Tag

self-esteem

Summer is Here, but There are Still Chores to Do – The Importance of Chores in a Child’s Development

By | NESCA Notes 2021

By Dot Lucci, M.Ed., CAGS
Director of Consultation and Psychoeducational Services, NESCA

What a year it’s been! Hopefully with the pandemic restrictions lifted and the start of summer, we are all breathing a sigh of relief. I’m certainly looking forward to traveling, seeing relatives and getting out without masks. The pandemic upturned our lives in so many ways, but now that there is a “sense of normalcy” returning, we may be tempted to kick back and really relax this summer. However, I would caution that in kicking back and relaxing, there are still chores that need to be done. So, why not include your children in taking ownership and helping out around the house? There is research that states that toddlers who are taught to “help out” around the house continue to help out as they age. Many children in indigenous communities grow up asking to help or just help out because it is needed. Wouldn’t it be nice if that were the case in the United States?

Jim Fay, co-founder of the Love and Logic parenting website, says that all of us need to feel needed and know we are making a contribution to those around us or to our world at large – even kids. In many families, chores are a tradition, but in others they have fallen by the wayside. Many upper and middle class families have hired household help, so the need to do chores isn’t as great, and fighting with children to do chores doesn’t seem worth it. Let’s face it, no one likes to do chores, but they have to get done. Psychologist Roger McIntire, author of Raising Good Kids in Tough Times, says, “A child has to have some responsibilities.” The family is a community, and everyone should chip in and help out. Helping out with family responsibilities and doing one’s own personal responsibilities are useful and necessary skills for a child’s development. The American Academy of Child and Adolescent Psychiatry states that, “there are benefits to including chores in a child’s routine as early as age 3. Children who do chores may exhibit higher self-esteem, be more responsible, and be better equipped to deal with frustration, adversity, and delayed gratification. These skills can lead to greater success in school, work, and relationships.” Research also shows that children who grow up contributing to the family responsibilities grow up to be adults who work well in collaborative groups and have a “can-do” attitude.

Helping kids learn that they have to do chores and that they are a part of life teaches them that it’s not just about me and what I need at this moment, but that I’m part of a system. I’m part of a family (I set the table). I’m part of my class at school (I clean up after an art project). I’m part of my sports team (I carry the bat/ball bag). I’m part of the workplace (I do my part). Humans crave a sense of belonging and connection, and helping others out and doing work for the good of the whole helps us understand why connection is important. The more we can do to foster this in our kids, the better off they will be as adults. Chores are a form of selflessness and help children develop a sense of responsibility and awareness of the needs of others. They begin to recognize that when they pick up, they can find their toys and they are grateful for the small things. Parents show gratitude when children do chores. Praise is good! Children feel appreciated and connected, and gratitude helps wire our brains to notice more things to feel thankful for, leading us to feel better overall.

Chores are powerful teachers. They help a child develop a greater sense of responsibility and awareness of the needs of others, and they also contribute to a child’s social and emotional well-being. Chores help children believe that they are competent and capable and help them develop greater self-esteem. Doing chores can also help children learn problem solving skills as well as the consequences of not doing their chores (i.e., not putting your baseball shirt in the laundry so it’s dirty for the next game). Chores are an excellent teacher of life skills. Knowing how to set the table, walk the dog, pick up toys, do laundry, prepare a meal, sweep/vacuum the floor, change a vacuum cleaner bag, etc., all help prepare a child for the responsibilities of adulthood. More involved tasks (i.e., cleaning out the garage) can be used in the development a child’s executive functioning skills, prompting them (perhaps with parent assistance) to figure out how to tackle the task in the most efficient, most systematic manner. And they learn about solutions that may be applied to a host of other life responsibilities.

Being a part of a family and taking responsibility for oneself and contributing to the family by doing chores is a powerful gift to give to children, even if they may not do the chores perfectly, may need to be reminded to do them, or grumble while they are doing them. It’s okay. Over time, these will lessen. Stay with it and help your child recognize and understand that life is work, and they have to be a part of the work of life.

