NESCA is Now Open in Hingham, MA! Currently scheduling neuropsychological evaluations and projective testing. NESCA’s Hingham clinicians specialize in elementary-, middle school-, and high school-aged children and young adults, including those who show signs of: autism spectrum disorders, being psychologically complex, mental health or mood disorders, and emotional, behavioral, and attentional challenges. To book an appointment, please start by filling out our intake form.

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reading

Literacy-based Speech Therapy: Winter Edition

By | NESCA Notes 2021

By: Abigael Gray, MS, CCC-SLP

NESCA Speech-Language Pathologist

Books are a great speech-language therapy tool. They can be used to target many different goals for a variety of ages and profiles. With books, children are given context for learning vocabulary, concepts and important story elements. Literacy-based therapy is not only more fun, but research also supports its use in teaching children with speech and language disorders:

  • Teaching story elements has been shown to improve oral language production and reading comprehension.
  • Teaching within a narrative context can make language learning less demanding, more meaningful and more authentic.
  • Students’ comprehension and story retelling/generation skills improved more with contextualized (literacy-based) intervention than decontextualized intervention.

Books can easily be incorporated into life at home, if they are not already a part of the daily routine. Just grab your or your child’s favorite book, or find a YouTube read aloud of it, and have your child help you read it! Be sure to pause throughout the book to talk about the pictures, make inferences about why events are happening and ask a few questions. Don’t be afraid to change the words to match your child’s level of understanding or interests.

My top three favorite winter books to use in speech-language therapy are:

  1. Sneezy the Snowman by Maureen Wright

A story about a cold and sneezy snowman who melts several times while trying to get warm. His human friends help him by rebuilding him and sharing their winter clothes.

Amazon: https://www.amazon.com/Sneezy-Snowman-Maureen-Wright/dp/1477810544

YouTube Read Aloud: https://youtu.be/iUsHnKSyDH0

Skills that I target and can be incorporated into shared book reading at home:

  • Producing subject-verb-object or complex sentences to talk about what is happening.
  • Predicting what will happen before and throughout reading (e.g., “Sneezy is drinking hot chocolate, what do you think will happen?”).
  • Answering detail (what, where, who, when) and inferential (why) questions.
  • Discussing story parts (e.g., characters, setting, problem, solution) and retelling the story.
  • Writing using different prompts, such as “My snowman melted because…” or “When I’m cold, I…”.
  1. The Mitten by Jan Brett

A traditional story about a boy whose grandmother knits him new mittens. He loses one mitten when he is outside playing, and many different animals climb inside to stay warm.

Amazon: https://www.amazon.com/Mitten-Jan-Brett/dp/0399231099

YouTube Read Aloud: https://youtu.be/duhj0Op_slo

Skills that I target and can be incorporated into shared book reading at home:

  • Sequencing events by talking about the order of animals that climbed into the mitten.
  • Creating a craft by printing a mitten and animals, coloring the animals and putting them inside the mitten as you retell the story.
  • Watching a different rendition of The Mitten on Vooks.com and comparing and contrasting the two stories using a Venn diagram.
  • Producing past tense verbs to describe what happened.
  • Making inferences about characters’ emotions and motivations.
  1. The Snowy Day by Ezra Jack Keats

A Caldecott Medal-winning book about a boy’s adventures in the snow when he puts on his snowsuit and goes outside to play.

Amazon: https://www.amazon.com/Snowy-Day-Board-Book/dp/0670867330

YouTube Read Aloud: https://youtu.be/FmZCQfeWjeQ

Skills that I target and can be incorporated into shared book reading at home:

  • Telling an original story together by covering up the words on the pages.
  • Finding words that contain the child’s target speech sound (i.e., if your child is working on producing the “R” sound, find all the words that contain “R” and practice those).
  • Describing character traits of Peter, the main character.
  • Discussing cause and effect (e.g., cause: Peter smacked a snow-covered tree, effect: snow fell on Peter’s head).
  • Writing using different prompts, such as “On a snowy day, I like to…” or “I can save a snowball by…”.

 

References:

Davies, P., Shanks, B., & Davies, K. (2004). Improving narrative skills in young children with delayed language development. Educational Review, 56, 271 – 286.

