NESCA’s Newton, MA location has immediate availability for neuropsychological evaluations. Our MA clinicians specialize in the following evaluations: Neuropsychological; Autism; and Emotional and Psychological, as well as Academic Achievement and Learning Disability Testing.

Visit www.nesca-newton.com/intake for more information or to book an evaluation.

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6

NESCA Offers Vermont-based Transition and Coaching Services

By | Nesca Notes 2023

By: Jane Hauser
Director of Marketing & Outreach, NESCA

NESCA recently announced that it is now offering transition services and coaching services in the Greater Burlington, Vermont region. Learn more about what is being offered by our Vermont-based staff from my interview with Vermont-based Program Manager Dr. Lyndsay Wood, OTD, OTR/L.

Why did NESCA expand to Vermont and how can clients benefit from your services?

NESCA is expanding our in-person services to Vermont to widen the breadth of transition services offered within the state. Through research and conversations with local professionals and parents, we recognized that there is an opportunity to bolster local transition services for students to meet their personal postsecondary goals and to live fulfilling lives post-high school. Through our variety of services, our goal is to empower teens and young adults to create their own vision for the future and build the skills necessary to achieve it. This is important for students currently in public middle and high schools as well as local college students and young adults new to the world of work. At NESCA, we take a relational approach with to build a strong foundational relationship between ourselves and the clients we support. Our priority to is create a safe, inclusive, and welcoming environment within our sessions.

What services do you offer?

At this time, NESCA’s Vermont-based practice will offer transition assessment, real-life skills coaching, executive function coaching, transition consultation, and functional community-based occupational therapy evaluations. All Vermont-based services are delivered by experienced occupational therapists and transition specialists with expertise in developing functional and relevant goals. For more information on each of these services, please visit our website and view our Post-Secondary Transition Services and Coaching Services links: https://nesca-newton.com/our-services/. Many folks are unfamiliar with transition assessments, so to learn more, see the following blog written by our Director of Transition Services Kelley Challen, Ed.M., CAS: https://nesca-newton.com/transition-assessment-what-is-it-anyway-how-is-it-different-from-neuropsychological-evaluation/.

What type of client does NESCA serve in Vermont?

NESCA’s Vermont-based practice primarily works with teens and young adults with autism spectrum disorders (ASD), attention-deficit/hyperactivity disorder (ADHD), mental health diagnoses, specific learning disabilities, executive function (EF) challenges, and other complex cases based on the expertise of our providers. A specialty at NESCA is working with clients who have multiple diagnoses or who don’t fit neatly into a singular diagnostic box.

Where are you in Vermont? Are services in-person or remote?

Coaching services will be offered in the home, school, or community within the greater Burlington area. Services can also be delivered remotely if deemed appropriate for the client. Transition assessment is typically conducted within the client’s school setting.

What is different about what NESCA offers in Vermont compared to other organizations or services already available?

NESCA will be a premier independent transition assessment provider in Vermont. We are happy to collaborate with school districts or work with families directly. Additionally, we are unique in providing one-on-one occupational therapy services that specifically address life skills within a client’s home and community setting. Working within the home and community, and not only within the school setting, is incredibly important for the generalization of life skills as well as social skills, functional academic skills, and executive functioning skills.

Does insurance cover your services in Vermont?

NESCA is primarily a private pay service provider. Some families are able to obtain some coverage or reimbursement for our real-life skills coaching service with their health insurance, but it is vital that folks first check with their insurance provider to ensure our services would be covered.

How do people get more information about NESCA’s Vermont services?

To learn more about NESCA, please visit our website at: https://nesca-newton.com/.

If you would like to fill out an intake form, follow this link: https://nesca-newton.com/intake.

If you have more specific questions, do not hesitate to call: 617-658-9818

Additionally, you can contact our Vermont-based Program Manager Dr. Lyndsay Wood, OTD, OTR/L, directly at: lwood@nesca-newton.com

 

About Lyndsay Wood, OTD, OTR/L

Lyndsay Wood, OTD, OTR/L, is an occupational therapist who focuses on helping students and young adults with disabilities to build meaningful skills in order to reach their goals. She has spent the majority of her career working in a private school for students with ASD. She has also spent some time working in an inpatient mental health setting. Lyndsay uses occupation-based interventions and strategies to develop life skills, executive functioning, and emotional regulation. While completely her doctoral degree at MGH Institute of Health Professions, Lyndsay worked with the Boston Center for Independent Living to evaluate transition age services. She uses the results from her research to deliver services in a way that is most beneficial for clients. Specifically, she focuses on hands-on, occupation-based learning that is tailored the client’s goals and interests.