If you aren’t having your child do chores now, consider it while the summer is here. It will help them out in many ways in the long run, helping them to be better functioning and more capable adults. If you need help figuring out which chores are age-appropriate, there are many lists online offering ideas and ways to assist in helping children do chores without too much complaining!

References

https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Chores_and_Children-125.aspx

https://www.loveandlogic.com

https://www.nytimes.com/2018/08/18/opinion/sunday/children-chores-parenting.html

 

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.

 

New Year’s Resolution to Lasting Lifestyle Changes

By | NESCA Notes 2019

By Billy Demiri, CPT
Certified Personal Trainer

The New Year can bring with it so many possibilities, and beginning a new decade is even more exciting. This is the time of year so many of us envision great goals and changes that we want to make in the new year. A 2016 study published in scientific journal Personality and Social Psychology Bulletin, investigated New Year’s resolutions and found that, “55% of resolutions were health related, such as exercising more, or eating healthier.” I know from personal experience and working with so many people, helping them achieve their fitness and lifestyle goals, just how hard it can be to make lasting changes. So how do we stay on track with all of our New Year’s resolutions when, “about 80% of people fail to stick to their New Year’s resolutions for longer than six weeks”? Here are some of the best strategies I use when setting goals and staying consistent with them.

First, when it comes to New Year’s resolutions and goal setting, it is important to make sure they are doable and meaningful if we want to give ourselves the best shot at success. It is essential to make sure that whatever goal we choose really matters to us, and we are making it for the right reasons. I like to use the acronym SMART when setting goals for myself and my clients. That means goals should be S-Specific, M-Measurable, A-Achievable, R-Relevant and T-Time-bound. For example, if your goal is to lose weight, you should be specific about how much weight you want to lose. Also, make sure it is realistic and set a time frame for yourself; such as losing 1-2 pounds a week vs. 5 pounds per week. Most important of all, it has to be the right goal for you! It is really easy to lose sight of our goal if we are making changes based on what someone else or society is telling us to change. So how do we find a goal that will be right for us?

My favorite technique for finding goals that matter to me and my clients is asking the 5- Whys—or the Downward Arrow Technique—which was coined by psychiatrist Dr. David Burns. It works for any goal or statement by asking why five times to really explore why that goal is important. For example, let’s stick with the goal of losing weight and explore it further:

  1. Why do you want to lose weight?
  • Because I want to lose fat and build some muscle.
  1. Why does that matter?
  • So I could walk around with my shirt off in the summer.
  1. Why do you want to be able to walk around with your shirt off?
  • Because I will look good and feel good about myself.
  1. Why do you want to feel good about yourself?
  • Because when I feel good about myself, I am more confident and assertive.
  1. Why do you want to be more confident and assertive?
  • Because I will be in control and will have a better chance at getting what I want out of life.

By using the 5-Whys technique, we can gain critical insight to our goals. For this person, weight loss was really a matter of taking charge of his life. He’s not really motivated by the number on the scale or just looking good with his shirt off. By having that insight, he is far more likely to keep working towards his goal—even if the scale hasn’t moved as fast as he would have liked.

Now that we have a way of choosing the right goals for ourselves, how do we stay consistent and make sure we reach our objectives? The two most important steps to achieving any goal are making time and taking action! Making time declares that you matter, and it is a commitment to your values, priorities and goals. If you don’t make time, time will be taken from you. Practicing making time will also help you practice valuable life skills, such as identifying what is important to you and looking ahead, planning and preparing for anything life throws at you. One way to start this process is by making a time diary. For one day, about every 30 minutes, record how you are spending your time. This will help you assess how you are spending your time and figure out what activities are helping you, adding value, what is non-negotiable, and what is taking your time but not helping you. Now you can figure out what activities you can do less of so you can do more to accomplish your goals.

