NESCA is booking neuropsychological evaluations within the next several weeks in our Newton and Foxborough-area locations in Massachusetts. To secure evaluation appointments with our expert clinicians, please complete our Intake Form.

Tag

routine

13

Building Executive Function Skills over the Summer

By | NESCA Notes 2024

By: Kristen Simon, M.Ed, Ed.S
Transition Specialist; Psychoeducational Counselor

As the countdown to Summer begins post April vacation, teens are getting excited for this season of rest, with more time to socialize and spend their days doing the things they want to do. While the first two weeks tend to be filled with high energy and plans, as the summer continues, the energy starts to slow down and boredom sets in. This part of the summer is a great time for adolescents to lean into building executive functioning skills that they may not have had time to practice fully during the school year. And the planning to do so should begin now, prior to the summer, instead of introducing this when they already feel unmotivated.

Executive dysfunction is supported through the school year with structure, routines, consistent visual schedules, online calendars, reminders, and many other external supports. As noted in previous blog posts for students with executive functioning challenges, the focus during the school year can easily fall into a pattern of “putting out fires” or providing intense support to catch up on never-ending assignments, instead of proactive skill building. The summer offers a low-pressure environment for students to practice planning, organizing, following through, and self-monitoring.

Some ways to practice and build these skills might include:

  • Manage their own schedule. Have your adolescent practice keeping a weekly schedule. Teens can print off a blank weekly schedule or utilize a digital version to list what needs to be accomplished each week (work, appointments, chores, exercise, social, hobbies, small goals) and plug these into a weekly checklist or visual calendar. At the end of each week, teens can reflect on how much they were able to follow the system they tried and what obstacles got in the way of anything they didn’t accomplish.
  • Practice setting alarms. Even if it’s for 10:15 AM (or later) and actually waking up at the time they needed to is important all year long. Allow them to troubleshoot if they sleep in, including what routine can they shift from the night before to meet this?
  • Set their own appointments. Is there a dentist appointment that needs to be made or a car service that family needs completed? Have your teen take ownership of calling or going online to make the appointment, tracking the appointment, and following through with going to the appointment.
  • Household chores. Ask your teen to take ownership of one part of the home (e.g., mowing the lawn). Work to schedule out how often throughout the summer this job needs to be completed and set a plan for how to follow through with this responsibility.
  • Make a meal for the family. Following through with all the steps included (finding a recipe, budgeting, food shopping, prepping, managing the timing of each item that needs to be cooked) is a great way to practice executive functioning skills.
  • Get a summer job. Working is a great way to build many executive functioning and self-determination skills for teens. Not only does it add structure to the week, it also helps with regulation and provides social opportunities.

Summer is a great time to build executive functioning skills for school but also life. If you’re interested in hearing more about NESCA’s executive functioning coaching session or real-life skills coaching, visit: https://nesca-newton.com/coaching-services/ or complete our Intake Form at: www.nesca-newton.com/intake.

 

About the Author

Kristen Simon, M.Ed, Ed.S, has worked with transition-aged youth as a licensed School Psychologist for more than a decade. She has extensive experience working with children and adolescents with a range of learning and social/emotional abilities. Kristen’s strengths lie in her communication and advocacy skills as well as her strengths-based approach. She is passionate about developing students’ self-awareness, goal-setting abilities, and vision through student-centered counseling, psychoeducation, social skills instruction, and executive functioning coaching. Mrs. Simon has particular interests working with children and adolescents on the Autism spectrum as well as individuals working to manage stress or anxiety-related challenges.

Mrs. Simon is an expert evaluator and observer who has extensive working knowledge of the special education process and school-based special education services, particularly in Massachusetts. She has been an integral part of hundreds of IEP teams and has helped to coordinate care, develop goals, and guide students and their families through the transition planning process. Mrs. Simon further has special expertise helping students to learn about their diagnoses and testing and the IEP process in general. She enjoys assisting students, families, and educators in understanding a student’s disability-related needs as well as the strategies that can help the student to be successful in both academic and nonacademic settings. Mrs. Simon has often been a part of teams in the years when students are initially participating in transition services, and she has helped countless students to build the skills necessary to be part of their first team meetings. She is committed to teaching students—as well as parents and educators—how to participate in student-centered team meetings and the IEP processes.

At NESCA, Mrs. Simon works as a transition specialist and psychoeducational counselor. She works with adolescents, their families, and their school communities to identify and build the skills necessary to achieve their postsecondary goals. Mrs. Simon provides transition assessment (including testing, functional evaluations, and observations), program observations and evaluations, case management and consultation, and individualized counseling and skills coaching.

 

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

 

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

 

39

So, You Are Taking a Leave of Absence from College—Now What?

By | Nesca Notes 2023

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

Almost 75% of college students reported moderate to severe psychological distress during the 2020-2021 school year (National College Health Assessment, American College Health Association, 2021). College students across the country are continuing to struggle with depression, anxiety, self-harm, and suicidal thoughts this school year. My appointment calendar is often made up of meetings with college students or parents of college students beginning the process of taking a leave of absence and wondering what to do next. Here are some tips that I shared with many of these students and families.