 

To book coaching and transition services at NESCA, complete NESCA’s online intake form. 

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

161

College Freshman and Executive Function: The Often Unexpected Demands

By | NESCA Notes 2022

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

It is no surprise that the experience of a high school student is vastly different than that of a college student. This transition is seen as a pivotal step towards independence as we send students off to learn, grow, and explore in an often substantially less supported and less controlled environment. The hope is that after 13 years of K-12 education, our students have developed the academic, communication, and organization skills needed for success in school. They know the tricks of the trade. They have systems to employ and even more systems to fall back on if needed. They have become experts at learning, and they know the drill. But what happens when students get to college and everything, from the style of instruction, to the flow of coursework, all the way to the demands outside of learning are just…a little bit different? For some students, this is a welcome opportunity to rise to the challenge, but for others, this is a daunting, overwhelming, and seemingly impossible ask. As an occupational therapist specializing in executive function, I have spent the last few years directly supporting those college freshman – the ones who look at the new demands and think, “I was never prepared for this, I don’t know if I can do this.” And I don’t blame them for feeling that way! The demands and expectations truly change. Here are a few that stand out:

  • Time management – High school schedules are rigid. Students are expected to arrive at a specific time, follow a block schedule, and make it to each of their classes (generally all in one building). If they forget what period it is, they can ask a friend, teacher, or almost anyone in the hallway. Conversely, every student in college has their own schedule that they are expected to track and manage. On Monday, they may be in class from 10am-2pm, while on Tuesday they are in class from 3pm-5pm on the other side of campus. There is no one to quickly ask or check in with regarding when and where they are supposed to be and consistency is rare. This trouble is further compounded by the fact that college coursework requires a substantial amount of work to be done outside of the classroom that must be planned for and built into the weekly schedule.
  • Reading a syllabus – While “reading a syllabus” may sound simple, these documents are often over 20 pages long, providing information about course content, course expectations, professor’s preferred method of communication, grading systems, and a full schedule of what is due and when. Additionally, each of these documents uses a different format and is frequently amended during the semester. High school students are used to an online portal that is consistently used by their teachers and provides built-in reminders and updates. Syllabi are tricky, and many students skim them without absorbing.
  • Assignment tracking – As mentioned above, college portals are nowhere near as comprehensive, up-to-date, or accurate as most ex-high school students expect. Professors may change a due date in class without updating a syllabus or expect students to keep track of a paper that is due more than a month away. Many college students need support putting a system in place to quickly consolidate due dates, set internal deadlines, and track what they need to hand in. This is especially important when breaking down large assignments into manageable chunks or learning to prepare in advance to for busy times in the semester, such as midterms or finals week.
  • Communicating with instructors – Many college students need support in pushing themselves to attend office hours, reach out early and often via email if they have questions about classwork or assignments, and even introduce themselves to their professors.
  • Developing healthy habits and routines – On top of academic executive function demands, college students are dealing with an increase in life-based executive function demands. They are managing their own eating habits, morning routines, evening routines, and organizing all of their personal belongings in their own space. Completing all of this while maintaining life balance can be tricky, and may require some support.
  • Accessing accommodations – The accommodation process at a college level is vastly different from the IEP or 504 process in high school. While this topic could be a blog on its own, the biggest takeaway for me is the level of responsibility that falls on the students. They are in charge of letting each professor, at the beginning of every semester, know about their accommodations for sitting in classes, taking exams, or turning in assignments. This requires a level of self-advocacy and functional communication that they may not have had to demonstrate in high school. This demand does not disappear throughout the semester, as they often need to remind professors a week before an exam about their needs or independently book a room to take their test.

While this may seem like a lot, the good news is that our students have learned how to learn. Their systems may need updating, and their strategies may need fine tuning, but with guidance I have found college success to be a truly achievable goal. I often find that once provided with a foundation and tips for how to be successful, my college freshmen do rise to the challenge and eventually build the ability to do all of this independently. If you feel that your student could benefit from some executive function support as they embark on their college journey, please reach out about NESCA’s EF Coaching Program!

 

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

 

To book an appointment or to learn more about NESCA’s Executive Function 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.

