Tag

resilience

Resilience, Covid and College Admissions

By | NESCA Notes 2021

By: Tabitha Monahan, M.A., CRC
NESCA Transition Specialist/Counselor

It’s been a year since schools across the nation closed their doors and moved education to the world wide web. Teachers, many of whom have never received training to teach in a virtual format, were now providing lessons remotely. The challenges of teaching remotely highlighted many of the disparities that affect our students. Students did not always have the technology or literal bandwidth to learn from home. Students with learning differences and disabilities faced even more challenges in receiving their support in a format not conducive to their needs. However, there were some silver linings. Students had more opportunities to practice executive function skills and become more familiar with software programs outside of video games, social media and YouTube videos.

As students – and, well, all of us – adjusted to the pandemic and what that meant for our daily lives, mental health concerns increased. Faced with uncertainty, constant changes and fear, anxiety, stress and depression increased among students. In response, they built coping skills.  Not all coping mechanisms are positive, but our kids survived this past year. As we work our way back to some semblance of normalcy, what does that mean for our students who were planning to move on to postsecondary education? Extracurricular activities are considered a relatively important part of the admissions process, but those weren’t available last spring and are barely available now. What should colleges use instead to find students that would be a good fit?

Resilience.

Resilience, the ability to adjust and adapt to changes and adversity, is an important factor necessary to reach goals, especially once a person faces a challenge. We encourage students to build resilience by setting high expectations of them and assisting them in creating challenging goals. We help students process what to do when they reach a roadblock. As students build coping skills and learning strategies, they are building resilience. How does resilience help in college? College is a different environment than high school. Many students experience challenges as they adjust to their newfound freedom and responsibilities. Students now find themselves responsible for scheduling their classes, getting to those classes and figuring out how to manage their schedules.

As colleges receive applications in a year unlike any in recent history, students may want to consider how they can show the colleges how they persevered. Matthew Pietrafetta of Academic Approach suggests students use the college admission essay as an opportunity to present the college with their stories that demonstrate how they became more resilient. Recommendations may also provide another factor for colleges to consider. Teachers and counselors understand the challenges that the student experienced and can share how they overcame adversity. Our students have already overcome additional challenges than many of their general education peers have not. Their past successes are the reason colleges should consider their admission. Test scores and grades are only one part of the picture. The next generation of college students has already built the resilience that will help them succeed. The past year has only exemplified this point further. Our students have proven that they can adapt and meet whatever challenges come their way. What a better way to prove to the colleges that they have what it takes?

Sources:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7473764/

https://admissions.usf.edu/blog/do-extracurriculars-matter-in-the-college-admissions-process

https://www.insidehighered.com/admissions/views/2021/02/16/covid-19-era-college-admissions-officers-should-pay-attention-resilience?fbclid=IwAR3MNIb9ABfUJgVMZnyuJqKoF0HhBsOmYTB_ms4JZUbExvG9G_BbDUOn-gw

 

About the Author

Tabitha Monahan, M.A., CRC, is an experienced transition evaluator and vocational counselor. While she is well-versed in supporting a wide range of transition-aged youth, she is especially passionate and knowledgeable in helping clients and their families navigate the complex systems of adult services and benefits as well as medical and mental health systems. She is further adept in working individually with students of all abilities to empower self-advocacy and goal achievement.

 

To schedule an appointment with one of NESCA’s expert transition specialists or neuropsychologists, please complete 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, 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.

 

Appreciating and Responding to The New York Times article, For Some Teens, It’s Been a Year of Anxiety and Trips to the E.R. by Benedict Carey

By | NESCA Notes 2021

By: Sophie Bellenis, OTD, OTR/L
Occupational Therapist; Real-life Skills Program Manager and Coach, NESCA

As an occupational therapist working almost exclusively with teenagers and young adults over the past year, the title of Benedict Carey’s article jumped out at me like a tired and worn flag, waving frantically for acknowledgement. Our teens are anxious, tired, and dealing with living through the proverbial “unprecedented times” without the developmental capabilities needed to quickly adapt in this era of remote learning, remote social interaction, and remote extracurriculars. Remote everything!

It is important for me to note that I really enjoy working with teenagers. I find myself in constant awe of their resiliency, their willingness to confront hard truths that many of us shy away from, and their ability to push forward despite having huge questions about who they truly are. All of these things are tough and require immense emotional fortitude, but this year many of these challenges feel impossible.

Carey has taken the time to gather perspectives from multiple stakeholders. He provides a platform for parents, educators, professors, therapists, pediatricians, and directors of hospital programs to explain the struggles of supporting these kids without adequate resources. Parents describe the fear of supporting their children as they struggle with mental health. Doctors discuss the frustration of having inadequate resources and support in emergency rooms around the country. Carey highlights that, according to the Centers for Disease Control and Prevention (CDC), the proportion of adolescent emergency admissions for mental problems, like panic and anxiety, is up 31 percent. Some of my clients add to this statistic and are navigating their own path through chaotic hospitalizations and overwhelmed support systems. Carey’s article is absolutely worth taking the time to read, if only to see the ubiquity of these issues and how they are happening all around our country. Simply put, we have a clear problem. Less clear, is the solution.

When meeting with adolescents and young adults themselves, I hear three main fears popping up week after week. Here are a few thoughts and suggestions on how to support these specific fears or feelings.

  1. “I can’t get this done, (and therefore) I am going to completely ruin my future.”