Get Treatment

Many students need to participate in skill-based therapies (cognitive behavioral therapy, dialectical behavioral therapy, exposure and response prevention, acceptance and commitment therapy, etc.) in order to build up coping skills that may not have been developed in high school. Depending on the severity of current mental health issues, a student may need to participate in an intensive inpatient or outpatient treatment. Ultimately, many students need to find a supportive outpatient therapist—ideally someone who will be able to continue treating the student if they plan to make a future college attempt.

Psychopharmacological intervention (i.e., medication) can be important to consider. Sometimes students have not been taking medications as prescribed or they are taking medications exactly as prescribed but not gaining the intended benefits. Consulting with a prescriber can be an important treatment step for determining whether medication, or medication changes, are necessary.

Get Exercise

For any student, having a regular routine for exercise, sleep, and healthy diet has an impact. However, this is even more critical for students who are vulnerable to anxiety and/or depression. Exercise does not have to start big. Walking (with or without the dog), hiking, or just moving along to a YouTube fitness video for 10 minutes a day will make a difference. It’s critical to schedule the exercise in and often easiest if this is part of a morning or evening routine. For some students, working with a personal trainer or attending scheduled classes helps with accountability. Using a wearable exercise tracker like a Fitbit, Garmin Watch, or Apple Watch can also help with motivation and consistency.

Get a Job

Over the past 25 years, we have seen a notable decrease in the number of high school students who have participated in paid employment. Many students went off to college without taking time to connect college participation with future career interests. Using time off from school to explore work preferences and build transferrable skills (and a resume) can help students experience efficacy and improve mood. As a college student, no one is particularly excited when you show up to class, and the professor certainly doesn’t depend on you in order to get their job done. However, as an employee, students can experience tangible success through accomplishing work activities, receiving gratitude from coworkers and supervisors, and earning money. Work can also provide an important social experience. This is also an historic time to be looking for a first or early career position in the American workforce. Entry-level workers can make good wages. and there are plenty of part-time job openings across industries. Moreover, it’s difficult to get fired right now because good help is truly hard to find.

For students who are not ready to commit to paid work, and need time to recover and build energies up, volunteer jobs are also good opportunities. Some students will do better with brief drop-in volunteer activities while others my want to schedule more routine work hours.

Consider Taking Classes

When students take a leave of absence from college, the assumption is that the student will want to return to a college experience. But many students take a leave of absence and determine that they do not want to go back to college or that they do not want to go back to the same college. If a student wants to keep up academic skills, they can audit or take one or more college courses during the spring semester (depending on their college’s policies and whether they are planning to return). Community colleges, state colleges, and part-time or online college programs (like Harvard Extension School) are good options to explore for classes of interest as a non-degree seeking student. Starting back with a class that is high interest or a low degree of difficulty can be helpful for students who need to rebuild confidence. Additionally, when students are unsure if they are going to return to college or uncertain of a potential future major, it can be good to try classes that are likely to transfer and generally meet basic liberal arts requirements.

Get a Coach

Some students with mental health issues have other underlying challenges that contributed to their struggles in college. There could be a learning disability that wasn’t appropriately being addressed with accommodations, executive function challenges that impacted keeping up with pace, or volume of academics, social challenges that were exacerbated by the highly social dorm environment, or other issues. It is important to consider whether there are skill deficits that may have contributed to a student experiencing anxiety or depression. Some students will benefit from life skills, executive function, or social coaching in order to build up areas that are weaker before heading back to college (or may want to continue with that coaching when they head back).

Other students may want to take time to work with a career or transition coach to do some self-exploration. Taking a step back to participate in self-assessment related to one’s preferences and interests and to determine how those align with potential college major and future career interests can be helpful. I have worked with several students on leave to go through a career planning process. For some, they discover that they chose exactly the right college and major, and that can increase motivation when they get back to school, with proper supports in place. For others, this process sets a student on a completely new path.

Let us know, in our online Intake Form, if your student needs support during their time off from school and/or coaching to assist during their time off or when they return to college.

 

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. Ms. Challen also provides expert witness testimony in legal proceedings related to special education. 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, call 617-658-9800 or complete our online Intake Form.

39

So, You Are Taking a Leave of Absence from College—Now What?

By | NESCA Notes 2022

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

Almost 75% of college students reported moderate to severe psychological distress during the 2020-2021 school year (National College Health Assessment, American College Health Association, 2021). College students across the country are continuing to struggle with depression, anxiety, self-harm, and suicidal thoughts this school year. In the weeks leading up to Thanksgiving, my appointment calendar consisted primarily of meetings with college students or parents of college students beginning the process of taking a leave of absence and wondering what to do next. Here are some tips that I shared with many of these students and families.

Get Treatment

Many students need to participate in skill-based therapies (cognitive behavioral therapy, dialectical behavioral therapy, exposure and response prevention, acceptance and commitment therapy, etc.) in order to build up coping skills that may not have been developed in high school. Depending on the severity of current mental health issues, a student may need to participate in an intensive inpatient or outpatient treatment. Ultimately, many students need to find a supportive outpatient therapist—ideally someone who will be able to continue treating the student if they plan to make a future college attempt.

Psychopharmacological intervention (i.e., medication) can be important to consider. Sometimes students have not been taking medications as prescribed or they are taking medications exactly as prescribed but not gaining the intended benefits. Consulting with a prescriber can be an important treatment step for determining whether medication, or medication changes, are necessary.