Gillam, S. L., Gillam, R. B., & Reece, K. (2012). Language outcomes of contextualized and decontextualized language intervention: results of an early efficacy study. Language, speech, and hearing services in schools43(3), 276–291. https://doi.org/10.1044/0161-1461(2011/11-0022)

Tomasello, M. (2003). Constructing a language. A usage-based theory of language acquisition. Cambridge, MA: Harvard University Press

 

About the Author

Abigael Gray has over six years of experience in assessment and treatment of a variety of disorders, including dysphagia, childhood apraxia of speech, speech sound disorder, receptive and expressive language disorder, autism spectrum disorder and attention deficit hyperactivity disorder. She has a special interest and experience in working with children with feeding and swallowing disorders, including transitioning infants to solid foods, weaning from tube feeding, improving sensory tolerance, developing chewing skills, increasing variety and volume of nutritional intake and reducing avoidance behaviors during mealtimes.

 

 

 

To book an appointment or to learn more about NESCA’s Speech & Language Therapy, please fill out our online Intake Form, email NESCA’s Director of Clinical Services Julie Robinson or call 617-658-9800.

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.

 

Meet Abigael Gray, NESCA’s Speech-Language Pathologist & Feeding Specialist

By | NESCA Notes 2020

This Fall, NESCA debuted its new feeding, speech and language and direct sensory/motor occupational therapy services. Leading NESCA’s feeding and speech and language therapy is Abigael Gray, MS, CCC-SLP. In today’s blog, we sat down with Abbey to learn about her role as a Feeding Specialist; Speech-Language Pathologist.

What led you to your interest in speech and language and feeding, in particular?

I received an undergraduate degree in psychology from Syracuse University. After graduating, I worked in a preschool for children with autism and developmental delays. This is really what made me interested in speech and language pathology (SLP), since all of the children there were receiving speech-language therapy. While I was working there, I observed quite a bit and decided I wanted to learn and do more in this area. After five years of working there, I enrolled at Emerson College to earn my Master’s in Communications Sciences and Disorders. While there, I discovered that Emerson has a great program for feeding. Many schools don’t have a focus on swallowing and feeding in pediatrics, like Emerson does. I had a placement with one of my professors at her practice in Needham. I eventually took a position with this clinic and received great training in pediatric feeding therapy there during my clinical fellowship. This is where I became passionate about feeding therapy. I eventually moved into a multidisciplinary practice for two more years and then joined the team at NESCA.

Why were you attracted to NESCA?

I saw this as a great opportunity to bring speech-language pathology and feeding therapy to NESCA. I loved the  multidisciplinary aspect to the practice and thought I could strengthen what NESCA already offers by adding feeding and SLP to it. I like how all of the various services are built into one practice right here. Many of the  kids being seen at NESCA can also benefit from the therapies that I offer. Having those services available to parents and children right in the same location is a huge plus for them.

After meeting Ann Helmus, Ph.D., NESCA’s founder and director, I knew that it was the right cultural fit for me, being so collaborative. It also gave me the opportunity to continue to work with Julie Robinson, OT, who oversees this new clinical offering. It’s great to be able to continue with my working relationships with the occupational therapists who also joined when I did. The seamless communication between all of us in the clinical therapy practice makes for really well-rounded therapy for the children we treat as well as more convenient for their parents/caregivers.

What are the most exciting and the most challenging parts of your role?

The most exciting part of my new role at NESCA is being able to offer speech-language and feeding  services in-house. Often the recommendations from neuropsychologists through their assessment is to have some SLP support, whether it’s having to do with reading, writing, social skills, expression or comprehension. Being able to offer that right in the same practice allows for continuity of care among clinicians on behalf of the child. It’s exciting for me because I can go back to the neuropsychologist or other clinician at NESCA who referred the client with any new observations or questions I may have. This makes the process much smoother for the parents and our clinicians. There’s just a lot less “red tape” to go through to be able to communicate and collaborate.

It’s also exciting to build this service offering from the ground up. I can take all of the experiences I have had and knowledge I’ve gained through my years in various positions and make our services our own at NESCA.