When looking at future success through a transition lens, we consider the areas of independent living, community participation, post-secondary education, and employment. In the school setting, most students’ curricula are focused solely on academic success. Sometimes, we do a poor job of teaching students about multiple intelligences or emphasizing the importance of hard work. While grades are important, they are not everything, and while standardized testing is returning to students’ schedules, they should not serve as students’ measure of self-worth. We know this, but do they? We have to teach our children that if they are hardworking, kind, and truly doing their best, the threat of “ruining their future” is much less likely than they fear. Let’s highlight the undeniably true narrative that everyone’s path can look different and still lead to success.

  1. “I’m so tired. All of the time.”

Many of my clients tell me they are not sleeping. If they are sleeping, they fall asleep late with a phone in their hand, constantly refreshing apps or trying to maintain communication with their peers. In our current remote world, the phone can feel like a lifeline. Sleep is a foundational need for mental and physical health. Students who are 15 or 16 years old often have a limited understanding of how holistic the effects of decreased sleep can be. Sleep is not their priority. Recently, I have seen parents disable the internet or have their teenagers put their phones into a lockbox from midnight until 6:00am. This new boundary is often met with anger or frustration at the beginning, but then these students start to sleep. They are better able to manage their emotions. They have more energy. They start to see the benefits despite their skepticism. If a tech break doesn’t feel quite right for your family, it is still worth opening up a conversation about the need for strong sleep hygiene and modeling a routine that promotes calming down by limiting screens before bed, which can have hugely positive effects.

  1. “This is never going to end.”

In many ways, a year feels much longer to a 17 year-old than it does to an older adult. Working at a job for four years never feels as long or as formative as the four years of high school. And objectively, a year to a 17 year-old is over five percent of their life, while it’s only two percent of 50 year old’s life. Let’s acknowledge that. Let’s verbalize the fact that teenage years are also full of milestones that have been constantly cancelled or changed to fit social distancing recommendations and safety precautions. There is a sense of loss and grief surrounding many events that these students have been looking forward to since elementary school. Encourage students to do their own research into what the next six months may look like as we start to open back up. Help them to understand the vaccine rollout and the pitfalls and successes that we have had as a nation tackling a novel disease.

Adolescent mental health is going to be an on-going challenge that we tackle as a community. As we slowly forge out of isolation, let’s center our conversations around the mental health of our teens and honestly acknowledge the unique position that they have found themselves in.

References

Carey, B. (2021, February 23). For some teens, it’s been a year of anxiety and trips to the e.r. The New York Times. https://www.nytimes.com/2021/02/23/health/coronavirus-mental-health-teens.html

Leeb, R.T., Radhakrishnan, L., Martinez, P., Njaj, R., Holland, K.M. (2020, October 27). Mental health-related emergency department visits among children aged <18 during the covid-19 pandemic. MMWR Morbidity and Mortality Weekly Report 2020:1675-1680. DOI: http://dx.doi.org/10.15585/mmwr.mm6945a3

 

About the Author

Sophie Bellenis is a Licensed Occupational Therapist in Massachusetts, specializing in educational OT and functional life skills development. Bellenis joined NESCA in the fall of 2017 to offer community-based skills coaching services as a part of the Real-life Skills Program within NESCA’s Transition Services team. Bellenis graduated from the MGH Institute of Health Professions with a Doctorate in Occupational Therapy, with a focus on pediatrics and international program evaluation. She is a member of the American Occupational Therapy Association, as well as the World Federation of Occupational Therapists. Having spent years delivering direct services at the elementary, middle school and high school levels, Bellenis has extensive background with school-based occupational therapy services.  She believes that individual sensory needs and visual skills must be taken into account to create comprehensive educational programming.

 

To book an appointment or to learn more about NESCA’s Occupational Therapy Services, please fill out our online Intake Form, email info@nesca-newton.com 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.

 

Approaching 2021 with Ease and Grace

By | NESCA Notes 2021

By Dot Lucci, M.Ed., CAGS

Director of Consultation and Psychoeducational Services, NESCA

I think we are all relieved that 2020 is behind us. All of us experienced a “mental health crisis” of some level of anxiety, depression and fear since March, 2020. As the pandemic spread across our globe, ravaged our lives, took loved ones from us, created economic upheaval, food insecurity and amplified the technological discrepancies that existed within our communities, we adapted and survived…we had to. And the Black Lives Matter movement gained strength also because it had to. From the crisis came opportunity.

Hopefully we learned something about ourselves and each other both across the globe and within our small circles. Now we know the unfathomable and unexpected can and does happen, and it upends our lives like we never expected. What we once thought was important doesn’t seem as important any more. Hopefully, as the months passed in 2020, we settled into the “new normal” and began to develop rhythms and beliefs that sustained us and fed our souls. Let’s hope that we developed a sense of what is truly important and can approach 2021 with new-found hope, resiliency, ease and grace. Approach 2021 by cultivating and remembering the bright spots of this past year, the surprises or treasures of 2020. They may help you think more clearly about 2021.

At the start of a new year, many people make New Year’s resolutions that are long-term goals. Some people manage to keep their resolutions while others aren’t able to sustain the motivation and commitment. Given this past year, it may be difficult to think about resolutions or even conceptualize what the future will look like. Even with vaccines on the horizon, our brains are not ready for long-term planning as our futures may still be a bit unclear. We can hope for a “return to normal,” but what will that “normal” look like?

There is still an uncertainty of what the future holds, so my thinking is to keep it simple. As we start 2021, remember what’s important. If you chose to make New Year’s resolutions, keep them manageable and small. Hopefully what you learned in 2020 can guide your thinking in 2021. Some everyday ideas might be to be kind and gentle with oneself and others. Don’t sweat the small stuff; most of it is small stuff. Smile and laugh every day. Promise yourself to go outside every day and breathe fresh air, be amazed at the glistening snow, the warmth of the sun, the flight of a bird. Take a walk. Three times a day, focus on your breath for at least three minutes. Before going to sleep, think of something to be thankful and grateful for. 2021 can be a year of hope, wonder and faith in a “newer normal” that will emerge, where each of us is responsible for creating a better day, world and a normal that may be even better than the normal of the past.