Get Exercise

For any student, having a regular routine for exercise, sleep, and healthy diet has an impact. However, this is even more critical for students who are vulnerable to anxiety and/or depression. Exercise does not have to start big. Walking (with or without the dog), hiking, or just moving along to a YouTube fitness video for 10 minutes a day will make a difference. It’s critical to schedule the exercise in and often easiest if this is part of a morning or evening routine. For some students, working with a personal trainer or attending scheduled classes helps with accountability. Using a wearable exercise tracker like a Fitbit, Garmin Watch, or Apple Watch can also help with motivation and consistency.

Get a Job

Over the past 25 years, we have seen a notable decrease in the number of high school students who have participated in paid employment. Many students went off to college without taking time to connect college participation with future career interests. Using time off from school to explore work preferences and build transferrable skills (and a resume) can help students experience efficacy and improve mood. As a college student, no one is particularly excited when you show up to class, and the professor certainly doesn’t depend on you in order to get their job done. However, as an employee, students can experience tangible success through accomplishing work activities, receiving gratitude from coworkers and supervisors, and earning money. Work can also provide an important social experience. This is also an historic time to be looking for a first or early career position in the American workforce. Entry-level workers can make good wages. and there are plenty of part-time job openings across industries. Moreover, it’s difficult to get fired right now because good help is truly hard to find.

For students who are not ready to commit to paid work, and need time to recover and build energies up, volunteer jobs are also good opportunities. Some students will do better with brief drop-in volunteer activities while others my want to schedule more routine work hours.

Consider Taking Classes

When students take a leave of absence from college, the assumption is that the student will want to return to a college experience. But many students take a leave of absence and determine that they do not want to go back to college or that they do not want to go back to the same college. If a student wants to keep up academic skills, they can audit or take one or more college courses during the spring semester (depending on their college’s policies and whether they are planning to return). Community colleges, state colleges, and part-time or online college programs (like Harvard Extension School) are good options to explore for classes of interest as a non-degree seeking student. Starting back with a class that is high interest or a low degree of difficulty can be helpful for students who need to rebuild confidence. Additionally, when students are unsure if they are going to return to college or uncertain of a potential future major, it can be good to try classes that are likely to transfer and generally meet basic liberal arts requirements.

Get a Coach

Some students with mental health issues have other underlying challenges that contributed to their struggles in college. There could be a learning disability that wasn’t appropriately being addressed with accommodations, executive function challenges that impacted keeping up with pace, or volume of academics, social challenges that were exacerbated by the highly social dorm environment, or other issues. It is important to consider whether there are skill deficits that may have contributed to a student experiencing anxiety or depression. Some students will benefit from life skills, executive function, or social coaching in order to build up areas that are weaker before heading back to college (or may want to continue with that coaching when they head back).

Other students may want to take time to work with a career or transition coach to do some self-exploration. Taking a step back to participate in self-assessment related to one’s preferences and interests and to determine how those align with potential college major and future career interests can be helpful. I have worked with several students on leave to go through a career planning process. For some, they discover that they chose exactly the right college and major, and that can increase motivation when they get back to school, with proper supports in place. For others, this process sets a student on a completely new path.

Let us know, in our online Intake Form, if your student needs support during their time off from school and/or coaching to assist during their time off or when they return to college.

 

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. Ms. Challen also provides expert witness testimony in legal proceedings related to special education. 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, call 617-658-9800 or complete our online Intake Form.

4

The Importance of SMEDMERTS

By | NESCA Notes 2022

By: Ann Helmus, Ph.D.
NESCA Founder/Director; Clinical Neuropsychologist

While supporting a friend who was recently diagnosed with bipolar disorder, I have come to appreciate how challenging it is for people with this disorder to maintain a stable mood state. One of the most helpful resources I discovered in my search for information to help me support my friend was a TEDx talk by Ellen Forney, an author who has successfully managed her bipolar disorder for two decades by following SMEDMERTS, an acronym for: Sleep, Medication, Eat Well, Doctor/therapy, Mindfulness/Meditation, Exercise, Routine, Tools (coping), and Support System. I was struck that only 25% of the solution for managing her mental illness involves the mental health system: medication and doctor. The bulk of her treatment system relates to lifestyle choices.

While attention to SMEDMERTS is important for all of us, especially in these stressful times, consistent focus on these lifestyle choices is particularly critical for the many children and adolescents who we see at NESCA presenting with anxiety, mood disorders, ADHD, and behavioral issues. Most of us struggle to achieve our daily goals for sleep, diet, meditation, exercise, sticking to a routine, practicing adaptive coping strategies, and nurturing our support system, even though we know how much better we feel and how much better our children function when we are focused on SMEDMERTS in our daily life. While the impact of medications and doctors on functioning is largely outside of our control, we can control our lifestyle choices, which are critical to the success of managing any mental health issue.

How can we help the children in our lives to embrace SMEDMERTS?

  • Modeling it for them. As Robert Fulgham said, “Don’t worry that your children never listen to you; worry that they are always watching you.”
  • Praising their efforts. Offer positive feedback, such as, “Great idea to get up early to go for a run,” or, “I like how you called a friend when you were upset to get some advice.”
  • Enlisting the help of a coach. NESCA offers real-life skills coaching, executive functioning coaching, and health coaching to help children, adolescents, and young adults build and maintain habits to support positive lifestyle choices.

