they are at.

When students enroll with disability support services, they are often asked how their disability impacts their learning, what accommodations they were provided in high school, and what accommodations they think they will need. For students with processing speed deficits, it is critical to be able to answer these questions before beginning a college search and to find colleges that truly match their learning needs as well as their more general wishlist!

 

 

About the Author:

Kelley Challen, Ed.M., CAS, is NESCA’s Director of Transition Services, overseeing planning, consultation, evaluation, coaching, case management, training and program development services. She is also the Assistant Director of NESCA, working under Dr. Ann Helmus to support day-to-day operations of the practice. Ms. Challen began facilitating programs for children and adolescents with special needs in 2004. After receiving her Master’s Degree and Certificate of Advanced Study in Risk and Prevention Counseling from Harvard Graduate School of Education, Ms. Challen spent several years at the MGH Aspire Program where she founded an array of social, life and career skill development programs for teens and young adults with Asperger’s Syndrome and related profiles. She additionally worked at the Northeast Arc as Program Director for the Spotlight Program, a drama-based social pragmatics program, serving youth with a wide range of diagnoses and collaborating with several school districts to design in-house social skills and transition programs. Ms. Challen is co-author of the chapter “Technologies to Support Interventions for Social- Emotional Intelligence, Self-Awareness, Personality Style, and Self-Regulation” for the book Technology Tools for Students with Autism. She is also a proud mother of two energetic boys, ages six and three. While Ms. Challen has special expertise in supporting students with Autism Spectrum Disorders, she provides support to individuals with a wide range of developmental and learning abilities, including students with complex medical needs.

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.

Processing Speed Deficits and College – Part 1 – The Dilemma

By | NESCA Notes 2020

By: Kelley Challen, Ed.M., CAS
Director of Transition Services; Transition Specialist

By nature, transition specialists are generalists—professional who support students with a wide range of disabilities in moving toward an even wider range of learning and life outcomes. Working in Massachusetts, with an early background as a guidance counselor in a college preparatory high school, I often support students who are contemplating whether and when they should matriculate to a four-year college program. Many of these students experience processing speed deficits. This means that these students may be capable of reasoning at average or above average levels, and therefore being stimulated and actively engaged by college course content, but these students also need extra time to process visual and verbal information, to make sense of this information, and to produce output.

Landmark College in Putney, Vermont, assembled an assessment for parents and students—A Guide to Assessing College Readiness—that includes five areas considered essential for students with learning disabilities who want to succeed in a traditional college setting. These include academic skills, self-understanding, self-advocacy, executive function and motivation/confidence. Some of the academic items include being able to read up to 200 pages of college level text in a week, writing an organized 10-page paper that cites multiple sources, and being able to complete all of the steps of a long-term project in a timely manner. Within the assessment, it is carefully noted that this is not a diagnostic tool and is intended to inform discussion about the appropriate environment and supports that the student will need to achieve success and struggle less in college. So, when I recently received a question from a parent who was wondering if it actually mattered that her student was not able to read 100 pages in only a few days, the answer I provided was, “it depends.”

While there are many ways that we accommodate and modify instruction for students who have processing speed deficits during high school, some of these methods are easy to replicate across college environments and others are heavily dependent on the environment or only replicable with a good deal of external support provided by people and technologies. For example, in high school, students with significant processing speed deficits may be supported through modifications, such as teachers reducing their pace of instruction, providing copies of instructional materials and/or fill-in-the-blank note-taking templates, actively following up with students to confirm their understanding of material, reducing the amount of work a student is expected to do per quarter or on a test, and actively assisting students in digesting complex reading materials or offering lighter/alternative reading. When all of these modifications are added together, a student has a highly specialized high school experience and may be left with gaps in their academic, executive functioning and self-advocacy skills that need to be carefully bridged when the student aspires to participate in college learning.

While high school accommodations and modifications center on supporting a student to successfully make progress in school, accommodations at the college level focus exclusively on what a student needs to be able to access the instruction that is already available at that college. Rather than individually modifying the curriculum or work load in a college course, a student must be able to keep up with the same instruction provided to every student in the class and the same requirements as every student in the college through a combination of accommodations, self-help strategies and use of supports (tutoring, academic coaching, office hours, study groups, etc.) outside of the classroom. Accommodations are still very individualized, but educational programming is typically not. This makes the college search and selection process complex and important for students with processing speed deficits. Not every college that specializes in supporting students who face learning difficulties is a good choice for a student with slow processing speed. And not every student with a processing speed deficit has the same skills, or faces the exact same challenges, when navigating college.

Stay tuned for our next Transition Thursday blog where I will elaborate on some of the common modifications and accommodations provided to high school students with processing speed deficits and how to think critically about college selection, support and accommodation based on experience with those accommodations.