Once you find the time, now you can take action! Often, we come up with great, elaborate plans and idea, but  then get stuck in the thought process. The world’s best workout plan, diet plan or life plan is no good unless we can do something about it. The best way to get unstuck in this process is by taking a five-minute action. Only action creates change! Taking action almost always comes before motivation, and it is usually only after we’ve done something that we feel motivated. By taking small actions, we can gain momentum and bust out of procrastination. Usually, all we have to do is drive through the first few minutes of resistance and then five minutes turns into 30 and then into 60 minutes. By being consistent and learning to use this five-minute action, we will not only achieve our goals, but also learn these valuable life skills and truths along with it. Action is empowering, satisfying and serves as evidence that you’re getting things done even if it’s just for five minutes.

To accomplish any goal, we need to build certain skills and practices, then put them into action. Each goal requires different skills and practices to apply, but the process is the same for all of them. Let’s stick with the goal of losing weight by working out. To do so, we must develop and build up the skill of time management. Then we can practice making time to go to the gym or for a jog. Finally, we can take action and go to the gym or do anything that will help us reach our goal. The more we focus on this process, rather than the outcome, the better the results we will see. We will also build valuable life skills that can be used for more than just fitness goals.

So, now that you have a way to find a meaningful goal and an action plan to go with it, it is time to take charge of your path. Also, it’s really important to remember that when working toward a goal or resolution, that you only compare yourself to where you were yesterday, not to where someone else is in the present moment. Adopt a growth mindset and know that there is no such thing as failure…only feedback. There may be setbacks, and that is normal, but you can learn from it and take a five-minute action. Most importantly, have fun with the process, try new things and as Jocko Willink would say, “Get After It!”

References:

https://faculty.chicagobooth.edu/ayelet.fishbach/research/Woolley&FishbachPSPB.pdf
About the Author:

Certified Personal Trainer Billy Demiri offers Personal and Social Coaching (PSC) at NESCA. Billy has several fitness certifications including: NSCA-CPT (National Strength Condition Association- Certified Personal Trainer) Certified and Autism Fit Certified.

To book sessions with Billy Demiri, complete NESCA’s online intake form and note that you are interested in Personal & Social Coaching.

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.

Parenting Orchids and Dandelions

By | NESCA Notes 2019

By: Nancy Roosa, Psy.D.
Pediatric Neuropsychologist, NESCA

I recently evaluated a 15-year-old boy, who we’ll call Sam, whose parents brought him in due to some concerning new behaviors, including failing classes, disobeying his parents’ rules – particularly around curfew and technology use – and smoking marijuana on a daily basis. When meeting Sam, I was amazed at how engaging, polite and good-natured he was. It was hard to imagine this young man disobeying his parents and staying out all night, which he was also doing frequently.

Sam had grown up in an affluent and supportive family, the third of four children. The other three were, like their parents, easy-going, adaptable and successful – academically, socially and athletically. They were on the path to becoming independent and successful adults. Sam had always been a bit different. He was the child who had colic as an infant, sleep disturbances throughout childhood, separation anxiety at preschool, and extreme sensitivity to sensory stimuli. His parents cut tags out of his clothes, bought him loose-fitting pants, and avoided birthday parties at Chuck E. Cheese’s – or almost anywhere there would be crowds of loud children, as these situations could reduce Sam to tears.

When evaluating Sam, I was impressed by his intelligence, quick reasoning and solid academic skills.  There was nothing obvious that standard neuropsychology tests uncovered. But Sam was also open and articulate about his difficulties. He explained that he was easily overwhelmed – “jangled,” he called it – in social situations, in a fast-paced classroom or on an athletic field. When he started ninth grade in a challenging parochial school, he was faced with more stressful situations, academically and socially. He became extremely anxious about tests and lengthy homework assignments, so he fell behind academically and developed pretty serious school anxiety. Given his sensitive nature, he was particularly likely to struggle in a class where the teacher was, in his words, “too strict,” or even “mean.” He wasn’t successful enough socially or athletically to sustain his self-esteem in these areas, particularly compared to his talented siblings. He found himself becoming angry and anxious, and he started using marijuana to calm himself. As he described it, getting high was the only time he felt happy and relaxed.