 

158

Executive Function: Skill Building and Maintenance over the Summer

By | NESCA Notes 2022

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

With summer right around the corner, many students are thinking of warm evenings outside, days at the beach, pool or park, summer camps, and summer jobs. For parents, summer can sometimes feel like both a time of fun and a time of struggling to keep up with skills mastered and learned throughout the past school year, all while acclimating to a completely new summer routine. While some students receive summer services to keep up with important academic and executive function skills, there are absolutely ways for us to help support children and adolescents at home. Consider these three ways to incorporate executive function skill building into your child’s summer.

  1. Plan and Complete a Project – Work with your child to brainstorm a project that they would like to complete this summer. Some examples include having a lemonade stand, building a tree fort, doing a full bedroom makeover, or raising money for a cause they care about. Help your child figure out how to put together a plan to complete their goal. This will likely include a timeline complete with a comprehensive “To Do List,” a list of materials or supplies, and a list of people they may need to ask for help. The more intentional the planning of these steps is, the more a child will internalize the level of planning and prioritization that goes into accomplishing such a goal. You may need to jump in to help, but take every opportunity to defer to them and let them actively think things through before making suggestions or solving problems for them. Planning and executing a personal summer project helps to build organization, planning and prioritizing, flexible thinking, working memory, and task initiation.
  2. Organize a Family Outing – Summer can absolutely be a whirlwind, but reserve a day in the calendar for your child to plan a family outing or activity. This could be as big as a full day at the beach or as simple as a trip to lunch at their favorite restaurant. Help them think through everything that will be needed. What time will we leave? How long will it take to get there? How can you find that information? Should we check Google Maps together? How will we pay for the meal? By guiding your child through all of the steps before these activities, you help them recognize the level of planning and forethought that is necessary. For older children or adolescents, consider giving them a budget and asking them to plan a family outing independently, taking into account each family member’s preferences and schedules.
  3. Add a Weekly Task – During the school year, parents often do not have time to add chores or anything new at all to their child’s calendar. Dinners are often prepared and eaten on the fly between rehearsals, appointments, practices, and homework, and laundry gets done when someone has a free moment. Summer can be a great time of the year to add in an expectation for students who have been a bit overloaded with homework or other distractions. Consider adding a weekly task that student both need to complete and figuring out a way to remember (often a digital reminder!). One of my favorite options is to have a student cook a meal for the family one night per week. Have them set an alarm for 12pm that day, or even the day before, that prompts them to “figure out the plan for dinner.” This may look drastically different at various ages. An eight-year-old may be very proud of themselves for serving boxed macaroni and cheese (made with supervision), while a high school student may be up for trying to recreate a family recipe. The goal is not a gourmet Tuesday night meal, but practice with prior planning, sequencing, following directions, and building time management skills.

Incorporating children and adolescents into the planning, hard work, and many executive function tasks that go in to making a summer run smoothly allows them to build skills naturally. By handing down responsibility and increasing expectations bit by bit, we can allow our students to build their skills slowly and confidently. It’s important that students realize all of these many steps before they are expected to do everything on their own. Often, allowing children to feel this level of control and responsibility leads them to feel quite accomplished and proud of themselves! If you feel that facilitating this may be tricky, consider reaching out about executive function coaching, as all of these strategies can be practiced one-on-one with a coach!

 

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

 

To book an appointment or to learn more about NESCA’s Executive Function 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.

 

158

Executive Function and Goal Setting

By | NESCA Notes 2022

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

Personal, professional, and academic goals are a large part of what drives us as we transition from one stage of life to the next. They also provide direction as we choose and maintain the habits and routines that we feel are important to daily life. Determining what our goals are is a big step, one that students are often working on with their families, school supports, and friends as they start to figure out their next steps in life. But once these goals are solidified, what’s next? How  do we get there? As an executive function coach working with high school and college students, I can attest that this can unexpectedly be the most difficult step in the process. Let’s talk about some ways that we can support students in these endeavors.

  1. Break down goals into manageable chunks. Many goals tend to be large or long-term and can feel daunting and amorphous. For example, a common goal for high school seniors might be, “I will apply to five colleges by their application deadlines.” We can help students by breaking a goal like this down and creating step by step lists, such as: put together a list of preferences for my ideal school, research schools that fit these preferences, meet with guidance counselor to review my research, finalize list of five schools, ask teachers for letters of recommendations, fill out each section of the Common App, write personal essay, have English teacher or other support person review personal essay and give feedback, etc. This list is not comprehensive, but it does show how much goes into the seemingly simple initial goal.
  2. Help them prioritize. Once students have created a comprehensive list of steps, help them to understand what steps need to be attended to right away and which can wait. Continuing with the example of applying to college, figure out what steps need to happen before the Thanksgiving or winter break! It may also be helpful to figure out which steps seem difficult for your specific student. For some, this may be writing the personal essay; for others, it may be building up the courage to ask a favorite teacher to write them a recommendation. Busy students who are already taking multiple classes may have trouble figuring out how to add the steps needed to reach another goal into their schedule.
  3. Put together a plan. Set a timeline. Put internal deadlines into a calendar. Figure out specific times to work towards the goal. Find people who can be solid supports and help to make things happen.
  4. Check in on them. Offer to check in along the way. Some students will love having a partner to track their progress with, while others simply need help setting the foundation.