To everyone, peace, good health and Happy New Year!

 

About the Author

NESCA’s Director of Consultation and Psychoeducational Services Dot Lucci has been active in the fields of education, psychology, research and academia for over 30 years. She is a national consultant and speaker on program design and the inclusion of children and adolescents with special needs, especially those diagnosed with Autism Spectrum Disorder (ASD). Prior to joining NESCA, Ms. Lucci was the Principal of the Partners Program/EDCO Collaborative and previously the Program Director and Director of Consultation at MGH/Aspire for 13 years, where she built child, teen and young adult programs and established the 3-Ss (self-awareness, social competency and stress management) as the programming backbone. She also served as director of the Autism Support Center. Ms. Lucci was previously an elementary classroom teacher, special educator, researcher, school psychologist, college professor and director of public schools, a private special education school and an education collaborative.

Ms. Lucci directs NESCA’s consultation services to public and private schools, colleges and universities, businesses and community agencies. She also provides psychoeducational counseling directly to students and parents. Ms. Lucci’s clinical interests include mind-body practices, positive psychology, and the use of technology and biofeedback devices in the instruction of social and emotional learning, especially as they apply to neurodiverse individuals.

 

To book a consultation with Ms. Lucci or one of our many expert neuropsychologists, complete NESCA’s online intake form. Indicate whether you are seeking an “evaluation” or “consultation” and your preferred clinician/consultant in the referral line.

 

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.

 

Positive Coping Strategies for Stress, Anxiety and Trauma During Times of Crisis

By | NESCA Notes 2020

By Renée Marchant, Psy.D.
Pediatric Neuropsychologist

Amidst the global pandemic, children, their caregivers, their teachers and therapists are naturally experiencing heightened stress and anxiety. We are more likely to be sent into “fight, flight, freeze, mode” – the body and brain’s critical survival strategy to prepare and deal with perceived threat. For example, when you see a Grizzly Bear on your hiking trail, you instinctually run, fight back or hide.

However, we can become “stuck” or more sensitive to this instinctual urge, which is not adaptive and can negatively impact physical, emotional and social health. For example, chronic deployment of the “flight, flight, freeze” response occurs for individuals who experience post-traumatic stress disorder. Chronic deployment of “fight, flight, freeze” responses is also more likely amidst a global pandemic, such as COVID-19. Importantly, chronic deployment of “fight, flight, freeze” responses also occurs for individuals and communities who experience chronic racial injustice and oppression.

Under chronic experiences of stress and threat, our body remains activated and hyper-aroused, even when deploying this response is not helpful. For example, children may shut down or dysregulate when faced with even small stressors – making an error on a math worksheet or even accidentally spilling something on the table. Children and teens may be more irritable, defiant or isolative. Overall, chronic deployment of the “fight, flight, freeze” response heightens anxiety, stress and general feelings of malaise.

So, what can we do? What can we do to “turn off” or lessen this stress response? What are some ways to positively cope during these difficult times?

  1. Research shows that the #1 resiliency factor is the reliable presence of at least one supportive relationship with an adult. Build connection and community through shared activities and conversations about your experiences. Remember to always take care of yourself before taking care of others – self-care is critical.
  2. Focus on validation first; problem-solving second. Validating, acknowledging and accepting pain, distress, hurt and the like builds communication and naturally decreases tension and stress. Validation is the essential first step prior to action, problem-solving and positive coping.
  3. In order to grow positive coping, it is helpful to build mastery and self-expression. Strategies that can help to both organize and “release” feelings and stressful experiences rather than “bottle them up” include:
  • Use your body to heal your mind: play, do yoga, engage with nature, exercise;
  • Engage in shared action to promote communication and change at a community and systemic level. Volunteer or advocate for a cause of importance. Contact your local legislators and express your concerns;
  • Write or draw about your experience. Use collages, images or videos to express your goals, experiences and fears;
  • Engage in therapeutic movement. Create a music playlist for various emotions. Dance or engage in rhythmic actions (e.g. knitting, pottery);
  • Identify your strengths and what you value in life. Happiness is fleeting – goals and values last longer and support positive coping. For a free strengths and values survey, check out: https://www.viacharacter.org/;
  • Connect with community resources available in your area, such as therapists, mentors, religious organizations, support groups, local-nonprofits, etc.; and
  • Be kind to yourself and practice self-compassion.

 

About the Author:

Dr. Renée Marchant provides neuropsychological and psychological (projective) assessments for youth who present with a variety of complex, inter-related needs, with a particular emphasis on identifying co-occurring neurodevelopmental and psychiatric challenges. She specializes in the evaluation of developmental disabilities including autism spectrum disorder and social-emotional difficulties stemming from mood, anxiety, attachment and trauma-related diagnoses. She often assesses children who have “unique learning styles” that can underlie deficits in problem-solving, emotion regulation, social skills and self-esteem.

Dr. Marchant’s assessments prioritize the “whole picture,” particularly how systemic factors, such as culture, family life, school climate and broader systems impact diagnoses and treatment needs. She frequently observes children at school and participates in IEP meetings.

Dr. Marchant brings a wealth of clinical experience to her evaluations. In addition to her expertise in assessment, she has extensive experience providing evidence-based therapy to children in individual (TF-CBT, insight-oriented), group (DBT) and family (solution-focused, structural) modalities. Her school, home and treatment recommendations integrate practice-informed interventions that are tailored to the child’s unique needs.