Sam was clearly struggling, easily meeting criteria for an anxiety disorder and a substance use disorder.  But I wanted to explain some of the “why” behind his struggles, so, in talking to his parents, I relied on the explanation put forth by Dr. W. Thomas Boyce, in his book, Orchids and Dandelions: Why Some Children Struggle and How All Can Thrive. He explains that most children are like dandelions, born with sturdy, resilient temperaments so that they, like dandelions, grow and thrive wherever they land –  assuming there’s some minimal level of appropriate conditions. But about 20% of children are more like orchids. They are born with a very sensitive nervous system, which is highly attuned to all the stimulation in the world around them. Dr. Boyce found that for these children, lower levels of stress precipitated a full-fledged anxiety response, involving the release of stress hormones that create a Fight, Flight or Freeze response – an appropriate response for a life-threatening situation, but not much help when facing, say, a strict teacher or a hard test. These children are therefore much more likely to develop full-blown anxiety disorders. On the positive side, their high level of sensitivity to the world around them means they are typically very empathic and emotionally attuned. Like an orchid with careful nurturing, they will develop into exceptional adults.

Fortunately, many orchids do naturally gain resilience as they grow, according to Elaine Arons, Ph.D. In her book The Sensitive Child, she cites studies that find most children who are shy as preschoolers – suffering social and separation anxiety – will develop coping strategies and not appear shy by the time they reach school age. These orchids gain resilience without losing their sensitivity.

But this positive evolution requires good parenting. While dandelions do fine with the average “good-enough” mother, as famously defined by psychologist Donald Winnicott, orchids need parents to be just a bit better.

How does one do this? How can a well-meaning, good-enough parent help these orchids become better able to manage the squalls, large and small, that occur in any one’s life?

Fortunately, there is a wealth of research – contained in books and articles – on building resilience in children. Most emphasize that we need to allow children to struggle with challenges, even to the point of sometimes failing, so they learn that they can cope and succeed in the face of adversity. This message is clear from the title of several such books: e.g. The Blessing of the Skinned Knee: Using Timeless Teachings to Raise Self-Reliant Children, by Wendy Mogel and The Gift of Failure: How the Best Parents Learn to Let Go So Their Children Can Succeed by Jessica Lahey.

We also have a neurobiological explanation for this process. We know that continued exposure to a stressful situation allows the body to habituate and the terrible feelings – such as fear and panic – that accompany a stress response gradually recede. As this happens, the previously scary situation becomes routine, and the child’s self-confidence and willingness to tackle new risks grows. Every preschool teacher knows this. The crying child who is being left by his parents in an unfamiliar preschool will eventually calm down and start to enjoy himself. The process goes more quickly if parents calmly and confidently reassure the child, then leave. The parent who is also anxious, who hovers over the child, attempting to sooth his fears, only increases the child’s anxiety by sending the message that this IS a scary situation. This phenomenon was dramatically illustrated in a study by Susan Crockenberg and Esther Leerkes (Development and Psychopathology, 2006). They found that 6-month-old children had different levels of reactivity – or startle – in response to unfamiliar stimuli. These infants also showed differences in how much they tried to avoid the situation, versus distracting themselves while staying in the presence of the stimuli. Children with high reactivity and a tendency to withdraw from novel stimuli, along with parents who were less sensitive, were more likely to show high anxiety at 2.5 years of age. Exposure to challenge causes the body to habituate and builds resilience. Trying to avoid stressful situations only exacerbates fears.

However, this can be counterintuitive for parents of very sensitive children. In fact, the more attuned a parent is to his/her child’s sensitivity, the harder it becomes. Sam’s parents had always coddled him a bit more than their other children. Knowing that he didn’t like loud birthday parties, his mother tended to decline these invitations. When he became upset and started to cry at a soccer game, his father felt so sorry for him that he didn’t insist that Sam return the next week. This avoidance did not allow Sam to grow and master new situations, but instead narrowed his world.