While this example is very concrete and includes working towards a specific predetermined deadline, not all goals need to be. Whether your student’s goal is to find a summer job they enjoy, get an average of a B in all of their classes, or find a new hobby that makes them happy, using these strategies can help to make a goal feel more manageable.

Finally, you might notice that these steps are quite similar to some of the strategies for completing specific academic tasks, and you would be right! Take, for example, writing a research paper. We want students to break that task down into smaller pieces, such as finding sources, creating an outline, writing a rough draft, and developing a final draft. We then help them to prioritize which steps will need more time to complete and eventually put together a plan so they dedicate sufficient time to each section and submit a final draft on time. Many of the academic executive function tasks that we learn in school create processes and roadmaps for how to tackle life skills that require similar executive function skills. However, not all students can transfer these skills to setting goals without some direct support or help seeing the similarities in the process.

 

To learn more about Executive Function from Dr. Bellenis, join her along with Dan Levine from Engaging Minds, for a free webinar, “Executive Function in the Covid Era: Managing School and Life (Kindergarten through High School),” on March 8 at 7:00PM ET.

Register now: https://engagingmindsonline.zoom.us/webinar/register/WN_vWNlilZkS36imBqvr4IMZQ

 

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

 

To book an appointment or to learn more about NESCA’s Occupational Therapy Services, please fill out our online Intake Form, email info@nesca-newton.com or call 617-658-9800.

 

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

 

157

Occupational Therapists and Transition Assessment, A Natural Fit!

By | NESCA Notes 2021

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

Being an occupational therapist (OT) often means working in a profession that many people do not have extensive experience with or knowledge about. It can be hard to give one definition of this profession when OTs are at hospitals and schools, working on advocacy in DC, running mental health groups, and in some cases even responding to natural disasters. We are all around! Despite the broad range of settings, OTs are all guided by the Occupational Therapy Practice Framework: Domain and Process (AOTA, 2020), an ever-evolving framework that describes the central concepts, foundational views, and basic tenets of the profession. As an occupational therapist who has worked in schools with a huge focus on access to the curriculum, functional skill building, and increasing students’ overall participation, I frequently reference the document to ensure I am staying true to my profession and using my lens to help support clients’ goals in the most effective ways possible. As a member of the transition team here at NESCA, I have been fascinated by the natural fit between occupational therapy and transition assessment. Both of these require a holistic lens, consideration for the client as well as their environment, and an ability to focus on multiple different aspects of a person’s life simultaneously.

While occupation is sometimes considered a synonym for “job,” OTs focus on the broader definition of occupations as, “the everyday activities that people do as individuals, in families, and with communities to occupy time and bring meaning and purpose to life. Occupations include things people need to, want to, and are expected to do” (WFOT, 2012). We consider nine separate “areas of occupation,” which include: Activities of Daily Living (bathing, showering toileting, etc.), Instrumental Activities of Daily Living (driving, financial management, meal preparation, etc.), Health Management (medication management, social and emotional health promotion, physical activity, etc.), Rest and Sleep, Education, Work, Play, Leisure, and Social Participation. We want to make sure that individuals have balance, are meeting their personal goals, and feel fulfilled by the activities of life. OTs both assess and provide direct intervention around all of these areas.

Similar to occupational therapy, transition assessment is complex and broad, and it is best thought of as an ongoing process incorporating a wide range of formal and informal assessment of a student’s strengths, interests, and preferences. When developing recommendations for transition assessments, we work in accordance with the federal law (as well as the Massachusetts Student-Driven Transition Model core areas of transition planning) to relate our findings to the demands of transition planning areas: Education/Training, Employment, Independent Living, and Community Participation. Each of these areas needs to be considered as a part of the transition planning process and plays a substantial role in putting together a comprehensive vision for a student.