Dr. Marchant received her B.A. from Boston College with a major in Clinical Psychology and her Psy.D. from William James College in Massachusetts. She completed her internship at the University of Utah’s Neuropsychiatric Institute and her postdoctoral fellowship at Cambridge Health Alliance, a Harvard Medical School teaching hospital, where she deepened her expertise in providing therapy and conducting assessments for children with neurodevelopmental disorders as well as youth who present with high-risk behaviors (e.g. psychosis, self-injury, aggression, suicidal ideation).

Dr. Marchant provides workshops and consultations to parents, school personnel and treatment professionals on ways to cultivate resilience and self-efficacy in the face of adversity, trauma, interpersonal violence and bullying. She is an expert on the interpretation of the Rorschach Inkblot Test and provides teaching and supervision on the usefulness of projective/performance-based measures in assessment. Dr. Marchant is also a member of the American Family Therapy Academy (AFTA) and continues to conduct research on the effectiveness of family therapy for high-risk, hospitalized patients.

 

To book an evaluation with Dr. Marchant 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.

 

Positive Coping Strategies for Stress, Anxiety and Trauma During Times of Crisis

By | NESCA Notes 2020

By Renée Marchant, Psy.D.
Pediatric Neuropsychologist

Amidst the global pandemic, children, their caregivers, their teachers and therapists are naturally experiencing heightened stress and anxiety. We are more likely to be sent into “fight, flight, freeze, mode” – the body and brain’s critical survival strategy to prepare and deal with perceived threat. For example, when you see a Grizzly Bear on your hiking trail, you instinctually run, fight back or hide.

However, we can become “stuck” or more sensitive to this instinctual urge, which is not adaptive and can negatively impact physical, emotional and social health. For example, chronic deployment of the “flight, flight, freeze” response occurs for individuals who experience post-traumatic stress disorder. Chronic deployment of “fight, flight, freeze” responses is also more likely amidst a global pandemic, such as COVID-19. Importantly, chronic deployment of “fight, flight, freeze” responses also occurs for individuals and communities who experience chronic racial injustice and oppression.

Under chronic experiences of stress and threat, our body remains activated and hyper-aroused, even when deploying this response is not helpful. For example, children may shut down or dysregulate when faced with even small stressors – making an error on a math worksheet or even accidentally spilling something on the table. Children and teens may be more irritable, defiant or isolative. Overall, chronic deployment of the “fight, flight, freeze” response heightens anxiety, stress and general feelings of malaise.

So, what can we do? What can we do to “turn off” or lessen this stress response? What are some ways to positively cope during these difficult times?

  1. Research shows that the #1 resiliency factor is the reliable presence of at least one supportive relationship with an adult. Build connection and community through shared activities and conversations about your experiences. Remember to always take care of yourself before taking care of others – self-care is critical.
  2. Focus on validation first; problem-solving second. Validating, acknowledging and accepting pain, distress, hurt and the like builds communication and naturally decreases tension and stress. Validation is the essential first step prior to action, problem-solving and positive coping.
  3. In order to grow positive coping, it is helpful to build mastery and self-expression. Strategies that can help to both organize and “release” feelings and stressful experiences rather than “bottle them up” include:
  • Use your body to heal your mind: play, do yoga, engage with nature, exercise;
  • Engage in shared action to promote communication and change at a community and systemic level. Volunteer or advocate for a cause of importance. Contact your local legislators and express your concerns;
  • Write or draw about your experience. Use collages, images or videos to express your goals, experiences and fears;
  • Engage in therapeutic movement. Create a music playlist for various emotions. Dance or engage in rhythmic actions (e.g. knitting, pottery);
  • Identify your strengths and what you value in life. Happiness is fleeting – goals and values last longer and support positive coping. For a free strengths and values survey, check out: https://www.viacharacter.org/;
  • Connect with community resources available in your area, such as therapists, mentors, religious organizations, support groups, local-nonprofits, etc.; and
  • Be kind to yourself and practice self-compassion.

To learn more about this topic, a helpful webinar is available at “Supports for Students with a History of Trauma and Significant Anxiety,“ presented by Dr. Renee Marchant, PsyD, and Dr. Stephanie Monaghan-Blout, PsyD.

 

About the Author:

Dr. Renée Marchant provides neuropsychological and psychological (projective) assessments for youth who present with a variety of complex, inter-related needs, with a particular emphasis on identifying co-occurring neurodevelopmental and psychiatric challenges. She specializes in the evaluation of developmental disabilities including autism spectrum disorder and social-emotional difficulties stemming from mood, anxiety, attachment and trauma-related diagnoses. She often assesses children who have “unique learning styles” that can underlie deficits in problem-solving, emotion regulation, social skills and self-esteem.

Dr. Marchant’s assessments prioritize the “whole picture,” particularly how systemic factors, such as culture, family life, school climate and broader systems impact diagnoses and treatment needs. She frequently observes children at school and participates in IEP meetings.

Dr. Marchant brings a wealth of clinical experience to her evaluations. In addition to her expertise in assessment, she has extensive experience providing evidence-based therapy to children in individual (TF-CBT, insight-oriented), group (DBT) and family (solution-focused, structural) modalities. Her school, home and treatment recommendations integrate practice-informed interventions that are tailored to the child’s unique needs.

Dr. Marchant received her B.A. from Boston College with a major in Clinical Psychology and her Psy.D. from William James College in Massachusetts. She completed her internship at the University of Utah’s Neuropsychiatric Institute and her postdoctoral fellowship at Cambridge Health Alliance, a Harvard Medical School teaching hospital, where she deepened her expertise in providing therapy and conducting assessments for children with neurodevelopmental disorders as well as youth who present with high-risk behaviors (e.g. psychosis, self-injury, aggression, suicidal ideation).