Health coaching is available to parents of NESCA clients who are seeking support in developing positive health habits, such as exercise, diet, stress management, and meditation.

If you are interested in coaching services at NESCA to support your quest for SMEDMERTS, please contact Crystal Jean: cjean@nesca-newton.com or fill out our intake form at www.nesca-newton.com.

 

About the Author
NESCA Founder/Director Ann Helmus, Ph.D. is a licensed clinical neuropsychologist who has been practicing for almost 20 years. In 1996, she jointly founded the  Children’s Evaluation Center (CEC) in Newton, Massachusetts, serving as co-director there for almost ten years. During that time, CEC emerged as a leading regional center for the diagnosis and remediation of both learning disabilities and Autism Spectrum Disorders.

In September of 2007, Dr. Helmus established NESCA (Neuropsychology & Education Services for Children & Adolescents), a client and family-centered group of seasoned neuropsychologists and allied staff, many of whom she trained, striving to create and refine innovative clinical protocols and dedicated to setting new standards of care in the field.

Dr. Helmus specializes in the evaluation of children with learning disabilities, attention and executive function deficits and primary neurological disorders. In addition to assessing children, she also provides consultation and training to both public and private school systems. She frequently makes presentations to groups of parents, particularly on the topics of non-verbal learning disability and executive functioning.

To book an evaluation with one of NESCA’s many 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, as well as Londonderry, New Hampshire. NESCA serves clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

10

Getting Back in the Swing of Things

By | NESCA Notes 2021

By Miranda Milana, Psy.D.
Pediatric Neuropsychologist

The past 22 months have brought more transitions and changes to our daily lives than ever before. Whether children and parents have had to transition from routine school breaks, or to unprecedented remote learning environments, we have all dealt with our fair share of the unexpected since the COVID-19 pandemic began. As we prepare to enter yet another transition with winter break ending (and February break not too far away), these changes in schedule and routine can be difficult adjustments for entire families. Not to mention the seemingly never-ending worries wondering whether virtual learning will resume once again. In order to help ease these times of transition, try utilizing the following tips:

Consider sticking to similar routines when possible. Sleeping in, unusual mealtimes, and later bedtimes are all tempting (and sometimes unavoidable!) when we don’t have our regular school or work routines during breaks and vacations. Try to implement some sort of routine whenever possible if routine is what works best for you and your family. It might mean that you can still sleep in, but mornings start consistently at 7am instead of 5am. Maybe dinner is no longer eaten at 7pm but at 6pm. Whatever the changes may be, consistency is key.

Schedule time for fun! As much as routine and schedules can be important, don’t forget to leave time for enjoyable activities! The holiday season can bring numerous obligations between holiday parties, visiting with family/friends, and previously scheduled extracurricular activities. Take some time to plan preferred family activities as well! After all, a break is supposed to be just that…a break!

Don’t wait to start transitioning back to school day routines until the morning of. Going back to work or school after extended time off can be really challenging. There is often a sense of dread and “Sunday Scaries” that accompany a return back to our daily responsibilities. Don’t wait until the night before or morning of to resume a typical bedtime and wakeup call. Instead, gradually shift the nighttime and early morning routine over a few days so that the night before/morning of doesn’t feel so daunting and overwhelming! By pushing back bedtime and setting the alarm 15 minutes earlier over the course of several days, the difference won’t seem as insurmountable.

Create visual calendars and talk about the transition ahead of time. Creating visuals can be crucial in helping children to prepare for what is to come. For younger children who do not yet have an appropriate conceptualization of time, a visual can be a particularly useful resource in preparing them for what to expect and when. Make reviewing the visual calendar a part of the nighttime or morning routine.

Provide validation and have patience with yourself. No matter how hard we try to prepare, seeing an increase in problematic behaviors, temper tantrums, and emotional outbursts is to be expected throughout times of change. Helpful strategies during times of dysregulation include naming the emotion, validating it, and creating space for safe and appropriate expression. Try using statements such as:

  • Labeling the emotion: “It looks like an earlier bedtime is really frustrating for you.”
  • Validating the feeling: “It’s okay to feel this way.”
  • Normalize the feeling: “Sometimes I feel overwhelmed when I have to do things I don’t like.”
  • Modeling appropriate strategies: “Something that can be helpful for me is deep breathing. Do you want to try and see if this is helpful for you, too?

 

About the Author

Dr. Miranda Milana provides comprehensive evaluation services for children and adolescents with a wide range of concerns, including attention deficit disorders, communication disorders, intellectual disabilities, and learning disabilities. She particularly enjoys working with children and their families who have concerns regarding an autism spectrum disorder. Dr. Milana has received specialized training on the administration of the Autism Diagnostic Observation Schedule (ADOS).

Dr. Milana places great emphasis on adapting her approach to a child’s developmental level and providing a testing environment that is approachable and comfortable for them. She also values collaboration with families and outside providers to facilitate supports and services that are tailored to a child’s specific needs.