As far as challenges go, right now as we build out this new service, I am currently the only SLP on board. While that is the case for now, I have a great network of past colleagues and friends who are SLPs to bounce thoughts off of. Our plan is to have other SLPs join our team as we grow the practice.

What are your clinical interests?

Feeding is my big passion area. Within feeding, I am currently completing a lactation counseling training to become a certified lactation counselor. Babies can struggle with breast feeding, then can have even more difficulties transitioning from the breast to solid foods. I love working with infants and toddlers, and having this certification will round out my knowledge about feeding for this age range.

Within speech, I love working on articulation with kids who have speech sound disorders, phonological disorders and childhood apraxia of speech. Within language, I really enjoy working on social pragmatic communication with kids who are on the higher functioning side of the autism spectrum, or Asperger’s, or those who have social pragmatics difficulties.

I also really enjoy working on early literacy skills, sound letters, identification, rhyming and phonological awareness. When it comes to kids who may be in their older elementary school or early middle school years, I love to work on writing skills with them.

One characteristic among NESCA clinicians is that they are all lifelong learners. In what ways are you a lifelong learner?

I loved that having the curiosity to continue to learn is a draw here at NESCA! That’s really important to me. Right now, I’m currently working my way through three different courses:

  • The lactation counseling certification that I mentioned previously
  • A “Feed the Peds” course, which is a refresher course on feeding therapy with some new approaches in the areas of tethered oral tissues (i.e., tongue ties, lip ties) and how those impact feeding. The course covers how to assess and treat these issues. What’s interesting is that these new approaches are appropriate for people across the lifespan – not just for young children. There is also a module on treating those with medical complexities. Often times, medically complex patients have issues with feeding and/or are tube-fed, and can then go on to have challenges progressing through age-appropriate feeding skills or transitioning off of tube-feeding.
  • The third area I am currently in training for is with orofacial myofunctional disorders, including tethered oral tissues and the impact on speech and feeding. This covers anything that structurally or functionally impairs speech, the airway or feeding. This is a growing area in our field, so it’s important to be current and well-informed on this topic.

How has Covid-19 impacted the way you treat patients and families?

Right now, we are delivering speech-language and feeding therapy via teletherapy. While it’s always great to work with a child and/or family in-person, the plus side of teletherapy is that we get to see the child in their natural home environment as well as how the child communicates with family members. Sometimes, when we see the child in this setting, we can detect and observe a feeding or speech-language issue as the family sees it on a regular basis. It’s also nice to be able to work with parents in their own setting. We can better understand their priorities for therapy since we are talking directly with them. It also allows the child to generalize the skills they would normally learn in the clinic setting right into their home. As therapists, we can see what a typical meal at home looks like, which is obviously a more natural setting than the clinic. We used to have to ask parents to send us videos of mealtimes. Now, it’s like we are at a meal with them over Zoom!

Covid-19 was the catalyst for us to offer teletherapy, which has helped parents who work and have to travel to get to therapy tremendously. They are now able to be more hands-on in the therapy sessions. Also, for some medically complex kids, it’s just hard to get out of the house and drive to therapy. And, parents don’t have to cancel appointments if a sibling is home sick or even quarantining. And, we can stay on track with therapy via telehealth even in inclement weather that makes it challenging to drive to the clinic.

Covid-19 has certainly had its drawbacks, but we’re seeing some of the upsides in teletherapy as well.

 

About the Author

Abigael Gray has over six years of experience in assessment and treatment of a variety of disorders, including dysphagia, childhood apraxia of speech, speech sound disorder, receptive and expressive language disorder, autism spectrum disorder and attention deficit hyperactivity disorder. She has a special interest and experience in working with children with feeding and swallowing disorders, including transitioning infants to solid foods, weaning from tube feeding, improving sensory tolerance, developing chewing skills, increasing variety and volume of nutritional intake and reducing avoidance behaviors during mealtimes.

 

 

 

 

If you are interested in learning more about NESCA’s speech-language therapy or feeding therapy, please complete our online intake form, or email NESCA’s Director of Clinical Services Julie Robinson at jrobinson@nesca-newton.com.

 

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.