This is not to say that Sam’s parents should have been less emotionally attuned. Rather, it’s important for parents of children like Sam to walk a fine line between exposing the child to moderate challenges that he can manage but do not overwhelm him. It’s also important that they stay calm themselves, empathizing with the child’s fears but reassuring him at the same time. Not an easy task.

Fortunately, Sam has many strengths, not the least of which are his sensitivity and his intelligence, as well as great artistic gifts. He also has a solid relationship with his parents, even though it has been quite strained of late. After our evaluation, Sam and his parents decided to place him in a therapeutic wilderness program so he could withdraw from daily pot use in a safe place and learn skills from therapists there, as well as learn from peers who were going through similar struggles. This coming year, he will not return to the challenging parochial school he attended for ninth grade and will instead start at an independent school that offers some academic supports and a flourishing arts program. Sam’s roots are well-established, and with a bit more awareness of the gifts and challenges inherent in his sensitive nature, he is expected to grow into a self-confident and resilient young man.

 

About the Author: 
Roosa

Dr. Roosa has been engaged in providing neuropsychological evaluations for children since 1997. She enjoys working with a range of children, particularly those with autism spectrum disorders, as well as children with attentional issues, executive function deficits, anxiety disorders, learning disabilities, or other social, emotional or behavioral problems. Her evaluations are particularly appropriate for children with complex profiles and those whose presentations do not fit neatly into any one diagnostic box. As part of this process, Dr. Roosa is frequently engaged in school visits, IEP Team Meetings, home observations and phone consultations with collateral providers. Dr. Roosa has also consulted with several area schools, either about individual children or about programmatic concerns. She speaks to parent or school groups, upon request.

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.

Exercise Before Medication: How consistent workouts can change your life

By | NESCA Notes 2019

By Billy Demiri, CPT
Certified Personal Trainer

Recently I came across an article that highlights what I have believed to be true since I first started exercising regularly myself…a healthy body will foster a healthy mind. The study shows that “lifting weights helps lift depression; cardiovascular activities reduce the effects of anxiety; and any type of movement improves mental health.” Throughout the study, patients were led in a structured exercise program for 60 minutes four times a week. An astounding 95 percent reported feeling better, and 91.8 percent were very pleased with their bodies during each session. With those kinds of results, exercise should be at the forefront of treating mental health issues before psychiatric drugs.

When I started working as a personal trainer and coach, I saw the positive effects that consistent exercise had on all of my clients. Here at NESCA, I have the privilege of working with some amazing kids and young adults—all dealing with different disabilities/mental illness from Autism Spectrum Disorder (ASD), Anxiety, Depression, Obsessive-Compulsive Disorder (OCD), Muscular Dystrophy, and Attention Deficit Disorder (ADD) or Attention-Deficit Hyperactivity Disorder (ADHD). My goal has always been to make exercise fun and challenging, while also trying to identify goals that drive each individual to want to make exercise a regular part of their lifestyle.

Using a variety of equipment, we work on agility, conditioning, strength, coordination and overall better movement mechanics. After six years of being a personal trainer, and working at NESCA the past year, I couldn’t agree more with the findings of the article. I continue to see firsthand that consistent exercise can unlock everyone’s full potential and, in turn, create a lot of joy and self-worth.

Over the past year, it has been spectacular to see each person progress from session to session—not just physically but mentally. One of my clients was struggling with staying on task and had a hard time completing one exercise at a time before he got frustrated and needed a break. Each session we kept on progressing, and one exercise turned into two, then three, until we built up to doing four-move circuits. Yes, he built up strength and endurance over time, but more Importantly, he gained confidence in himself. He learned that what he originally thought was daunting was actually easy and very doable. Then  he went one step further and wanted to make it even harder. It was amazing seeing his mood change from not wanting to do any exercise to smiling and celebrating after beating his previous time in a four-move circuit. By staying consistent with exercise and seeing himself improve each week, I could see noticeable changes in his self-esteem, on-task behavior and overall mood during workouts—not to mention that he also developed better movement patterns and gained strength, endurance and overall better health.