Before joining NESCA, Dr. Milana completed a two-year postdoctoral fellowship at Boston Children’s Hospital in the Developmental Medicine department, where she received extensive training in the administration of psychological and neuropsychological testing. She has also received assessment training from Beacon Assessment Center and The Brenner Center. Dr. Milana graduated with her B.A. from the University of New England and went on to receive her doctorate from William James College (WJC). She was a part of the Children and Families of Adversity and Resilience (CFAR) program while at WJC. Her doctoral training also included therapeutic services across a variety of settings, including an elementary school, the Family Health Center of Worcester and at Roger Williams University.

Dr. Milana grew up in Maine and enjoys trips back home to see her family throughout the year. She currently resides in Wrentham, Massachusetts, with her husband and two golden retrievers. She also enjoys spending time with family and friends, reading, and cheering on the Patriots, Bruins, Red Sox, and Celtics.​

 

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

 

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

 

1

Helping Students Transition Back to School

By | NESCA Notes 2021

By: Angela Currie, Ph.D.
Pediatric Neuropsychologist, NESCA
Director of Training and New Hampshire Operations

Back in June, I wrote a blog about dealing with uncertainty at the end of the school year. Now, two months later, families are focused on the transition back to school, and a level of uncertainty still remains. Many children are re-entering full in-person learning for the first time in over a year and a half. We are also facing the reality that our overall community health is not as improved as we hoped it would be by now. There is debate about how to appropriately re-enter school, and this stress is likely palpable for many children and teens. As a community, we are grieving the continued loss of “normalcy,” with no clear idea of when that will be recovered.

How do we help children, and their adults, transition back to school during such a time? Some of the basic strategies are similar to those that we do to help them cope with the end of the school year. This includes watching for signs that your child may be struggling (e.g., difficulty sleeping) and talking about their feelings related to starting school in an open and validating manner. In addition, here are some strategies for helping to ease the upcoming transition to school:

  • Start to work into your schoolyear daily routine within the last week or two of summer. This includes bedtimes and wakeup times.
  • Create a morning and evening routine checklist or schedule. Use visual prompts for young children. For example, a morning checklist may include: Wake Up, Get Dressed, Eat Breakfast, Brush Teeth, Pack Bag (listing words or pictures of what to pack), and Departure Time. Practice this checklist for a couple days ahead of school starting to help you child get into the routine and understand how long each task will take.
  • Preview your child’s schoolyear to the extent possible. This may include reviewing their class schedule, looking at their teacher’s profile or picture on the school website, going to a back-to-school event at their school, etc.
  • Help your child set some goals for the upcoming year, trying to create intrinsic goals (e.g., build confidence with reading; make a new friend; ask questions more; etc.), rather than extrinsic (e.g., get straight As).
  • For children who were full remote last year and whose schools have mask mandate, practice wearing a mask at home for increasing durations of time.
  • Avoid scheduling extra activities during the first two weeks of school, such as weekend trips or appointments, allowing for a more relaxed transition.
  • Particularly for elementary age children, email your child’s teacher ahead of the year starting in order to briefly introduce yourself and your child. If you child has specialized needs, concisely highlight key things that the teacher should be aware of heading into the year.
  • For children who will be using a locker for the first time, have them practice opening a combination lock at home before the year starts.
  • For families feeling dissatisfaction regarding your school’s COVID-related mandates or plan, work to keep this conflict or stress away from your child.

Understood.org has a range of tools to help children transition back to school, including a Back to School Update for teachers, Backpack Checklists, Back-to-School Worksheet, Introduction Letter templates, and a Self-Awareness Worksheet, among others. Consider the above tips and resources and determine which are most appropriate for your child and their current skill set and feelings regarding the return to school. With the right tools in place, children and families can feel more confident entering the school year.

 

About the Author:

Dr. Angela Currie is a pediatric neuropsychologist at NESCA. She conducts neuropsychological and psychological evaluations out of our Londonderry, NH office. She specializes in the evaluation of anxious children and teens, working to tease apart the various factors lending to their stress, such as underlying learning, attentional, or emotional challenges. She particularly enjoys working with the seemingly “unmotivated” child, as well as children who have “flown under the radar” for years due to their desire to succeed.

 

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

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Londonderry, NH, Plainville, MA, and Newton, MA serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call (603) 818-8526.

157

Sensory-friendly Sunscreen for Tactile-sensitive Kids

By | NESCA Notes 2021

By: Madelyn (Maddie) Girardi, OTD, OTR/L
Occupational Therapist, NESCA

Our Sense of Touch

Tactile processing is our ability to sense and interpret information from our environment through our sense of touch. Information from our tactile system allows us to gauge everyday sensations such as light touch, temperature, vibration, pressure, or pain.

Tactile Defensiveness

Tactile defensiveness is a term used to describe an individual who is hypersensitive to touch. As occupational therapists (OTs), this is something we come across often on our caseloads. Sensitivity to tactile stimuli can interfere greatly with a child’s functional, day-to-day activities. It can impact one’s ability to tolerate certain types of clothing, perform self-care tasks (bathing, toothbrushing, hair brushing), or eat a range of foods. Another activity that may cause difficulty in the summer months is tolerating the feeling of sunscreen on the body. While we want our families to enjoy the beach, the pool, or spend time outdoors, this task can be daunting for tactile-sensitive kids. The anticipation of this event alone may elicit an aversive response, or, in many cases, the child may begin avoiding the task altogether.

(Movement Matters, 2020).

