Tag

school observation

In Defense of the Lowly Questionnaire

By | NESCA Notes 2019

By Jason McCormick, Psy.D.
Pediatric Neuropsychologist

When gleaning information about a child’s areas of strength and challenge, neuropsychologists gather information from multiple sources, including parent and child interviews, conversations with teachers and mental health professionals working with the child, clinical observations, structured testing and questionnaires.

In my work with families, I sometimes hear complaints from parents about the myriad questionnaires that I saddle with them as part of the evaluation process – that some questionnaires might appear to be geared toward more challenged children than their own or that they are unsure how to respond to some of the questions (e.g., Is this behavior exhibited “sometimes” or “often?”).  While those are valid complaints, I find data from questionnaires to be particularly valuable in my work.

For instance, simply relying on clinical observations to glean information about a child’s attention span and degree of distractibility would be often misleading.  While the distraction-reduced, one-to-one, highly-structured testing setting is an ideal context in which to administer standardized assessments, within such a setting, even students with moderate attention disorders can often remain on task to an extent they are not able to demonstrate in less-structured, real-world contexts.

Similarly, children with mild social communication or autism spectrum disorders might be able to demonstrate reasonably-intact social skills within the context of a structured, one-to-one setting with an adult, while they struggle in their interactions with peers in less structured settings.

Conversely, children who might present with moderately high levels of test anxiety might appear so wound-up in a testing setting that, without additional information about their emotional state outside of the testing context, they could mistakenly be diagnosed with a generalized anxiety disorder.

In addition, relying exclusively on results of standardized testing to glean information about a child’s learning profile can be equally misleading.  For instance, children who might well present with executive function challenges can often fare well on specific tests of executive function, as those tests provide a level of structure not present in daily contexts.  Further, the nature of those standardized tests is such that specific executive function skills are measured in isolation (e.g., how well is a child able to brainstorm or switch gears or see the big picture), as opposed to in real life, when a child needs to make use of multiple different executive function skills in concert to complete given tasks.

Of further importance, I often find that a comparison between a child’s responses on a self-report questionnaire and those of parents or teachers yields critical information.  More specifically, it is often the case that from the parent perspective a child is running into pronounced executive function challenges, while from the child’s perspective they have minimal challenges in that domain of functioning.  That discrepancy can provide useful information about a child’s level of self-awareness or self-acceptance, information that can, in turn, illuminate an important area to address moving forward.

Again, a thorough, comprehensive, integrated neuropsychological evaluation draws on multiple sources of information.  As part of a thorough assessment, questionnaire data is a critical data source, not only in confirming observations made during the testing and results of structured assessments, but also in providing an additional perspective as to how a child might present outside of the structured testing setting.

 

About the Author:

McCormick

Dr. Jason McCormick is a senior clinician at NESCA, sees children, adolescents and young adults with a variety of presenting issues, including Attention Deficit Hyperactivity Disorder (AD/HD), dyslexia and non-verbal learning disability. He has expertise in Asperger’s Disorder and has volunteered at the Asperger’s Association of New England (AANE). Dr. McCormick mainly sees individuals ranging from age 10 through the college years, and he has a particular interest in the often difficult transition between high school and college. As part of his work with older students, Dr. McCormick is very familiar with the documentation requirements of standardized testing boards. He also holds an advisory and consultative role with a prestigious local university, assisting in the provision of appropriate academic accommodations to their students with learning disabilities and other issues complicating their education.

 

To book a consultation with Dr. McCormick or one of our many other expert neuropsychologists, complete NESCA’s online intake form.

 

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

 

Interview with Reva Tankle, NESCA Pediatric Neuropsychologist

By | NESCA Notes 2018

 

 

By:
Ashlee Cooper
NESCA Marketing and Outreach Coordinator

 

What made you become interested in being a neuropsychologist?

I first became interested in neuropsychology when I was in graduate school.  I was pursuing a Masters Degree in Developmental Psychology and I worked on a research project looking at brain organization in children with autism.  This sparked my interest in how the brain works and how differences in brain organization relate to different neurodevelopmental disorders. My doctoral research focused on differences in how right and left-handers processed information.  I had planned to make a career within the research field of neuropsychology and my first job was in the Neurology department of a medical school. However, after a short time, I found this to be rather unsatisfying as I did not feel that the work, I was doing was having any direct impact on individuals’ lives.  It was at that time that I took a job in Boston at a rehabilitation center working with adults with traumatic brain injury. I found working with the patients and their families to be very meaningful and satisfying.