As I compare the areas of occupation with the core areas of transition planning, I am struck by the similarities and constant overlap. There is an emphasis on functional independence, especially in daily living skills. There is the belief that connection and community are integral parts of life. There is also a need for purposeful activity, whether that be through work, continuing education, play, or all of the above. Each of the areas that OTs so passionately feel guide our work are areas that should be assessed and considered during transition assessment and planning. The lens through which OTs are taught to assess and evaluate clients lends itself perfectly to assessing students as they plan for their futures and transition out of high school. While there are many different ways that I could have applied my OT training, I am glad to be able to apply my expertise to transition assessment at NESCA as one of the ways we help youth and young adults achieve their goals and carry out fulfilling lives.

References

American Occupational Therapy Association. (2020). Occupational therapy practice framework: Domain and process (4th ed.). American Journal of Occupational Therapy, 74(Suppl. 2), Article 7412410010. https://doi.org/10.5014/ajot.2020.74S2001

Massachusetts Department of Elementary and Secondary Education. (2021). Massachusetts student-driven transition model. Retrieved from https://www.doe.mass.edu/sped/secondary-transition/resources-materials.html.

World Federation of Occupational Therapy. (2012) Definition of occupational therapy. Retrieved from https://wfot.org/about/about-occupational-therapy

 

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

 

To book an appointment or to learn more about NESCA’s Occupational Therapy Services, please fill out our online Intake Form, email info@nesca-newton.com or call 617-658-9800.

 

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

 

157

Handwriting vs. Typing: Where do we draw the line?

By | NESCA Notes 2021

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

For many of our students with dysgraphia, or those who struggle with the fine motor precision and the skills necessary for written output, digital tools and accommodations that promote the use of tech and keyboarding in the academic setting are immensely helpful. These tools allow our students to show their knowledge, demonstrate their written abilities, and fully access their curriculum.  When implemented correctly, these accommodations can have a huge impact on a student’s academic career. While all of this is true, it is worth discussing whether fully taking away the need to produce and practice handwritten work is leaving some of our students at a disadvantage.

When working with adolescents and young adults to help figure out future career or education plans, I am consistently reminded of the fact that despite our continuing transition toward a more and more digitally-based world, the need for handwriting has not disappeared. While we absolutely do not need to be handwriting essays, papers, or long letters sent via snail mail, there are aspects of almost every profession and daily life that require the skill. Here are a few common issues that I am seeing pop up that speak to the need for some continued practice –

  1. Job or rental applications. While some of this has moved over to an online format, many of these still need to be filled out appropriately and legibly by an applicant.
  2. Jotting down notes. The importance of this skill should not be diminished. Whether taking a phone message, making a grocery list, or writing down a phone number, most young adults are expected to be able to read their own handwriting at a later date, or leave a message for someone else who will need to be able to read it.
  3. Vocational responsibilities. Many of our students with disabilities choose to forgo the traditional college path and find a more suitable career field to pursue. Many of my clients have become successful carpenters, mechanics, or other tradespeople. These fields all require vast skill and talent, and often require employees to mark down measurements or make quick notations.
  4. Signing documents. Many banks, institutions, and legal documents require a handwritten signature and initials on any paperwork.

While I am not advocating that we take away accommodations from our students who do not have the foundational skills to write long paragraphs or essays, I am advocating that we stop fully eliminating the demand. By expecting some quick, consistent practice of handwriting, we are building a skill that will be needed multiple times throughout life. I would suggest that students who are being given a keyboarding fine motor/visual motor accommodation, also continue to receive instruction or opportunities to practice writing activities that are less fatiguing in order to continue to build the motor planning and skill necessary. It is unfair to equate the inability to use handwriting as a tool for academic output, with an inability to learn handwriting as a useful functional tool for life.

 

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

 

To book an appointment or to learn more about NESCA’s Occupational Therapy Services, please fill out our online Intake Form, email info@nesca-newton.com or call 617-658-9800.

 

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

 

158

Put Me In, Coach!

By | NESCA Notes 2021

 

Coaching Services at NESCA

For students and young adults with social, emotional, organizational and/or learning differences, hands-on instruction in real-world environments is a critical means of developing skills for postsecondary living, learning and working. NESCA is pleased to offer individualized home-, community-,and office-based coaching services as well as remote coaching services, delivered by a team of seasoned Occupational Therapists (OTs), Vocational Counselors and Transition Specialists to support the needs of transition-age youth.