Dr. Marchant provides workshops and consultations to parents, school personnel and treatment professionals on ways to cultivate resilience and self-efficacy in the face of adversity, trauma, interpersonal violence and bullying. She is an expert on the interpretation of the Rorschach Inkblot Test and provides teaching and supervision on the usefulness of projective/performance-based measures in assessment. Dr. Marchant is also a member of the American Family Therapy Academy (AFTA) and continues to conduct research on the effectiveness of family therapy for high-risk, hospitalized patients.

 

To book an evaluation with Dr. Marchant 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.

 

Let’s Stop Trash-talking Stress and Anxiety-Part 1

By | NESCA Notes 2020

By:  Stephanie Monaghan-Blout, Psy.D.

Coordinator of Therapy Services; Trauma-informed Therapist

Stress and anxiety have gotten a really bad name in our society. Just ask kids – it is a question we sometimes pose to our clients during testing, and the answers we get usually run along the lines of, “Are you kidding? There’s nothing good about stress!”. So, let’s talk about the purpose of stress, how it functions, and what we can do to manage it.

From a scientific viewpoint, stress is a challenge or stimulus to DO SOMETHING when certain circumstances arise – specifically, when danger is detected. Let’s make this easy – what would your body need to do if a tiger showed up? Let’s start with upping your heart rate and breathing faster to get oxygen into your blood so that you are able to move quickly, and then let’s send some fuel (glucose) to your muscles for strength. This is the process that happens when some kind of danger is sensed – the brain sends down orders to the body that diverts resources to the systems that help us escape from the tiger (fight, flight or freeze) while diverting resources from systems that are less important at that time (rest, digest and think). When the danger is over, the focus changes; our fear response is dampened, our heart rate and breathing slow down and those other systems come back online to get our bodies back to normal.

The feedback between these two systems of getting us prepared for danger (activation of the sympathetic nervous system) and calming down after the event has passed (activation of the parasympathetic nervous system) remain important, even when tigers are no longer a concern. Remember that stress is a stimulus to do something in the face of fear or danger. A little stress in our daily lives helps us get things done, like studying for that big test. It is also adaptive to be anxious at a time like now, when our whole world is under the threat of the COVID-19 virus. There’s lots to be worried about, and this stress can help us remember to take precautions like staying home and keeping physical distance. We’ll get back to this.

But what happens if the threat is more immediate, the danger sensor is too sensitive and/or the body never gets a chance to calm down? In this situation, the person remains activated, looking for danger and ready to respond, even when it is not appropriate or even against their best interests. Remember, during these times of perceived danger, the child does not have access to higher-level cognitive processes, like thinking flexibly, problem solving or even access to language. At these times of high stress, they are not available for learning. Asking a child to “talk about it” or even tell you what the problem is can be beyond their capacity at the time and will only add to their stress. This is the situation in school encountered by many children with learning issues, emotional concerns, autism or other neurodevelopmental disorders. They may find the academic, organizational and social demands of school to be so threatening that their danger alert is set off and only gets the chance to reset when school is finished.

So, what does the overly stressed child look like and how can we help? This is going to be the challenging part, because you are going to be asked to look at common behaviors in a different way. Let’s go back to the Fight-Flight-Freeze responses. Most of us tend to prefer one of these, though we will use all three depending on the situation.

Fight – This version of the response involves active resistance to the threat, but in the classroom or the dinner table, it more likely takes the shape of being argumentative, noncompliant and defiant (“You can’t make me!”).

Flight – This version is characterized by avoidance or getting away from the threat. This could mean needing to go the bathroom, see the school nurse or suddenly remembering that very important pen in their cubby that they absolutely have to have at that moment. However, it could also mean leaving mentally (“spacing out”).

Freeze – This version involves immobilization strategies, like wild animals who “freeze” so as not to attract the attention of a predator. In children, these behaviors are more subtle; they manifest as problems with getting started, switching from one thing to another and/or stopping. Oftentimes these kids are described as “shutting down,” but it is more accurate to describe them as “stuck.”

How do we help our kids get out of this stress response?

Remember, stress is a response to the perception of danger, and anxiety is the feeling of being helpless and out of control.

What “turns off” the threat alert and allows us to feel more capable and ready to try? The perception of being safe. When children feel safe, they can focus and concentrate on the task at hand. They can think and problem solve. And, they are more aware of others and what they are saying and doing.

How do we help our children feel safe and capable of tackling a challenge? Say a child doesn’t like math and does everything to avoid doing their homework. Which of these three approaches would make them feel more safe and ready to give it a try?

  • “Stop acting like a baby and just get that math done. It’s only 10 problems! Don’t even think of playing any video games tonight.”
  • “You poor thing. I know you are bad at math and it’s mean that your teacher is making     you work so hard. I’m going to write to her and tell her you can’t do that much.”
  • “Wow, you really don’t like to do your math homework, do you? That’s hard! Tell you what, I’ll help you with the first two and when you are done with the rest, we’ll play a game together!”

Notice that in the last example, the parent started with validating the child’s feelings, or just recognizing what the child’s emotional experience is like at the moment – not the same as agreeing with him or her. The second thing s/he did was to offer some help, and the third was to offer a fun activity to help the child feel calmer and more connected.

What if the child is really upset and can’t switch gears to start working? Just change the order of the events. Validate feelings, offer a calming and connecting activity and offer some help to get back to work. The calming/connecting activity doesn’t have to be a game – it just needs to be something they makes the child feel cared for and gives them something else to think about, like a cup of tea or a special cookie.