Based on my experiences, prescribing exercise before medication is a worthwhile approach to continue to look at. Each person needs to be looked at individually, and more research needs to be done to ensure the safety of the patient and others without medication, however it’s clear through research and my own experiences that exercise has positive impact on our overall well-being. It will take some time to change the norm of prescribing patterns, but we are heading in the right direction.

 

Related Links for Additional Reading:

https://bigthink.com/surprising-science/exercise-mental-health?fbclid=IwAR3bUtp7SQmpI4w6kITG0RVbVrS_XfE9K1eOIoa018iUpTds9WJrxAganL4

https://journals.sagepub.com/doi/full/10.1177/2164956119848657

https://nesca-newton.com/billydemiri/

 

About the Author:

Certified Personal Trainer Billy Demiri offers Personal and Social Coaching (PSC) at NESCA. Billy has several fitness certifications including: NSCA-CPT (National Strength Condition Association- Certified Personal Trainer) Certified and Autism Fit Certified.

 

To book sessions with Billy Demiri, complete NESCA’s online intake form and note that you are interested in Personal & Social Coaching.

 

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.

 

Just What the Doctor Ordered: A Director’s Update on Personal and Social Coaching (PSC)

By | NESCA Notes 2019

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

So many wonderful things have happened at NESCA in the past year including our recruitment of many talented interns, post-doctoral fellows, and staff members, the opening of an office in the Foxborough/Plainville Area, and the promotion of several staff. As Founder and Director, I continue to be both proud and humbled by the incredibly talented staff I go to work with each day and the community of families and professionals who allow us the privilege of being part of their lives.

As the New Year often brings about health resolutions, including the desire to increase one’s physical and mental fitness, I am taking this opportunity to spotlight one of our most exciting new staff and services at NESCA: Certified Personal Trainer and Autism Fit Instructor Billy Demiri who leads our Personal and Social Coaching (PSC) Program.

When I arrived to check on how things were going with his first training session,  I heard Liam (not his real name) say, “I make muscular dystrophy look easy!”  This proclamation from a 10 year old boy who had, just hours before, during his evaluation, protested loudly that he would “never work with a coach, no matter what!”    Following his diagnosis of muscular dystrophy, a progressive, degenerative disorder, Liam had become clinically depressed.  Over the past few years, he was often irritable, oppositional, volatile, and completely sedentary.  While a specialized school placement, psychopharmacological intervention and therapy had all been helpful, Liam was still struggling.  His mother and I both viewed physical activity as being an important intervention for him, for medical and psychological reasons.

They were scheduled to have their intake session with Billy Demiri, who heads NESCA’s PSC program, after lunch on the day of Liam’s testing.    Clearly, getting Liam to “sign on” was going to be a challenge.    So, I hatched a plan that I explained to Billy and to Liam’s mother.  Liam’s mother was to tell him that he didn’t have to work with the coach but that she herself wanted to talk with him.  I suggested that Billy focus only on talking with Liam’s mother and not give any attention to Liam.  While Billy and Liam’s mother chatted, Liam was reading a book but regularly glancing over at them, clearly interested.  Eventually, he couldn’t resist joining the conversation.  Billy invited Liam’s mother to look at the exercise room and Liam indicated that he wanted to go too.  Liam succumbed to Billy’s gentle encouragement and was soon navigating an obstacle course and doing hurdle steps…with a huge smile on his face, a smile that I had not seen in the course of our evaluation.  His mother’s smile was even wider.

Liam came back eagerly the following week for his training session.  When he and Billy took a break, Liam told Billy, “I like this!  I can use the stuff that we’re doing, like when I’m feeling mad or upset, to make me feel better.”  He then shared with Billy how hard it’s been for him to know that he has muscular dystrophy and to be depressed.