 

Supporting Your Child’s Reading Development – Even During a Pandemic

By | NESCA Notes 2020

By: Alissa Talamo, PhD
Clinical Neuropsychologist, NESCA

Aside from allowing children to access school instruction, the ability to read provides a child with the opportunity to read for pleasure. Reading for pleasure has been shown to support a child’s cognitive development, improve concentration, increase a child’s vocabulary, expand a child’s level of creativity and imagination, improve empathy and provide the child with a deeper understanding of the world around them.

Here are some ideas to support reading for children of all ages:

Pre-school Years:

  • Develop awareness of different sounds
    • For example, have your child look for things around the home that start with a certain letter sound.
    • Play rhyming games.
    • Sing songs.
  • Read the same book to them daily for several days
    • Point out and talk about different vocabulary words each time.
    • Repetition helps build vocabulary and comprehension.

Early School Years:

  • Practice rhyming
    • Say a word and have your child see how many real or made-up words they can say that rhyme with that word.
  • Practice reading
    • Have your child read a page of a “just right” book aloud. Be sure it’s a page they can read with fewer than two or three reading mistakes.
    • Have your student use their finger to ensure they stop and look at every word rather than guess or skip words.
    • Another goal may be to pause whenever they see a period, since many struggling readers miss punctuation.

For All School Grades/Ages:

  • Read books of interest aloud to your child that they may not yet be able to read independently. This will allow your child to enjoy more sophisticated stories and increase their exposure to complex syntax and new vocabulary.
  • Continue to introduce a wide range of books.
  • Let your child’s areas of interest(s) help determine the books you choose.
  • Provide your child with experiences that help increase their background knowledge before reading about a topic, as this will then help with reading comprehension.
  • Ask your child questions about what you’re reading as you go. For younger children, this may involve them retelling the story. Ask older students to identify the key points in the text.

Finally, here is a list of apps and websites that can provide activities and books for you to enjoy as a family.

 

If you suspect your child may have reading challenges, join Dr. Talamo for a webinar on how to spot those early signs on October 15, 2020, from 2:00-3:00 PM ET.

Register in advance for this webinar: https://nesca-newton.zoom.us/…/WN_4XOoaw4IS-e8xEkHt6ev_A

References

https://www.childrensmn.org/2020/05/13/help-kids-keep-reading-stay-home-order-distance-learning/

https://www.eschoolnews.com/2020/06/30/how-to-effectively-support-struggling-readers-during-distance-learning

https://hr.uw.edu/coronavirus/caring-for-self-and-family/child-care/at-home-learning-resources/

www.commonsensemedia.org/lists/reading-apps-games-and-websites

 

About the Author:

With NESCA since its inception in 2007, Dr. Talamo had previously practiced for many years as a child and adolescent clinical psychologist before completing postdoctoral re-training in pediatric neuropsychology at the Children’s Evaluation Center.

After receiving her undergraduate degree from Columbia University, Dr. Talamo earned her doctorate in clinical health psychology from Ferkauf Graduate School of Psychology and the Albert Einstein College of Medicine at Yeshiva University.

She has given a number of presentations, most recently on “How to Recognize a Struggling Reader,” “Supporting Students with Working Memory Limitations,” (with Bonnie Singer, Ph.D., CCC-SLP of Architects for Learning), and “Executive Function in Elementary and Middle School Students.”

Dr. Talamo specializes in working with children and adolescents with language-based learning disabilities including dyslexia, attentional disorders, and emotional issues. She is also interested in working with highly gifted children.

Her professional memberships include MAGE (Massachusetts Association for Gifted Education), IDA (International Dyslexia Association), MABIDA (the Massachusetts division of IDA) and MNS (the Massachusetts Neuropsychological Society).

She is the mother of one teenage girl.

 

To book a consultation with Dr. Talamo 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, 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.

Encouraging Your Child to Read

By | NESCA Notes 2020

By: Alissa Talamo, PhD
Clinical Neuropsychologist, NESCA

According to Sally Shaywitz M.D., (Audrey G. Ratner Professor of Pediatrics-Neurology; Co-Director, Yale Center for Dyslexia & Creativity), dyslexia is highly prevalent, affecting one in five people, and it represents over 80% of all learning disabilities.