What brought you to NESCA?

After working for many years in the field of adult brain injury, I found myself having to navigate the special education world. My family and I were assisted by a wonderful Special Education advocate and from that experience I found my next “calling.”  I did the advocate training through the Federation for Children with Special Needs and over the next 7 years, I had the opportunity to work with hundreds of families and help guide them through the process. I was fortunate to meet Dr. Ann Helmus, Director of NESCA, and she invited me to join NESCA; first, to expand my training as a neuropsychologist and then as a staff clinician.  I have been able to bring my experience of working with many wonderful families and dedicated school personnel and connect it to a deep understanding of the neuropsychological underpinnings of the learning and emotional challenges our children face.

Do you have a specialty? What do you specialize in?

I evaluate students age 6 years to young adulthood.  I see a wide range of children and young adults including those with language-based learning disabilities, attentional issues, brain injury, and other neurodevelopmental disorders.  I often do school observations and attend Team meetings. I provide recommendations that are individualized for that student and relevant for both school and home-based interventions.

What do you like about your job?

First and foremost, I love spending time with and evaluating children.  One very bright child asked me “Is this boring for you?” I told him “No, I am always thinking about what the child is doing and trying to figure out what else I need to do to best understand his or her thinking and learning.  And that is not boring.” And I try hard to have “fun” and make it an enjoyable experience for the child. No one is going to be a pediatric neuropsychologist and not find kids fun to be with. I also like my job because I can have an impact on the life of that child, their family and their school.  When we work effectively as a Team, we can really make the life of that child so much better and make their school experience more positive.

Why should parents bring their child to NESCA for evaluation?

The evaluations we provide at NESCA are individualized and comprehensive so that we can answer the referral questions being asked by either the family or the school district.  We have no time constraints; so, if a child needs a third or even a fourth session to get through the necessary testing, the clinician is encouraged to do so. This allows us to fully evaluate the child and develop a deep understanding of the cognitive, learning and/or emotional factors that are making school and life in general, hard for this child.

I would also like to point out that NESCA clinicians are provided with extended opportunities for continuing education and consultation with colleagues.  The NESCA clinicians meet several times a month for continuing education seminars provided at NESCA to further both clinical knowledge and information about resources in the community.  In addition, NESCA clinicians gather weekly for a “Case Conference” where colleagues can consult with each other to ensure that our evaluations and recommendations include the broad-based expertise of our many clinicians.

What advice do you have for parents who are not sure if a neuropsychological evaluation is needed for their child?

When I teach at the Parent Consultant Training course for the Federation for Children with Special Needs, I tell them that an evaluation should be recommended when parents have concerns about their child’s development, particularly cognitive or academic.  Parents might start out with a school evaluation, but, a more comprehensive neuropsychological assessment should be considered if the school evaluation does not provide a deep enough understanding of the child’s learning needs or if the child is not making meaningful progress.  There are great benefits to intervening early when a child is struggling. A neuropsychological evaluation can provide a better understanding of the child’s learning profile and offer recommendations for the interventions that can avoid longer-term negative consequences on learning and emotional well-being.

NESCA has opened up a 3rd location in Plainville, Massachusetts which is where you will be primarily seeing clients. Can you tell us more about your decision to work in Plainville?

Well, I have to admit that moving to Plainville will result in a significantly shorter commute for me.  I have loved being a part of the daily excitement in the Newton office but, I have struggled with the commute.  I am excited to extend this easier commute to families on the South Shore, MetroWest and even Central MA who will find it easier to get to our new office.  I don’t want to make our Newton colleagues jealous, but even parking will be easier.

 

Reva Tankle, Ph.D.
Pediatric Neuropsychologist

Combining her experience and training in both pediatric neuropsychology and educational advocacy, Dr. Reva Tankle has particular expertise in working with families who are navigating the IEP process. Having participated in numerous team meetings over the years, Dr. Tankle is especially knowledgeable about the many ways that schools can support and accommodate students with special learning needs, information that she clearly communicates in her evaluation reports and in team meetings, if needed. She also has a great deal of experience in articulating the reasons that a student may need a program outside of the public school.

Dr. Tankle evaluates students with ADHD, learning disabilities, high functioning autism spectrum disorders, and neurological conditions, as well as children with complex profiles that are not easily captured by a single diagnostic category.

 

NESCA’s new satellite office, opening December 1st,  is located at 60 Man Mar Drive, Suite 8, Plainville, MA 02762.  To schedule an appointment with Dr. Reva Tankle in Plainville, 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, 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.