Billy is not a psychotherapist but he is warm and an empathic listener, a young man who children and adolescents like, respect and trust.  He has done a remarkable job forging a strong connection with each of his clients and skillfully uses that relationship as the basis for getting them to take risks, move out of their comfort zone, and persist in the face of challenge, which are all ingredients in developing “grit.”  Billy’s clients make impressive progress not only physically but also emotionally.  Many of Billy’s clients struggle with self-esteem and the concrete, measurable improvements that they see on a regular basis in their physical capabilities is a huge self-esteem booster.    In addition, through the Physical and Social Coaching program, his clients reduce their level of anxiety, increase coping skills and learn about setting and achieving goals.

NESCA takes a highly integrative approach to the delivery of therapeutic services.  In the case of PSC, Billy coordinates care with the neuropsychologists who have evaluated his clients or the psychotherapists who are treating them so that he understands the underlying social-emotional concerns to be addressed in his sessions.  After an initial assessment of movement patterns, he develops an individualized physical training program that will result in improved physical well-being and serve as a vehicle for social-emotional growth for the client. As NESCA’s Founder and Director (and also a client of Billy’s!), I am tremendously proud to be able to offer this unique and ground-breaking service to our clients.

 

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.

 

Want to learn more about PSC? PSC will initially available for clients who are part of the NESCA family and have already participated in testing, consultation, or therapy at one of our Massachusetts or New Hampshire offices. To learn more about services, please email bdemiri@nesca-newton.com. Or, to book an intake with Billy, please complete NESCA’s Intake Form at https://nesca-newton.com/intake-form/ and select “Personal and Social Coaching (PSC)” as your reason for referral.

 

To book an evaluation with Dr. Helmus, NESCA Founder and Director, 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/Foxbourough, 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.

 

 

First Recommendation: Take up Golf

By | NESCA Notes 2018

 

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

A five-year old boy, whom I will call Marcel, was referred by his parents for evaluation to determine if he had Autism Spectrum Disorder (ASD) because he isolated himself socially. With a great deal of effort, I got Marcel through the neuropsychological evaluation process and observed him at his pre-school. Results of the evaluation revealed a significant communication disorder but no other symptoms of ASD. He was socially isolated because he didn’t have the language skills to interact easily with others. Although his verbal abilities were limited, Marcel’s visual-spatial skills were superior, based on testing results. During my school observation, I was struck by his ability to focus intently, seemingly immune to distraction, on building an extensive highway system for his cars for more than an hour.In thinking about treatment for Marcel, my top priority was to conceive of a plan for luring him out of his “own world” where he retreated much of the time to avoid the communication demands inherent in engaging his surroundings. Because the language skills of young children develop most rapidly in social contexts, increasing Marcel’s opportunities for interaction with others would be expected to improve both his language skills and his social confidence. Since people can be most readily induced to change by leveraging their strengths, I asked myself, “What activity requires superb visual-spatial skills, and the ability to concentrate for hours on visual stimuli?”, both conspicuous strengths for Marcel. I also wanted an activity that would provide ample opportunities for interactions with others but not demand it.Deciding that Marcel was too young to become a pool shark, I recommended golf to his parents, explaining my reasoning. I told them that, in addition to using Marcel’s natural strengths to build a skill that would enhance his self-esteem, golf would provide a “controlled social arena”. Marcel could get away with socializing primarily about the game, which would require him to use a limited vocabulary (e.g. birdie, bogey, slice) whereas socializing in less controlled environments involves a broader range of topics and associated language demands.Marcel excelled with golf, quickly mastering the game and often playing more than 36 holes during weekends, such that he was interacting with others throughout the day, instead of engaging in solitary pursuits, but still “having a break” from other people while he focused on his game. He and his family were rightfully proud of his tournament trophies and Marcel established relationships with his teammates and coaches. As he spent more time interacting with others, Marcel’s communication skills and self-confidence blossomed.

When I saw him recently for his two-year follow-up evaluation, Marcel told me that he wanted to switch from golf to tennis “because its more social”.

Leveraging a child’s strengths can be one of our most potent tools for remediating weaknesses.

 

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 a consultation with Dr. Helmus 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.