But what if the stress and anxiety is related to something that is bigger than math homework and can’t be easily fixed with a cup of tea and some extra help with those fractions? What if it is something that is out of the parent’s control, like the COVID pandemic? Again, the way to “turn off” the threat alert in our children’s brains is to help them feel safe and to have some control over what is happening to them. How do we do that? Validate their feelings makes them feel heard. Answering their questions (but sticking to their concerns) will tell you what they are really worried about and allow you to correct misperceptions and reassure them. Calming and connecting activities are still really important. Finally, helping them feel more in control by being able to do something to help. Utilize a child’s skills and interests in finding ways for them to help. If your child likes to draw, have them make pictures for family, friends and neighbors. Do you have a budding computer whiz? Help them make a zoom video of their classmates saying hi to their teacher. Is your child someone who loves people and isn’t shy? Have them call grandparents and older neighbors who may not be able to leave their houses. Equally importantly, remind them that they can help others by following the guidelines of washing their hands, keeping physical distance and, as hard as it is, staying home.

In a follow-on blog, we’ll discuss how to build resilience in children.

 

About the Author:

Dr. Stephanie Monaghan-Blout is a senior clinician who joined NESCA at its inception in 2007. She specializes in the neuropsychological and psychological assessment of children and adolescents with complex learning and emotional issues and enjoys consulting to schools on these issues. Her responsibilities at NESCA also include acting as Clinical Coordinator, overseeing therapeutic services, providing therapy and psychoeducational counseling and, in the time of the COVID-19 crisis, providing teletherapy to parents and teens.

In her early career as an adolescent and family therapist, Dr. Monaghan-Blout became very interested in the needs of those contending with traumatic experiences. She brought that interest to her work as a pediatric neuropsychologist and continues to be passionate about treating this population. She has developed an expertise in working with adoptive children and others who have experienced early trauma. She is a longtime member of the Trauma and Learning Policy Initiative (TLPI) associated with Massachusetts Advocates for Children and the Harvard Law Clinic and presents nationally and regionally on assessment and treatment of children with complex/developmental trauma.

Dr. Monaghan-Blout graduated from Bowdoin College and received a Master’s Degree in Counselor Education from Boston University. She obtained her Doctorate in Clinical Psychology from Antioch New England Graduate School with a dissertation entitled, “A Different Kind of Parent; Resisting the Intergenerational Legacy of Maltreatment.” She completed an internship in pediatric neuropsychology and child psychology at North Shore University Hospital in New York, and a postdoctoral fellowship at HealthSouth/Braintree Rehabilitation Hospital.

She joined Dr. Ann Helmus at Children’s Evaluation Center in 2003, and again at NESCA in 2007. A member of the Massachusetts Neuropsychological Society Board of Directors from 2010 – 2013 and from 2014-2017, Dr. Monaghan-Blout served in many capacities, including as President. Dr. Monaghan-Blout is the mother and stepmother of four children and the grandmother of six. She is also an avid ice hockey player, cook, gardener and devotee of urban fantasy.

 

To book therapy services with Dr. Monaghan-Blout or an evaluation with one of our many expert neuropsychologists and transition specialists, 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.

Resilience during COVID-19: Collective Efficacy

By | NESCA Notes 2020

By Renée Marchant, Psy.D.
Pediatric Neuropsychologist

There is an array of research-proven factors shown to increase psychological and physiological resilience or “bounce-back” from stressful experiences, such as maintaining a social network and practicing healthy coping skills when in distress.

One important factor is self-efficacy. Self-efficacy is distinct from self-esteem. Self-esteem is a judgement of self-worth whereas self-efficacy is a judgement of personal capability. People with a strong sense of self-efficacy:

  • View challenging problems as tasks to be mastered;
  • Develop deeper interest in the activities in which they participate;
  • Form a stronger sense of commitment to their interests and activities; and
  • Recover quickly from setbacks and disappointments (Bandura, 1995).

The COVID-19 crisis has cultivated a closely related and critical construct, collective efficacy. Collective efficacy is a group’s shared belief in its capability to organize and execute actions required to achieve goals (Bandura, 1995). In other words, members of a community look out for each other, support each other in solving problems, and, in effect, improve their lives through combined efforts.

Collective self-efficacy is everywhere amidst this crisis. Social distancing is in itself a collective efficacy measure. Thousands of communities across the world continue to show everyday kindness for those in need and solidarity for those on the front lines. A few local Massachusetts examples are:

Collective efficacy is proven to increase resilience at a family level and at a community level. Collective efficacy is critical for navigating through, tolerating and “bouncing back” from this crisis. Collective self-efficacy can be cultivated and grown at home through small, meaningful and intentional acts.

Here are three research-proven “collective self-efficacy” enhancers to practice while you’re home with your family during COVID-19:

  1. Stay active in a cause for kindness and connection: Make art or compliment cards for first responders. Record a video and send to a local nursing home. Participate in an organized trip to the grocery store for vulnerable members of your community.
  2. Create collective mastery experiences: Mastery experiences are experiences we gain when we take on a challenge and succeed. Identify a “home project” such as organizing a closet together. Creatively problem solve how to cook a snack or meal with four ingredients already in your kitchen. Organize a family “work-out” exercise challenge.
  3. Encourage reflection and communication: Identify a small, realistic goal for each family member to accomplish each morning. Have each family member name a “take away” and “throw away” from their day in the evening. Share a “strength story” to reflect on a strength you and/or your family member showed that week. Consider using specific value-driven language to identify this strength (see examples from the VIA character strengths research studies below).

