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sophie bellenis

NESCA’s New OT, Speech & Language and Feeding Services

By | NESCA Notes 2020

An interview between Sophie Bellenis, OTD, OTR/L, NESCA Occupational Therapist; Real-life Skills Program Manager and Coach, and Julie Robinson, OT, NESCA

NESCA just announced that it has expanded its Occupational Therapy (OT) services to include Direct Sensory-/Motor-based OT for its existing and new clients.

As you may know, NESCA already offers educational OT assessments and consultation along with Executive Functioning (EF) and Real-life Skills Coaching, mainly for those students in grades 6 and up. Now, NESCA broadens the range of students it can provide with OT, feeding, speech, language and social skills.

To introduce NESCA families and community members to the new team and its services, NESCA’s Sophie Bellenis, OTD, OTR/L, sat down for an interview with Julie Robinson, OT, to learn more.

What is the main focus of the new OT services that we are adding here at NESCA?

We are so excited to be on board and collaborating with the existing clinical team at NESCA to bring these new services to our community. The main focus of the new OT services is to provide instruction and practice, through teletherapy, and when appropriate at the home or in the community, in order to promote the best functionality kids can achieve on a daily basis. Where academic-based occupational therapy is focused on accessing the curriculum and receiving services while at school, Direct Sensory-/Motor-based OT services really look at giving our clients those wrap-around services outside of school to help with sensory processing, self-regulation, attention/following directions, fine and gross motor skill development, social pragmatics, managing routines, feeding and independence in carrying out daily activities, such as dressing, hygiene and sleep.

Who is a candidate for these new OT services?

We work with children of all ages, but our team typically works with children who are in the fifth grade or below. Many of the skills we are working on are skills that should be targeted and developed early on. Ideally, we are working with children from a young age or as soon as the challenges noted above come to light. Children with motor delays or sensory processing disorders, delays with play skills, and/or feeding difficulties are appropriate for these services.

How does the process of getting OT services start?

We usually start with an OT assessment that is focused on function. Insurance typically covers a 45-minute in-office screening. We would typically conduct a phone intake with the family, then look at the child’s skills using standardized tests for motor/sensory performance. With COVID-19, we are gathering sensory information from The Sensory Processing Measure and assessing other skill levels through interviews and checklists from parents, as well as 1:1 observation either virtually or in-person, as determined through the phone intake.

After an initial assessment is conducted, we work with families on a once or twice weekly basis. Each OT session is 45 minutes long and generally either begins or ends with a conversation with parents.

How do the services work?

We would typically provide services in-person inside the OT clinic at NESCA. Due to COVID-19, we are primarily providing services through telehealth, on a HIPAA-compliant virtual platform on a weekly basis. Sessions are 45 minutes each, with parents involved in part of each session to facilitate engagement of the child, to be coached by the clinician and for education about activities to incorporate in the days before the next session for follow through.

A small number of patients are being seen outdoors at their home or in the community, mainly when online engagement is too challenging, and when it can fit accordingly into clinician schedules. All patients are being seen individually for their services.

How do you set goals for the children you work with?

We get some of our background information for goal-setting from the assessment, but much of the real information on goals, strengths and weaknesses is revealed through observation during our sessions.

From the initial evaluation, we develop a brief report identifying the areas that we need to work on and collaborate with the parents to help achieve those goals and potentially target other areas that arise through ongoing observation and informal assessment during sessions and in parent consults.

When can families expect to see progress with goals being achieved?

We like to see our established goals being achieved in a three to six month time period. While every child is different, many kids go on to work with us for approximately 12 to 18 months, focusing on various goals throughout that period.

What are the related services that have just been introduced at NESCA?

Along with our new occupational therapy services, we are also now providing assessment and treatment of a variety of Speech & Language disorders, including dysphagia, childhood apraxia of speech, phonology/articulation disorder, receptive and expressive language disorder, social pragmatic communication disorder, autism spectrum disorder and language-based learning disabilities.

In addition, our therapists work with children with feeding and swallowing disorders, including transitioning infants to solid foods, weaning from tube feeding, improving sensory tolerance, developing chewing skills, increasing variety and volume of nutritional intake, and reducing avoidance behaviors during mealtimes. Our feeding therapists work with families to make mealtimes easier and more enjoyable for everyone using a systematic desensitization approach to increase sensory comfort with foods. We also employ the TR-eat®—Transdisciplinary Effective Assessment and Treatment—method for highly challenging feeding and eating issues.

Does NESCA accept insurance for its new services?

Direct Sensory-/Motor-based OT at NESCA (not academically-focused), is covered by BCBS and AllWays. Speech therapy at NESCA is covered by BCBS, AllWays and Harvard Pilgrim.

NESCA can provide receipts for Direct Sensory-/Motor-based OT sessions for clients to attempt to submit to their insurance carrier, should they not have insurance through the above carriers. NESCA does not submit claims to any carrier other than those outlined above and cannot guarantee any reimbursement when claims are submitted to them by the client.