The Role of OT

Occupational therapists help children and families participate in meaningful daily activities. When a child is sensitive to certain stimuli, the therapist will provide an environment where controlled and guided exposure can take place. This process allows for ongoing positive interaction with the medium, often through play-based activities. The therapist can help the family find alternative solutions and to identify positive coping mechanisms that allow the individual to be successful in the given task.

Tactile Defensiveness and the Beach

As a pediatric occupational therapist, a question that often comes up in the summer months is: “What do I do if my child is having trouble tolerating the feeling of sunscreen on his skin?” The first thing you can do is consider the sensory properties of the sunscreen. Is it lotion? Is it thick? Sticky? Clumpy? Smooth? Does it absorb quickly, or does it stay on the skin? Is it greasy? Does it have a certain smell to it? Stick, spray, and powder options are great alternatives for children who may be sensitive to some of the less desirable lotions. Here are some of the most recommended, sensory-friendly sunscreen options:

      Stick options

  • Neutrogena Wet Skin Kids Stick *
  • Neutrogena Dry Touch Ultra Sheer Stick *
  • Aveeno Baby Face stick sunscreen

      Spray options

  • Babo Botanicals Sheer Zinc Spray
  • Banana Boat Light as Air

      Powder-based options – primarily for the face

  • Brush on Block Translucent Mineral Powder Sunscreen
  • Sunforgettable Total Protection Brush-On Shield

      Lotions

  • Neutrogena Dry Touch Ultra Sheer *
  • Supergoop Unseen Sunscreen
  • Biore UV Aqua Rich Watery Essence

(Evolution, 2021; No Author, 2018).

Additional Recommendations

As an occupational therapist, I am always thinking of other ways to adapt activities to make them easier for my clients. Beyond changing the actual sunscreen, here are some more ways to help make protection from the sun easier for our kids.

  • Coolibar Clothing – Limit the amount of skin that is exposed directly to the sun using protective clothing. This brand offers sun protective clothing options in shirts, hats, bottoms, and swimwear.
  • Make it a routine! – Like any other daily activity, such as getting dressed or brushing teeth, make it a part of the day! This way, it is familiar and expected.
  • Make it fun! – Play a game or sing a song while applying sunscreen. Use a timer so that the child can know when the activity is going to end.
  • Involve the child in the process as much as possible – As appropriate, have the child help with putting on the sunscreen. Use a mirror so that the child can see what is going on.
  • Proprioceptive input – Providing proprioceptive input prior to sunscreen application can help to reduce touch sensitivity. This is the sensory input one receives from the movement and force of muscles and joints. Some examples include massage/deep pressure to applicable areas, any pushing/pulling movement, use of weighted items, digging in sand, animal crawls, or wheelbarrow walks. Have the child rub down arms, legs, and back with a towel before applying sunscreen.

References:

Evolution, M. (2021, May 26). Sunscreen Ideas for Tactile Defensive Kids. Mommy Evolution. https://mommyevolution.com/sunscreen-ideas-tactile-kids/

No Author. (2018, March 31). Autism Inclusivity [Facebook page]. Facebook. Retrieved August 6, 2021, from https://www.facebook.com/groups/autisminclusivity

Movement Matters. (2020, May 3). Occupational Therapy ABC. https://www.movementmatters.com/

 

About the Author
Madelyn (Maddie) Girardi is a Licensed Occupational Therapist in Massachusetts with experience in both school-based and outpatient pediatric settings. Maddie received her undergraduate degree in Exercise Science/Kinesiology at The College of Charleston in South Carolina and  earned her Doctorate degree in Occupational Therapy from The MGH Institute of Health Professions in Boston.

Maddie is a passionate therapist with professional interest in working with young children with neurodevelopmental disorders, fine and gross motor delays and Autism Spectrum Disorder (ASD).

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.

 

18

Life Skills for College to Work on Now – Part 2

By | NESCA Notes 2020

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

In Massachusetts, we are more than five weeks into home-based learning and looking toward another two months (or more) of schools and childcare facilities being closed. Unfortunately, this is taking a particularly large social and emotional toll on our teenagers and young adults. One strategy for coping with current conditions is to focus on concrete ways that we can control our daily lives and to set short-term tangible goals. With that in mind, I am writing a second blog focusing on the opportunity teenagers are being given to build daily living and executive functioning skills that will ultimately help them live away from home and self-direct their lives. Last week, I discussed four important skills that are critical for attending residential colleges: getting up on time each morning, doing laundry, having basic kitchen skills, and using basic tools for assembling and fixing things around home. This week, I am offering another four skills. For any young person, I always suggest letting the student pick the skill(s) they want to work on first. When you have a lot to work on, you may as well pick the starting point that feels most important and motivating!