 

Catch Them When They’re Good!

By | NESCA Notes 2017

 

By:  Ryan Conway, Psy.D.
NESCA Clinical Psychologist

If your child’s go-to response to your requests is typically “no,” then keep reading…

Children who tend to disobey rules, become easily agitated, experience temper outbursts and argue with authority figures are known to display a pattern of behaviors called disruptive behaviors. These behaviors can cause significant family turmoil and become quite challenging for schools to manage. Children who have trouble regulating their emotions and behaviors may be pinned as “the bad kids.” This is unhelpful because it does not explain what exactly is underlying the acting out. This type of reputation can also impact a child’s self-esteem, resulting in feelings of inadequacy and self-doubt. Disruptive behaviors could be masking other issues that are not obvious to teachers and parents. Consider the possibility that the kindergarten student who shuts down and refuses to engage in class is not oppositional, but instead experiencing anxiety about being away from his mother or father. Maybe the second grader obtains his parents’ attention most often at home when she lashes out. In trying to control disruptive behaviors, children get a lot of attention from adults for what they are doing wrong, often times unintentionally.

One of the hallmarks in teaching caregivers how to effectively manage these kinds of behaviors is positive parenting, which comes from a behavior therapy approach. Among positive parenting techniques is “catching them when they’re good,” which shifts the focus away from what is problematic and towards the appropriate behaviors parents want to see continue. With this technique, parents become more mindful about the behaviors they attend to and seek out opportunities to let their child know when he or she is on the mark. It feels good for both the giver and the receiver, and can bring you closer to your child!

Positive feedback is a powerful tool at any age. For children, it comes in many forms – a sticker for helping to set the dinner table, a praise statement (“I’m so pleased that you are using gentle hands with your brother”), even a hug! As your child starts to recognize that you are giving more attention to appropriate behaviors, they will similarly shift from negative actions (e.g., sassing off, whining, crying, etc.) to positive ones.

Behavioral parent training empowers caregivers by teaching them specific skills to not only manage their children’s behavior at home, but also to improve communication, build warmth within the parent-child relationship and create a calmer household. The Society of Clinical Child and Adolescent Psychology (SCCAP), a group dedicated to disseminating information about evidence-based therapies for youth mental health problems, sites behavior therapy (individual parent and groups of parents with or without child participation) as the most efficacious treatment for disruptive behaviors in children. The SCCAP website, www.effectivechildtherapy.org, was recently updated and is a helpful resource for parents seeking information and guidance about treatment for children and teens.

NESCA is excited to be offering a new group for parents and children ages 7-10 who exhibit disruptive behaviors and/or ADHD symptoms. This group will have separate parent and child sections – with opportunities for combined parent-child sessions – and utilize both behavioral and cognitive-behavioral techniques. For additional information, visit http://www.nesca-newton.com/events.html.

Or visit our previous article about behavioral parent training and the research backing this approach: http://www.nesca-news.com/2017/04/parent-training-programs-101.html.

 

About the Author:

Conway

Ryan Ruth Conway, Psy.D., is a licensed clinical psychologist who specializes in Cognitive Behavioral Therapy (CBT), behavioral interventions, and other evidence-based treatments for children, adolescents and young adults who struggle with mood and anxiety disorders as well as behavioral challenges. She also has extensive experience conducting parent training with caregivers of children who present with disruptive behaviors and Attention-Deficit/Hyperactivity Disorder. Dr. Conway has been trained in a variety of evidence-based treatments, including Parent-Child Interaction Therapy (PCIT), Dialectical Behavior Therapy (DBT), and Exposure with Response Prevention (ERP). Dr. Conway conducts individual and group therapy at NESCA utilizing an individualized approach and tailoring treatments to meet each client’s unique needs and goals. Dr. Conway has a passion for working collaboratively with families and other professionals. She is available for school consultations and provides a collaborative approach for students who engage in school refusal.

 

If you are interested in working with Dr. Conway or have any additional questions about NESCA’s therapy services, please 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.