It is also worth noting that Educational OT assessment, consultation and treatment is less often, or less completely, covered by insurance because insurance carriers typically only cover treatments that are deemed “medically necessary.” However, this can be a vital service because students spend such a significant amount of their day and week in school programming.

To learn more about NESCA’s Occupational Therapy and Related Services, please click here.

 

About the Interviewer

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

About the Interviewee
Julie Robinson is an occupational therapist with over 25 years of experience as a clinician. The work Julie does is integral to human development, wellness and a solid family unit. She particularly enjoys supporting families through the process of adoption and in working with children who are victims of trauma. Julie has extensive experience working with children diagnosed with an Autism Spectrum Disorder (ASD), or who have learning or emotional disabilities. She provides services that address Sensory Processing Disorder (SPD) and self-regulation challenges, as well as development of motor and executive functioning skills.

 

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.

 

Sitting Down to Work – Tips for Proper Set-up and Posture

By | NESCA Notes 2020

By: Sophie Bellenis, OTD, OTR/L

Occupational Therapist; Real-life Skills Program Manager and Coach

When working from home, it’s easy to ignore the important things that most people know about maintaining proper posture. The draw of a bed covered in pillows or a cozy nook on the couch can outweigh the rational knowledge that sitting with good posture will help us to stay focused, decrease back or joint pain, and help build a strong core. When it comes to children, they are often unaware of the ways that posture can affect their bodies and their work. They need cues, reminders and examples of the best way to sit to stay focused and be productive. In our last OT Tuesday blog, we discussed the importance of a child’s physical foundation, the core. When it comes to learning, a strong core helps with postural stability. As the start of a new school year draws near, let’s review some important things to consider about the environment and physical set-up for learning and the best positions for our students’ bodies.

Creating a space for learning helps to differentiate between school and home activities that, for many students, are currently happening in the same building. Here are some tips for setting up this space:

  • Find appropriately sized furniture. Children should have their feet on the ground when sitting at their desk! Tables should be at an appropriate height. Tables that are too tall tend to prompt children to hunch their shoulders or sit on their feet, while tables that are too small cause children to slouch and lean their heads on their hands.
  • Help them organize. Classrooms are built to help students grow their executive function skills, as teachers constantly help set up organizational systems and use tricks to keep students on track. Your child may benefit from color coded folders for each subject, a hard copy of their daily schedule (with pictures for younger kids!) or a visual timer.

There are also a few important things to remember to help with proper seated posture.

  • Use visual reminders. Your child may benefit from a picture of someone using proper seated position posted near their workspace. While they may still need a reminder every so often, having an image gives children a model to mimic.
  • The Rule of 90 Degrees. When sitting at a table, children’s hips, knees and ankles should all be positioned at 90 degrees. This helps to create a solid foundation. When children have a strong foundation and postural stability, they are set up to freely and accurately use their fine motor skills. Being grounded allows for easier writing, typing, cutting and manipulation of all the tools necessary for learning. Ideally, children’s elbows will also create a 90 degree angle.
  • Consider a slant board. Placing a computer or a paper on a slanted board can help students realize that they need to sit up straight, promote proper wrist placement and angle, and draw their eye gaze up from the desk. Writing on a vertical or slanted surface in general can help with the development of handwriting skills.
  • Stabilize that paper. Reminding students to use their non-dominant hand to hold their paper helps with precision and accuracy.
  • Allow them to switch it up! Some tasks really require a child to be sitting up straight, grounded and engaged. For example, a student who is hand-writing a final copy of their paragraph or using scissors for an art class will want to be cognizant of their bodies and how they are seated. In contrast, some activities provide opportunities to move around and change positions. If a student is reading a book for English Language Arts, they may want to lie on their belly or sit in a beanbag chair.
  • Take breaks. No matter how perfect a child’s seated posture is, they will benefit from movement and stretching breaks. Little bodies are built to move, bounce and wiggle!

Prioritizing posture as a child helps to build good habits, evenly distribute stress on the body’s muscle ligaments and joints, and create a strong, grounded foundation.

 

About the Author

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

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

 

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

 

Core Strength and Stability: The Physical Foundation

By | NESCA Notes 2020

By: Sophie Bellenis, OTD, OTR/L

Occupational Therapist; Real-life Skills Program Manager and Coach

As our country heads into a period of unique learning, whether through a remote learning experience, a hybrid model or an in-person option with heightened rules and regulations, I find myself focusing on foundation. Foundation, simply defined, means, “the basis upon which something stands or is supported.” Currently, we are looking at a huge shift in how programs will run, how teachers will teach and how schools will support our children, but these principles are rooted in strong foundations. Our educators have knowledge, proven methods and an evidence base that allows for creativity, flexibility and evolution.