 

About the Author:

Kelley Challen, Ed.M., CAS, is NESCA’s Director of Transition Services, overseeing planning, consultation, evaluation, coaching, case management, training and program development services. She is also the Assistant Director of NESCA, working under Dr. Ann Helmus to support day-to-day operations of the practice. Ms. Challen began facilitating programs for children and adolescents with special needs in 2004. After receiving her Master’s Degree and Certificate of Advanced Study in Risk and Prevention Counseling from Harvard Graduate School of Education, Ms. Challen spent several years at the MGH Aspire Program where she founded an array of social, life and career skill development programs for teens and young adults with Asperger’s Syndrome and related profiles. She additionally worked at the Northeast Arc as Program Director for the Spotlight Program, a drama-based social pragmatics program, serving youth with a wide range of diagnoses and collaborating with several school districts to design in-house social skills and transition programs. Ms. Challen is co-author of the chapter “Technologies to Support Interventions for Social- Emotional Intelligence, Self-Awareness, Personality Style, and Self-Regulation” for the book Technology Tools for Students with Autism. She is also a proud mother of two energetic boys, ages six and three. While Ms. Challen has special expertise in supporting students with Autism Spectrum Disorders, she provides support to individuals with a wide range of developmental and learning abilities, including students with complex medical needs.

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.

When “Attention Problems” Are Not ADHD

By | NESCA Notes 2019

By Jessica Geragosian, Psy.D.
Pediatric Neuropsychologist

Attention-Deficit Hyperactivity Disorder (ADHD) is a neurological disruption of the arousal system in the brain resulting in difficulties regulating attention and activity levels. ADHD can present with or without hyperactivity. Children with ADHD often have trouble engaging in expected tasks and maintaining appropriate behavioral control due to problems with inattention and lack of self-regulation. This can result in problems in the home, at school, and in peer relationships.

When concerns regarding attention or activity level are raised by parents or teachers, common practice is to consult with the child’s pediatrician. Parents and teachers might fill out rating scales asking questions like: Does your child have problems paying attention? Does your child have a hard time sitting still? Is your child having problems with learning? Is your child having difficulty following directions at home? When the answers to these questions are “yes,” a diagnosis of ADHD may seem appropriate.

However, there are many cases where inattention and/or impulsive behavior present as a symptom of another underlying problem and are not attributable to a primary attention disorder (ADHD).

The 5 most common misattributions I have seen in my clinical practice as a pediatric neuropsychologist in New Hampshire and Massachusetts are:

  1. Anxiety—When an individual is in a state of “fight or flight,” the brain lacks appreciation for information from the external environment that isn’t critical. When an individual is in a generalized state of anxiety, it is extremely difficult to remain focused and engaged in expected tasks.
  2. Learning disability—A student may have a disability in a core academic area. For example, a teacher may observe a child as being inattentive, when, in fact, they are several grade levels behind in reading. Thus, they cannot access the materials being distributed to the class.
  3. Communication disorder—If a child’s primary deficit is in the way they process language, you can be sure they look inattentive (e.g., not responding accurately to questions, inability to follow directions, etc.)
  4. Autism spectrum disorder (ASD)—Some children on the autism spectrum appear quite inattentive. In my experience, many children with ASD are often more tuned in to their internal environment (i.e., their thoughts and interests) at the expense of the external/social environment (i.e., parent, classroom and social expectations). While this can look similar to ADHD, the treatment approach is quite different.
  5. Other neurocognitive disorder (e.g., Processing speed deficit)—Other cognitive deficits can also make a student appear inattentive. If a student has slow processing speed, for example, the individual may not be able to keep up with the pace of instruction, resulting in an inability to absorb all of the lesson.

Other less common issues can also present as inattention, including trauma, absence seizures, hearing impairment, hallucinations, Tourette’s syndrome, among others. Because the root cause of inattention can sometimes be something very specific and complex, it is important to get a thorough evaluation.

It is also not uncommon for ADHD to present alongside the challenges identified above. In this case, effective intervention requires a simultaneous treatment plan addressing all challenges concurrently.

It is important to get a big picture—and accurate—understanding of a child’s neuropsychological profile in planning effective interventions. Our brains are complex, and one symptom can be common to many different origins. Getting the correct diagnosis the first time helps to put the right treatments in place.

 

About the Author:

Dr. Jessica Geragosian is a Licensed Psychologist in Massachusetts and New Hampshire. She has a wide range of clinical experience – in hospital, school and clinic settings – working with children and adolescents presenting with a wide range of cognitive, learning, social and psychological challenges.