  • Medications: For students who have been on medication during high school, keeping that medication regimen stable is typically a must during the transition to college. Students need to have the knowledge, preparation and organizational skills needed to maintain their own medication regimen. Often a good way to start this process is to purchase a 7-day pill organizer and have teens be responsible for dispensing their own medication for the week. Certainly, a smartphone or smartwatch with several alarms can be useful for remembering medications at needed times. For more information about medication management expectations in college, check out this article by Rae Jacobson. He makes some useful recommendations, such as using a unique alarm tone for medication reminders and putting pills in highly or frequently visible locations (e.g., next to your toothbrush that you routinely use).
  • Money: Students in early stages of high school may be too young for their own bank accounts and credit cards. However, some banks do offer accounts that are specially tailored for minors. Students can open a joint bank account as a minor with a parent or legal guardian. Teens can also practice managing plastic through use of traditional prepaid debit cards, Amazon.com or store gift cards, or a debit card made especially for minors like Greenlight. From home, teens can practice making necessary online purchases, tracking payments and shipping, checking account balances, and using a software like Microsoft Excel or Google Sheets to keep a record of purchases. There are also plenty of great free web-based financial literacy resources that teens can use to learn about banking and consumer skills from home; a few resources that my colleague Becki Lauzon, M.A., CRC, and I like include:
  • Building an Exercise Routine: Believe it or not, basic fundamentals like healthy eating, sleep hygiene and regular vigorous exercise are strong predictors of college success and satisfaction. As we are living in a period of time where team sports are not accessible, this may be exactly the right time for teenagers to build their own individual exercise routine that can be carried out at home and in one’s local neighborhood. A good baseline to strive for is a routine that includes exercise sessions at least three days per week. With decreased time factors in our lives, students can play around with morning, afternoon or evening exercise to see what feels best for their bodies and brains. If brisk dog-walking, jogging/running or biking activities are not appealing, there are plenty of great YouTube exercise videos (e.g., dance, yoga, strength training, cardio training, etc.) that require no equipment and are calibrated for all kinds of bodies and levels of fitness. Setting a schedule for weekly workouts will help to ensure that exercise becomes more routine and tracking progress with that schedule (e.g., journaling, marking a calendar, using an app like Strava or Aaptiv, etc.) helps to build and sustain motivation. Some teens (and adults) also find that they are more able to stick to an exercise routine if they use a smartwatch to help track, celebrate and prompt their progress.
  • Using a Calendar System for Scheduling: The alarm clock mentioned in last week’s blog is certainly an important time management tool that is vital to master prior to attending college. Another critical time management tool for college (and life beyond) is a calendar system for managing one’s schedule. When starting to build time management skills, simply asking your teen to write down their schedule can be a good place to start. What do they know they have to do each day of the week? What appointments or activities are missing? Teens may have a calendar system that they are already accustomed to using for checking the date, but may not be using that tool to manage their entire schedule. Some common calendar app tools include iCal, Google Calendar and Outlook, but some teens may do better with paper-based systems. If a teen benefits from a paper copy of their schedule, I would still recommend that they learn to use something electronic, then just print off their daily, weekly or monthly schedule based on preference and need. Practice inputting activities that are happening right now, such as assignments, remote classes, meals, therapy, etc. Teens can also play around with reminder settings to see what feels best for prompting participation in activities. Sometimes 15 minutes is too much time, but 5 or 10 is just right. Other times, more than one reminder is needed.

To read more about the Life Skills recommendations from last week’s Transition Thursday blog, click here!

 

If you are interested in working with a transition specialist at NESCA for consultation, coaching, planning or evaluation, please complete our online intake form: https://nesca-newton.com/intake-form/.

 

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.

149

Remote Real-life Skills Coaching: How Does it Work?

By | NESCA Notes 2020

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

What is life skills coaching?

Coaching services in general aim to target functional life skills and help our children and adolescents to slowly build the ability to independent. While some of these skills, such as taking Uber, riding the T, or ordering in a restaurant, cannot be targeted using an online platform, the majority of these skills can absolutely be built with the help of a dedicated remote coach. Currently, many of our coaches are helping students through the great task of processing a huge life change in response to the COVID19 virus.

What skills can be worked on with a remote coach?

Hard skills are often thought of as specific, functional abilities that one can develop and perform. (In employment, these are often thought of as technical skills.) Options that can be worked on with a remote coach include cooking based on a specific recipe, ordering groceries on-line, calling to refill prescription, setting up a medication management system, typing, using Google classroom or Microsoft suite, electronic calendar management, etc.

Soft Skills include more abstract and broad abilities that are necessary for employment, academic success, and community independence. NESCA coaches work on executive function, social communication, and self-determination skills necessary for long-term independence at home, in school, and at work. Example skills taught include creating daily schedules, goal setting, preparing for interviews, organizing the home environment in order to be productive, reading and understanding IEPs and assessments, using technology to support memory, customer service skills, research skills, and more.

With the current pace and routine of life changing dramatically, NESCA coaches are working to help our clients establish healthy routines and habits. Coaches are available to help develop functional morning and evening routines, set up weekly to-do lists, develop a system to meet deadlines, use online resources for virtual learning, etc.

Who can benefit from this service?

Almost all adolescents and young adults could benefit from building life (and career or college readiness) skills, increasing independence, and practicing executive function; however, our neurodiverse population often has particular difficulty with changes in routine and greatly benefits from having a relational support to build structure and navigate change. All of our coaches have extensive experience working with adolescents and young adults with a wide range of learning, developmental, physical and social-emotional needs. NESCA is committed to helping young people who are struggling with this transition as well as families who are eager to use this unique situational opportunity to focus on skill building at home that is often difficult to fit in simultaneous to normal school demands.

What is a recommended coaching schedule?