Even when a child does not meet the criteria for dyslexia, they may be a reluctant reader. Children who do not practice reading perform poorly on reading tests relative to children who do read on a regular basis. In addition, reduced reading time results in exposure to fewer words. In general, people use limited vocabulary during conversation compared to the language one is exposed to while reading. As such, a reluctant reader is at risk to have poorly developed vocabulary knowledge compared to same-age peers. They are also less likely to improve their reading skills over time. In her book, Overcoming Dyslexia (2003), Dr. Shaywitz shared the following information:

Through reading, a child is introduced to new concepts and information. In addition, the more a child is exposed to literature, the more likely reading will become an integral part of their daily life. However, how does a parent encourage a reluctant reader? Here are some ideas:

1.  Read a story to your child. Then ask them to talk about their favorite parts of the story.

2. Be ready to read or listen to books over and over again – this is how children learn. FYI – Did you know you can listen to the audio version of Mrs. Piggle-Wiggle (a series of children’s books by Betty MacDonald originally published in 1947) four times in a row on a drive from Boston to Maryland and four times in a row on the way back? I did this with my daughter when she was 4-years-old (she is now 16) and I do believe that, to this day, I can still quote parts of the book!

3.  Surround your children with reading material – this can be comprised of books, graphic novels, or magazines, anything that is of interest to your child.

4.  Let your child take out their own library card and go with you to the library to pick out their own reading material. Allowing a child to read for pleasure is the best way to create a more engaged reader. However, it is also important to make sure the child is choosing an age-appropriate book. A librarian can be very helpful in providing recommendations based on a child’s age and areas of interest.

 5.  Have your children practice reading whenever possible. Baking a cake? Ask them to help you read the instructions (perhaps your hands are too messy to turn the page!). Ordering food? Let them read the menu aloud to a younger sibling.

6. Use technology to your advantage. For example, I worked with a 14-year old boy with dyslexia who was intimidated by the size of the first Harry Potter book. However, I mentioned to him that, on the iPad, the book is no bigger than the iPad itself. He was more willing to carry an I-pad around and read at his own pace. Another advantage is that with an e-reader the child can place as much or as little text on a page as they wish, another way to reduce reading stress.

 7. Take advantage of audiobooks. This technology is a huge benefit for students who struggle to access books that are written for children their age but beyond their current independent reading level. The child can simply listen along, or they can hold the book and follow along with the text while listening. There are several ways to access audiobooks, including downloading them from your library for free!

8. Finally, model good reading habits. If your child never sees you reading, but you insist that they read, they will see reading as a chore rather than a pleasure. If you are not a strong reader, that is ok, you, too, can listen to audiobooks!

While these recommendations will hopefully help your child experience increased reading pleasure and exposure to literature, it is still important to find out the reason why your child is struggling to read. If your child has not had a thorough reading evaluation, you can ask your child’s school to complete such an assessment. In addition, you may wish to have your child evaluated by an independent evaluator.

 

This blog was previously published in NESCA Notes. 

 

About the Author:

With NESCA since its inception in 2007, Dr. Talamo had previously practiced for many years as a child and adolescent clinical psychologist before completing postdoctoral re-training in pediatric neuropsychology at the Children’s Evaluation Center.

After receiving her undergraduate degree from Columbia University, Dr. Talamo earned her doctorate in clinical health psychology from Ferkauf Graduate School of Psychology and the Albert Einstein College of Medicine at Yeshiva University.

She has given a number of presentations, most recently on “How to Recognize a Struggling Reader,” “Supporting Students with Working Memory Limitations,” (with Bonnie Singer, Ph.D., CCC-SLP of Architects for Learning), and “Executive Function in Elementary and Middle School Students.”

Dr. Talamo specializes in working with children and adolescents with language-based learning disabilities including dyslexia, attentional disorders, and emotional issues. She is also interested in working with highly gifted children.

Her professional memberships include MAGE (Massachusetts Association for Gifted Education), IDA (International Dyslexia Association), MABIDA (the Massachusetts division of IDA) and MNS (the Massachusetts Neuropsychological Society).

She is the mother of one teenage girl.

 

To book a consultation with Dr. Talamo 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, 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.