 

Meet the Coaches

 

Sophie Bellenis, OTD, OTR/L

Dr. Sophie Bellenis is Licensed Occupational Therapist in Massachusetts, specializing in pediatrics and occupational therapy, including school-based service delivery. Dr. Bellenis has expertise in working with tweens, teens, and young adults with a wide range of social, emotional, and developmental needs. She joined NESCA full-time in the fall of 2019 in order to oversee the Real-life Skills Coaching program as well as to carry out transition assessment, occupational therapy assessment and treatment services. One of the keys to Dr. Bellenis’ success coaching students and young adults is her ability to form a meaningful relationship with each client and use that relationship to motivate lasting change.

 

 

 

 

Aubrey Matthews, OTD, OTR/L

Aubrey Matthews, OTD, OTR/L, is an occupational therapist who has focused most of her career on mental health and skill building for adolescents and young adults. She currently works full-time at a behavioral health hospital, splitting her time between the inpatient adolescent unit and the young adult intensive outpatient program. Aubrey tends to focus on building emotional regulation, executive function, and social skills through occupation-based strategies. Aubrey’s doctoral research at the MGH Institute of Health Professions focused on using LEGO therapy to build social skills at a pro-bono pediatric program, and she uses many of these creative strategies to increase client motivation and success.

 

 

 

 

Jasmine Badamo, MA

Jasmine is an executive function coach, and a New York State Certified ENL and Special Education teacher. She earned her bachelor’s degree in Biological Sciences from Cornell University and her masters degree in TESOL from CUNY Hunter College. She has over 10 years of teaching experience across three countries, and has worked with students ranging in age from 7 years to adults.
Her work focuses on creating individualized supports based on the specific needs and strengths of each client, and supporting the development of metacognition, executive function skills, and independence. Building an authentic connection with clients is a top priority, as this allows her to provide the best supports possible.

 

 

 

 

Lyndsay Wood, OTD, OTR/L

Lyndsay Wood, OTD, OTR/L, is an occupational therapist who focuses on helping students and young adults with disabilities to build meaningful skills in order to reach their goals. She has spent the majority of her career working in a private school for students with ASD and related social, emotional and executive functioning challenges. She has also spent some time working in an inpatient mental health setting. Lyndsay uses occupation-based interventions and strategies to develop life skills, executive functioning, and emotional regulation. While completing her doctoral degree at MGH Institute of Health Professions, Lyndsay worked with the Boston Center for Independent Living to evaluate transition-age services. She uses the results from her research to deliver services in a way that is most beneficial for clients. Specifically, she focuses on hands-on, occupation-based learning that is tailored to the client’s goals and interests.

 

 

 

Visit our website for more information about NESCA’s Coaching Services or complete our online Intake Form. 

157

Executive Function Tips: The Google Drive

By | NESCA Notes 2021

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

As we slowly start to emerge from lockdown measures, social distancing guidelines, and living life through the screen, there are few lessons that we have learned that still hold importance and should maintain their place in our lives. When it comes to executive function, a lesson that sticks with me is the need for digital organization and functional systems that help us stay in control. One tool that students often use every day, but very rarely receive direct instruction in, is the Google Drive. I have found that students often do not fully understand the concept of an online drive, including how this differs from saving a document to a hard drive, or why it is important to have folders and systems in place.

Now that students often have email address that they set up early (some parents reserve email addresses long before their children can use them!), and stay with them long-term, there is a risk of Google Drive quickly becoming unmanageable or filled with unnecessary documents. Once the drive becomes cluttered, many students are unable to reign it back in and put systems into place. Below, find some tips for how to help students use the Google Drive as a tool to promote digital organization, as opposed to a landing spot for any new download, file, or assignment.

Tips

  • Set up folders. Through high school and often beyond, our students live their lives on a September through August calendar. They see September as the beginning of a year and often think of time in terms of grade level, as opposed to biological age or calendar year. Starting in either kindergarten or first grade, students should have a folder for any academic work from each grade. By setting up this system early, students start to build the habit of saving documents to the correct place. It can also be helpful to have folders for extracurricular activities, such as Boy Scouts, Math Tutoring, Club Soccer, or simply Personal Work.
  • Set up subfolders. Once students start taking multiple classes at a time, there is a need to further organize. Starting in fourth or fifth grade, many students switch classrooms to see different teachers for their core subjects. As soon as this starts, add folders for each subject, such as Math, Science, History, and ELA.
  • Name documents purposefully. Some of the students I work with spend longer trying to find their assignments than they do working on the assignment itself. This is often because folders are not set up, but also because students often do not remember what they named an assignment. Teach your children to name their files in a fashion that they can quickly find again. Examples include: year_subject_assignment (20/21_math_knowledge check1), teacher name_year_assignment (Smith_20/21_WWII Article), or teacher name_assignment (Jones_Mockingbird Essay).
  • Set up an end of year clean out. At the end of each school year, take the time to sit with your student and clear their drive of clutter. Many students will only want to save a few important assignments or essays from each school year. That being said, make sure they do not delete important resources! This sets them up for success when they jump back into school in the fall.
  • Review the hard drive. Teaching our students which documents should be saved to a hard drive or printed out and saved as a hard copy is hugely helpful. Even reviewing the difference between a hard drive and an online drive helps provide valuable information. Many of us were introduced to computers when saving to the hard drive was the only option. Once an online drive was introduced, we naturally knew the difference. This is not the case for current students. For most of their academic lives, there have been two options or places to save their assignments, and it can be hard to define the differences between the two.