About the Author:

Dr. Renée Marchant provides neuropsychological and psychological (projective) assessments for youth who present with a variety of complex, inter-related needs, with a particular emphasis on identifying co-occurring neurodevelopmental and psychiatric challenges. She specializes in the evaluation of developmental disabilities including autism spectrum disorder and social-emotional difficulties stemming from mood, anxiety, attachment and trauma-related diagnoses. She often assesses children who have “unique learning styles” that can underlie deficits in problem-solving, emotion regulation, social skills and self-esteem.

Dr. Marchant’s assessments prioritize the “whole picture,” particularly how systemic factors, such as culture, family life, school climate and broader systems impact diagnoses and treatment needs. She frequently observes children at school and participates in IEP meetings.

Dr. Marchant brings a wealth of clinical experience to her evaluations. In addition to her expertise in assessment, she has extensive experience providing evidence-based therapy to children in individual (TF-CBT, insight-oriented), group (DBT) and family (solution-focused, structural) modalities. Her school, home and treatment recommendations integrate practice-informed interventions that are tailored to the child’s unique needs.

Dr. Marchant received her B.A. from Boston College with a major in Clinical Psychology and her Psy.D. from William James College in Massachusetts. She completed her internship at the University of Utah’s Neuropsychiatric Institute and her postdoctoral fellowship at Cambridge Health Alliance, a Harvard Medical School teaching hospital, where she deepened her expertise in providing therapy and conducting assessments for children with neurodevelopmental disorders as well as youth who present with high-risk behaviors (e.g. psychosis, self-injury, aggression, suicidal ideation).

Dr. Marchant provides workshops and consultations to parents, school personnel and treatment professionals on ways to cultivate resilience and self-efficacy in the face of adversity, trauma, interpersonal violence and bullying. She is an expert on the interpretation of the Rorschach Inkblot Test and provides teaching and supervision on the usefulness of projective/performance-based measures in assessment. Dr. Marchant is also a member of the American Family Therapy Academy (AFTA) and continues to conduct research on the effectiveness of family therapy for high-risk, hospitalized patients.

 

To book an evaluation with Dr. Marchant 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.

 

Mindfulness: It’s Not Just for Grown-ups

By | NESCA Notes 2019

By: Cynthia Hess, PsyD
Pediatric Neuropsychologist Fellow

There has been increasing interest in intervention strategies that target self-regulation in childhood. Self-regulation is the process through which the systems of emotion, attention and behavior are controlled in response to a situation, stimulus or demand. It develops rapidly in the early years of life. Self-regulation is necessary for social development because it supports and enhances peer acceptance and social success. Furthermore, it increases academic performance, particularly in elementary school. Problems with self-regulation and the accompanying executive functioning have been shown to correlate with a number of behavioral and emotional problems, particularly depression and anxiety. Mindfulness is emerging as an effective intervention for children struggling with self-regulation, especially when implemented at a time when children are acquiring these foundational skills.

Mindfulness is a way of paying attention, on purpose and non-judgmentally, to the experience of the present moment. Being mindful involves reflecting on the current internal experiences such as thoughts or emotions and the current external environment, such as sights and sounds, both clearly and objectively. This act of purposeful reflection enhances and facilitates self-regulation by promoting control, such as sustained attention and cognitive flexibility. Furthermore, it helps to reduce the incidences of such things as snap judgments, emotional reactivity or distressing thoughts.

Mindfulness-based social-emotional training has been shown to be effective in reducing stress, improving coping skills and building resilience when used with children. Mindfulness teaches children the skills needed to improve focus, calm themselves, plan and organize, and behave in a thoughtful manner. Research on adult populations shows that practicing mindfulness may reduce symptoms of anxiety and depression, and limited number of studies show some of the same benefits in children. Mindfulness is well tolerated by children and has been proven to improve psychological well-being. Introducing mindfulness practices to children has the potential to make a positive impact on a child’s ability to self-regulate, and thus facilitate their social, emotional and educational growth.

There are a number of ways to introduce children to mindfulness. One activity that children have responded positively to is being challenged to sit still and silent for as long as they possibly can. I have used this strategy in classrooms of children from pre-k to high school, as well as individually with children of all ages. Sometimes they are able to sit for 15 seconds, but they embraced the challenge of trying to beat their record by trying it again. Another mindful technique that works well with children is called “grounding.” Grounding techniques use the five senses to bring ourselves into the present moment. One grounding technique is finding five things in the room – they can be 5 things of the same color or any five things; four things the child can feel; three things the child can hear; two things the child can smell; and one thing the child can taste. Mindfulness can be playful and fun for children and families while effectively reducing stress, improving coping skills, improving ability to self-regulate and building resilience in children.

 

Helpful resources for families:

Mindful Games Activity Cards: 55 Fun Ways to Share Mindfulness with Kids and Teens. Susan Kaiser Greenland and Annaka Harris

A Still Quiet Place: A Mindfulness Program for Teaching Children and Adolescents to Ease Stress and Difficult Emotions By Amy Salzman, MD

I am Peace: A Book of Mindfulness By Susan Verde and Peter H. Reynolds

Breathe Like a Bear: 30 Mindful Moments for Kids to Feel Calm and Focused Anytime, Anywhere By Kira Willey

 

References:

Britton, W. B., Lepp, N. E., Niles, H. F., Rocha, T., Fisher, N. E., & Gold, J. S. (2014). A randomized controlled pilot trial of classroom-based mindfulness meditation compared to an active control condition in sixth-grade children. Journal of School Psychology, 52(3), 263-278.

Masten, A. S., Best, K. M., & Garmezy, N. (1990). Resilience and development: Contributions from the study of children who overcome adversity. Development and psychopathology, 2(4), 425-444.