Due to the individualized natural of coaching, the schedule and frequency can be incredibly personalized for each individual client. All of our coaching sessions begin with an intake process that includes input from both the adolescent and their family. Schedules are often developed in collaboration with the teen or young adult, the family, and the coach to best meet the client’s needs. Some example schedules that are used by current NESCA clients include:

  • Weekly Skill Building. Clients who are looking to target specific skills often choose to do a weekly session focus on learning and repetition.
  • Monday, Wednesday, Friday 30 Minute Check-ins. This model allows for a student to receive some guidance creating their own scheduling, while simultaneously holding them accountable.
  • Monday Motivation/Friday Follow-up! These sessions range from 1-2 hours and include weekly goal setting, check-ins regarding a weekly to-do list, and personal scheduling. For many clients a Friday follow-up session is an important opportunity to practice self-monitoring and review the previous week.

As somebody who coaches students in person and remotely, what differences do you notice?

I find that the main difference when coaching students remotely is when and how skills are targeted. In person, much of my coaching focuses on community integration, using our transit systems, and navigating the complex social interactions that are necessary when out in the community. Remote coaching can still target pieces of each of these skill areas but the process is in many ways more intrinsic. We may focus on learning to use the internet to find community opportunities, learning to create schedules for travel or complete applications for para-transit, using video learning to “try out” travel, employment, and community activities, and bolstering social media skills. We focused on building global skills in new ways that will help in the future, across environments. For instance, social communication by phone and video conferencing is a skill that will support social and employment success in the future.

In terms of the personal connection and opportunity to build rapport, I find that some teenagers are incredibly adept at communicating over a digital medium. Those who are not, tend to learn quickly. I am continually impressed by their ability to focus, discuss real-life topics, and build skills remotely.

 

About the Author

Dr. Sophie Bellenis is a Licensed Occupational Therapist in Massachusetts, specializing in educational OT and functional life skills development. Dr. 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. Dr. 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, Dr. 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, Transition Services, or Virtual Coaching 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.

 

149

School-based Occupational Therapy at Home

By | NESCA Notes 2020

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

While school districts and government officials work to plan for the current “new normal,” no concrete decisions have been made about the delivery of special education and provider services. As parents take on the huge task of educating within the home, it is important to consider how we can bolster some of the skills that are continuously targeted in the school setting. As an occupational therapist, I have provided direct services and worked with teachers who are adeptly teaching a class of 20, while simultaneously making sure that their two students with OT needs are being provided appropriate accommodations and motor practice. Here are some activities that can be done in the home to keep the development and learning going!

If your child’s occupational therapy (OT) evaluation mentions difficulty with fine motor coordination, consider incorporating these activities into your day.

  • Sort marbles, pompom or coins. Using fingers to pinch and pick up small objects helps to build strength and solidify grasp and grip patterns. Increase the difficulty of this activity by having kids push pompom and marbles through small holes or manipulate coins through slits in a tub or box.
  • Play with playdough or putty. Make shapes using cookie cutters, push beads into putty and pull them all out, roll playdough into a snake and use different pinches to create patterns from head to tail. Pinches to consider include: thumb and index finger, thumb and index+middle finger and thumb against the side of the index finger (lateral pinch).
  • String beads, cheerios or pasta with holes. This activity promotes bilateral coordination, fine motor control and grasp patterns. Scaffold this activity by starting with threading on pipe cleaners, moving to dry spaghetti and finally working to thread onto string.
  • Practice using tweezers to pick up small objects.

If your child’s OT evaluation mentions difficulty with visual perception or visual motor integration, try these!

  • Puzzles! Doing a puzzle requires multiple visual perceptual skills, as well as the fine motor precision to fit pieces together.
  • Word searches. Word searches require horizontal and vertical tracking, letter discrimination and visual figure ground ability. Consider scaffolding this activity by finding word searches that only have horizontal words, have both horizontal and vertical, or have horizontal, vertical and diagonal words.
  • Sorting activities. Objects can be sorted by color, shape, size, texture and a plethora of other characteristics. Consider using objects found in the home, such as pens, buttons, silverware or simply items in a junk drawer for sorting activities.
  • Mazes, Hidden Pictures and Spot the Difference activities can all be found online.
  • Copying activities. Draw pictures using horizontal, vertical and diagonal lines, circles, squares, triangles and crosses and have your child try to copy them exactly. This activity works on visual motor integration specifically.

If your child’s OT evaluation mentions difficulty with endurance, postural stability or core strength, try these!

  • Draw or play while lying on the ground. Tummy time is often thought of as an activity to help our newborns, but lying on your tummy and using the muscles needed to keep the upper body and head stable can be beneficial for building strength in most of our kids.
  • Yoga! Incorporate an online video or movement break into your daily routine.
  • Pretend to be different animals! Walk like a bear, slither like a snake, hop like a frog or trot like a horse. Mimicking these animals is a great activity to do while listening to music and uses all different muscles.

While it can be difficult to target our children’s specific needs without direct access to therapists and our usual resources, building in small activities throughout the day can help to maintain strength, skill development and the foundational abilities needed for academic growth.

 

About the Author

Dr. Sophie Bellenis is a Licensed Occupational Therapist in Massachusetts, specializing in educational OT and functional life skills development. Dr. 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. Dr. 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, Dr. 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.