 

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

 

To book an appointment or to learn more about NESCA’s Occupational Therapy Services, please fill out our online Intake Form, email info@nesca-newton.com or call 617-658-9800.

 

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

 

157

Executive Function Tasks – Medication Management

By | NESCA Notes 2021

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

Medication management is an extremely complex executive function task that many of our students will have to master before they are able to tackle living alone. While there are many executive function tools available to help organize and remind individuals about their medication, there are also some long-term teaching strategies and opportunities for habit building throughout a students’ middle and high school career that parents may want to capitalize on before their children leave the home. Today we will explore some of the commonly used tools to help with medication adherence and touch on a few tips and suggestions to help adolescents develop a base of knowledge around their own health status and need for medication.

Tools

Seven Day Pillbox – The most ubiquitous tool to help individuals keep track of medication is a weekly pillbox. This may seem like a simple tool, but pillboxes are hugely varied and have many different additional features. Make sure to consider how many boxes there are per day (morning, afternoon, evening, etc.), whether there is a need for different colors to help with visual discrimination, and whether an audible or vibrating alarm could be beneficial. All of these are potential options that are built into the different pillbox options provided below:

Automatic Pill Dispenser – Some individuals may benefit from having the added support of a pill dispenser that automatically dispenses the correct prescriptions at the time they should be taken. Here is one example of this tool:

The Calendar – Those who have read my previous blog regarding the wonders of a functional digital calendar are likely unsurprised by this suggestion, but make use of this fabulous tool! Adding in an appointment to refill pillboxes, marking down anticipated dates to refill prescriptions, and setting notifications or alarms to go off when it is time to take medication each day can help students remember each step of the process.

Tips

Involve children in filling their pillboxes as early as possible. Many children will enjoy sitting down with a parent to place the pills in each little box and feel special when they are given some responsibility. When this is normalized as a typical part of a week, it becomes an expected activity of daily living for children. Make sure to point out the things that you notice as you fill the box. For example, stating, “Oh! I only count five pills left, that means I need to call and refill the prescription today,” each month will help your child to associate a nearly empty bottle with the need to problem solve.

Set a specific time or day of the week to refill pillboxes. Many children will continue to stick to routines and habits that they built up through childhood once they venture out of the home. Consider designating a specific time of the week to fill a pillbox together. For example, if Sunday after dinner works consistently, make this part of the family routine.

Pair medication with a daily task. Some individuals enjoy using alarms as reminders; however, others feel much more empowered by simply building medication into their routine. Pairing medication with an activity that happens daily anyways, such as brushing teeth in the morning, makes it easier to remember without direct prompting.

Help your child or adolescent put together a medication chart. Many of our children do not know the reasons for their medication. They are unaware of the intent, potential side effects, exact dosage, or name of the medication itself. The more our children and adolescents understand, the better they are able to advocate for themselves to doctors or other health professionals. Putting together a one-page medication chart that outlines all of this important information – in terms that can be easily understood and communicated to others by the child – can help children feel empowered in their conversation about their health. Consider adding a picture of each pill or capsule if they routinely appear the same. At times, pharmacies may unexpectedly need to fill generic prescriptions from different manufacturers, based on availability or other factors, therefore lending to a different appearance of the same generic prescription. This medication chart can also be a helpful tool to reference when adolescents start to independently fill their pillboxes.

Refill prescriptions together. While refilling prescriptions at the pharmacy is often a task that needs to be led and managed by adults, it’s still possible to include adolescents so that they start to learn the process. A great first step is to call the pharmacy on speaker phone and allow your child to listen in for a few months in a row.