Dr. Geragosian operates under the primary belief that all children want to, and can be, successful. The primary goal of her work is to identify the child’s innate strengths and find any underlying vulnerabilities preventing a child from achieving success. Whether the primary problem is an inability to acquire academic skills, maintain friendships, control emotions, or regulate behavior to meet expectations; she takes a holistic approach to understand the complex interplay of developmental, neurological and psychological factors contributing to a child’s presenting challenges.

Dr. Geragosian earned her doctoral degree from William James University, before completing postgraduate training in pediatric neuropsychology at the Massachusetts General Hospital for Children at North Shore Medical Center, where a focus of her work was neuropsychological assessment of young children with developmental challenges.

 

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

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton and Plainville, Massachusetts, 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.

 

Smart and Slow: What is a processing speed deficit? How can evaluation help?

By | NESCA Notes 2019

By Jessica Geragosian, Psy.D.
Pediatric Neuropsychologist

Emilia is in the 7th grade. Teachers have always found her to be an intelligent and academically motivated child; however, she has historically been quite slow in completing classwork and tests. Homework, particularly now in middle school, has been a highly laborious process, taking her far longer than her peers. Emilia’s parents were also concerned when receiving her SSAT results, as the scores did not seem to reflect the capabilities of their smart kid. But what is most concerning to Emilia’s parents is that Emilia has recently been coming home saying she is “dumb” and hates school.

Processing speed is the rate at which an individual can process information and produce an output. Although it is measured as part of many standard intelligence tests, it has nothing to do with how “smart” an individual is. Processing speed challenges can be visual, oral, and graphomotor in nature. They do not have to be related to a learning disability or ADHD, though they can be. Also, processing speed can be easily impacted by many things. For example, while an individual may not have a primary processing speed deficit, depression and anxiety can temporarily cause deficits in processing speed.

It is not uncommon for children to have strengths and weaknesses in their cognitive profile. Weaknesses in processing speed, however, can be particularly frustrating, especially when children are very bright. This is because these children may have many ideas, but cannot produce them efficiently or effectively. Children with processing speed deficits tend to experience a high level of frustration, as they are not able to demonstrate their knowledge and keep up with their peers in the classroom. Sometimes, processing speed deficits do not become apparent until middle or high school when work demands ramp up, or the student begins taking standardized exams with strict time limits.

For students like Emilia, who experience increased academic challenges as they progress in school, neuropsychological evaluation can be extremely useful and effective. In this case, the purpose of neuropsychological testing aims to better understand the nature of the processing speed challenges, the impact on the child, and how to utilize strengths to overcome challenges. Students with processing speed deficits are often entitled to academic accommodations and can be quite successful with such supports in place. Testing can also be important for ruling in, or out, emerging mental health issues.

For Emilia, the following recommendations were particularly important to address in her educational planning:

-extra time on tests (including standardized exams such as the SSAT)

-the use of a computer to minimize graphomotor output demand (and access to voice-to-text software)

-help with notetaking in the classroom (copy of teacher’s notes)

-learning tools to circumvent processing speed challenges (i.e. use of a Livescribe pen which records audio as she is taking her own notes)

-putting value on quality rather than quantity of school work (e.g., when given a homework assignment in math, Emilia was required to complete every other item)

However, the most effective approach, and one of the most important outcomes made possible by neuropsychological evaluation, was explicitly teaching Emilia about her unique strengths and challenges. Children (especially middle schoolers) tend to be black and white—if they finish their test last, then they must be “dumb.” When Emilia was able to see that this was a challenge that could be overcome, especially in the context of her very impressive intellectual abilities, she was able to re-engage in school without frustration. Moreover, parents and teachers were able to better understand and address her academic challenges in a thoughtful and effective way.

 

About the Author:

Dr. Jessica Geragosian is a Licensed Psychologist in Massachusetts and New Hampshire. She has a wide range of clinical experience – in hospital, school and clinic settings – working with children and adolescents presenting with a wide range of cognitive, learning, social, and psychological challenges.

Dr. Geragosian operates under the primary belief that all children want to, and can be, successful. The primary goal of her work is to identify the child’s innate strengths, and find any underlying vulnerabilities preventing a child from achieving success. Whether the primary problem is an inability to acquire academic skills, maintain friendships, control emotions, or regulate behavior to meet expectations; she takes a holistic approach to understand the complex interplay of developmental, neurological, and psychological factors contributing to a child’s presenting challenges.

Dr. Geragosian earned her doctoral degree from William James University, before completing postgraduate training in pediatric neuropsychology at the Massachusetts General Hospital for Children at North Shore Medical Center, where a focus of her work was neuropsychological assessment of young children with developmental challenges.

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

 

 

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, Plainville, MA, 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.