Schonert-Reichl, K. A., Oberle, E., Lawlor, M. S., Abbott, D., Thomson, K., Oberlander, T. F., & Diamond, A. (2015). Enhancing cognitive and social–emotional development through a simple-to-administer mindfulness-based school program for elementary school children: A randomized controlled trial. Developmental psychology, 51(1), 52.

Schonert-Reichl, K. A., & Lawlor, M. S. (2010). The effects of a mindfulness-based education program on pre-and early adolescents’ well-being and social and emotional competence. Mindfulness, 1(3), 137-151.

Sibinga, E. M., Webb, L., Ghazarian, S. R., & Ellen, J. M. (2016). School-based mindfulness instruction: an RCT. Pediatrics, 137(1), e20152532.

 

About the Author

Dr. Cynthia Hess recently graduated from Rivier University with a PsyD in Counseling and School Psychology. Previously, she earned an M.A. from Antioch New England in Applied Psychology. She also worked as an elementary school counselor and school psychologist for 15 years before embarking on her doctorate. During her doctorate, she did her pre-doctoral internship with RIT in Rochester, N.Y. where she worked with youth ages 5-17 who had experienced complex developmental trauma. Dr. Hess’s first post-doctoral fellowship was with The Counseling Center of New England where she provided psychotherapy and family therapy to children ages 5-18, their families and young adults. She also trained part-time with a pediatric neuropsychologist conducting neuropsychological evaluations. Currently, Dr. Hess is a second-year post-doctoral fellow in pediatric neuropsychological assessment, working with NESCA Londonderry’s Dr. Angela Currie and Dr. Jessica Geragosian.

 

To schedule an appointment with one of NESCA’s expert neuropsychologists, please complete 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, 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.

 

Why are they called “Soft” Skills?

By | NESCA Notes 2019

By Kathleen Pignone, M.Ed., CRC
Transition Specialist

If they are soft, why are they so crucial in this hard, cruel world? As a transition specialist, I meet with young adults and their parents on a daily basis. All parents want to know what is that missing piece for child to really succeed after high school? What should my priorities be? Is the right college more important than the right internship or vise versa? I often hear the saying, “I remember in my day, you just dusted yourself off and kept going. Why is this new generation struggling?”

While I don’t have an answer to those profound questions, I can offer some go-to skills that will support our young adults as they transition from high school to college, the world of work and the great beyond…soft skills—those intangible, hard-to-pin-down skills that we all know we need to succeed, but are so hard to teach. As a wise practitioner once told me, “Just because it is simple, it doesn’t make it easy.” While it’s critical to teach, prepare and equip our students with the necessary skills for academic success, soft skills can be just as important in many instances. Young adults need a balance of academic, executive functioning, communication and soft skills to set themselves up for success in their multi-faceted life after high school. These soft skills can make the difference between candidates competing for college acceptance and job opportunities.

I also like to refer to these skills as the job keeping and high achieving skills. Strong foundational academic, planning and team-building skills are necessary for success, but these soft skills are the subtle differences observed in the student chosen for that internship by the professor and recognized in the entry-level employee who quickly advances to the mentor employee.

In my practice, I am witness to amazing, capable, energizing and unique young adults, who are unaware of the many talents and strengths they already possess. I work to coach, teach and persuade them that these soft skills are in there, but are struggling to make an appearance. The key is identifying them and knowing when to call on them in stressful times. As a transition specialist, I offer the young people I meet with the opportunities to name and own these skills within themselves. For example, when a teenager is struggling with school, but shows up every day, I introduce them to their “grit,” their get-up- and-go and “try again” skill.  By identifying skills that may just be lying dormant or unrecognized, I offer them a chance to see that they have an innate strength that has both a name and a purpose. These skills are not only necessary, but are transferable to all aspects of their future lives. Their internal grit pushes them to go to class when their roommate is sleeping in and go to work even though they have a cold and could call out sick.

By definition, students ready to transition from high school are at an age and stage of curiosity, exploration, hope and optimism. But they may easily miss out on identifying these characteristics as strengths and skills, if we do not point it out and celebrate it with them. When they are resisting rules and boundaries, they are employing their skills of curiosity and exploration. When they want to protest against inequity in this unfair world and are perceived as naive and inexperienced, I praise their hope and optimism. We talk about how these soft skills are integral to their success as an adult and will serve them as they continue to grow and learn.

Young adults in our current society have no other option than to be flexible and adaptable. Technology is constantly updating and changing, forcing them to move forward or be left behind. Their resilience in handling all that social media exposes them to on a daily basis is admirable. I wouldn’t have stood as tall and strong as they do with such public scrutiny.

As we prepare our young adults for life after high school, let us always take the time to see, name and recognize the strengths and soft skills they show us. We have the opportunity to observe and learn from them and value these skills so that they may offer themselves as resources to their community. The balance necessary to teach young people how to manage an interdependent world as an adult is complicated. It is exciting and energizing to witness young people find these strengths within themselves, helping them to conquer that great big world.

 

About the Author:

Kathleen Pignone, M.Ed. CRC is a deeply knowledgeable and experienced transition specialist. Prior to her tenure at NESCA, Ms. Pignone was the Career Development Director at Bay Cove Academy for 15 years, providing students with classroom and real-world employment skills training, community job placement and on the job employment-training. She has also worked at Massachusetts Department of Secondary and Elementary Education and privately as a vocational rehabilitation consultant. As a certified rehabilitation counselor, Ms. Pignone brings unique expertise carrying out vocational assessment and employment planning for adolescents and young adults as well as supporting local school programs. In addition to fortifying NESCA’s premier transition assessment services, Ms. Pignone engages in person-centered planning with teens and young adults, consultation and training for parents, providers and schools, and community-based coaching services.

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 a transition assessment or consultation with Kathleen, please complete NESCA’s online intake form