 

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

 

To book an appointment or to learn more about NESCA’s Occupational Therapy Services, please fill out our online Intake Form, email info@nesca-newton.com or call 617-658-9800.

 

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

 

154

Executive Function Tools: Natural Consequences

By | NESCA Notes 2021

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

In my last blog that focused on executive function tools, I delved into the benefits of using and committing to a digital calendar. The calendar is a concrete tool that can be directly taught to students using traditional methods. Less concrete, but in many ways equally useful, is this next executive function tool – the natural consequence.

When most people think of natural consequences, they think of younger children refusing to do things like eat a meal that their caregiver prepared or put on a coat when it is cold outside. If a child refuses their dinner, the natural consequence is hunger. If a child refuses to wear their coat, the natural consequence is feeling cold. These are consequences that will happen without parents or caregivers explicitly providing a consequence. When it comes to executive function mishaps, the natural consequence is often the need to independently deal with the fallout.

Many of the students I serve directly need scaffolded executive function support with direct instruction and specific opportunities for practice. I am not advocating for removing these services or throwing these students to the proverbial wolves. What I am advocating for is using mistakes or lapses in executive function skill as learning opportunities, as opposed to absolving our students from all responsibility and continuously jumping in to save the day. To demonstrate this difference, here are a few examples of ways I have seen parents successfully use natural consequences as a tool to teach executive function.

Case Studies

  1. Amber is a student who has had consistent difficulty organizing her time after school. While she attends many different afterschool activities, such as recycling club and track, she is often late to practice or misses important changes to the schedule. To help Amber, her parents set up a calendar with notifications and reminders that appear on her phone and her computer directly after school. Recently, Amber started driving lessons with the local driving school. A few weeks ago, Amber had a conversation with her mother in the morning about the fact that she would be picked up for a lesson 10 minutes after the end of the school day. Amber’s notification on her phone went off 15 minutes before the lesson, and she received a pop-up on her computer screen 30 minutes before the end of the school day. Despite these reminders, Amber hopped onto the bus at the end of the day. While this was an honest mistake, Amber was not using her tools or the time management strategies that she has been taught and is expected to use. Amber’s parents decided that as a natural consequence, Amber would need to deal with fixing her mistake. They were there to support her as she called the driving school, apologized to the instructor, and rescheduled her appointment. If she was not willing to take these steps, another natural consequence would have been a delay in getting her license. This caused some heightened anxiety for Amber, but with encouragement from her parents, she practiced the phone call out loud and looked through her calendar to see where she had availability for a make-up appointment. Amber’s parents could have easily called the driving school and fixed these problems for her; however, Amber would have missed out on an opportunity to practice problem solving.
  2. Another student who benefited from natural consequences is Albert. Albert’s parents hired a tutor to meet with him over Zoom twice per week to prepare for the SATs. He was expected to meet with his tutor, Barry, two times per week to start building up his skills. Unfortunately, despite frequent reminders and systems being put in place, Albert often missed or was late to these meetings as he was distracted by playing video games. When Albert’s parents started to receive charges for missed appointments from Barry’s company, they thought carefully about how to impress on Albert the importance of using his strategies and making it to his appointments. Eventually, Albert’s parents informed him that if he missed another session, he would be responsible for the late fee, as the charge was an inevitable consequence. When Albert eventually missed another session, his father drove him to the bank and helped him withdraw the money from his own savings account to pay his parents for the missed session. Unsurprisingly, this was hugely frustrating to Albert in the moment; however, his meetings with Barry became a priority and Albert quickly started making it to tutoring on time. After experiencing the natural consequence himself, Albert began to change his actions.

Both of these examples led to increased buy-in from the adolescents who were actively working on building up their executive functioning skills. As they started to participate in problem solving after they made a mistake, they were more aware of the work that their parents had typically been doing for them. Some language that can be productive includes:

  • “I know it was a mistake and now we just need to figure out how to fix it. What do you think we should do?”
  • “What are the next steps you need to take to solve this problem?”
  • “I can tell you what I think we should do, but I would love to hear your ideas first. Where would you start?”

As adolescents forge toward young adulthood, they will inevitably make mistakes, miss appointments, arrive late, and misplace some of their belongings. If we are constantly picking up the pieces, then they are missing out on the opportunity to learn how to solve their own problems and build an understanding of the consequences.

 

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

 

To book an appointment or to learn more about NESCA’s Occupational Therapy Services, please fill out our online Intake Form, email info@nesca-newton.com or call 617-658-9800.

 

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

 

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