With regard to our students, foundational skills are the basics that help them feel secure and grounded enough to tackle the more individualized and creative aspects of learning. It is, in part, due to these foundational skills that many of our surprisingly resilient children have handled the COVID-19 pandemic with more flexibility and grace than the adults in their lives.

Today, let’s highlight the physical foundation that supports a child throughout their day, the core. Anatomically, the core refers to the transverse abdominis, internal and external oblique muscles, rectus abdominis, and the multifidus and erector spinae. This group of muscles holds a child upright when they are sitting at their seat, standing in line and running around on the playground. It is one of the foundational elements that promotes healthy motor development. Having a strong and active core makes it easier for a child to use their fine motor muscles with intent, stay alert for the duration of a class or a Zoom session, and develop healthy postural habits. Occupational therapists are trained to determine whether these activities are being affected by a weak core and if there is a need for intervention. Teachers and parents who spend substantial time with our children may want to be aware of and look out for the clues and signals of core instability, which include:

  • Compensatory strategies for stability – These are the subconscious ways that children compensate for core weakness. Essentially, they are bad habits that initially help to keep kids from getting too fatigued to participate in activities, but can have negative long-term effects. Some common examples include “W-sitting” and holding a breath during activities that require strength.
  • Leaning on anything and everything – Some children sit and lean their head on their hands or the desk when they write, lean against adults when standing up or sitting on a couch, and lean on furniture or tables when they are standing at home. These same students often slouch down in their seats and hunch their shoulders forward when they stand. This could signify a weak core.
  • Difficulty with balance – The inability to stay balanced and upright may be due to core instability. Many children are still developing the ability to run, jump, walk across a balance beam and stand on one foot, but if they seem to be falling over or losing control of their body more frequently than their peers, a weak core may be the culprit. These balance issues may also be apparent when a child is doing daily activities, such as getting dressed, putting on shoes or getting in and out of a car.
  • Difficulty with fine motor tasks – Sometimes children have a strong core and still have weak fine motor skills; however, often a weak core is exacerbating fine motor deficits. There is a little phrase that goes, “proximal stability for distal mobility” that is used by therapists, yogis and personal trainers alike. This means that it is important to have strength and stability at the core to easily move and control the muscles in our arms and legs.

Notably, helping a child to build their core is not always as simple as doing a few targeted exercises. While pure muscle strength may be the root cause of instability, it is not the only possibility. Other causes include poor alignment of the ribcage and pelvis, the need for some neuromuscular reeducation to help children engage the right muscles, and breathing habits that interfere with proper muscle use. If you feel like core weakness may be interfering with your child’s success, it may be worth seeking an occupational therapy assessment or speaking to your school’s occupational therapist about how to help them feel secure, sturdy and grounded. We can all benefit from a strong foundation.

 

About the Author

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

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

 

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

 

Interoception: Helping Children Develop their “Hidden Sense”

By | NESCA Notes 2020

By: Sophie Bellenis, OTD, OTR/L

Occupational Therapist; Real-life Skills Program Manager and Coach

In our last OT Tuesday, we reviewed the sense of interoception, the ability to perceive information coming from inside the body. From basic human experiences, such as hunger and fatigue, to more complex internal emotions, such as anxiety and fear, interoception allows us to perceive and understand the sensations coming from our own bodies. As with other senses, this sense develops as children grow and, like the rest of us, will all have varied abilities. Some of our kids are naturally in tune with their bodies – they take to potty training without a hitch, recognize when they need a snack or a drink of water, and intuitively understand what their bodies are trying to tell them. Unsurprising, these exceptionally well regulated kids are not the majority, and most of our children benefit from some guidance, modelling and direct education on how to interpret the signals and sensations they are experiencing. Let’s discuss some tips and strategies for helping children to perceive, understand and appropriately respond to this internal information. Many of these tips are simple ideas to build into daily life and ways to take advantage of naturally occurring teachable moments.

Language – Incorporating language that teaches children to acknowledge internal cues and body sensations helps them to naturally and consistently notice the clues they are receiving from their bodies.

  • Verbally describe the choices that you make based on your own sense of interoception.
    • “I am going to put on a jacket because when I stepped outside this morning, I felt really cold.”
    • “My mouth feels dry and I’m starting to get a bit of a headache, I am going to have some water because my body is telling me that I am thirsty.”
  • Link requests that your child makes to how they may be feeling inside.
    • “You asked me for a snack. Are you hungry? How is your belly telling you that you’re hungry?”
  • Point out physical clues that hint at internal sensations.
    • “I notice you are having a hard time keeping your eyes open. That tells me you are feeling tired.”
    • “You are crossing your legs and dancing around a bit while you are coloring that picture. I think that your body is giving signals that you have to pee. It is important to pay attention to those signals so that you don’t wet your pants.”

Activities

  • Check Your Pulse! – Have your child sit quietly and teach them how to feel their pulse or heartbeat. Ask them to describe it – is it slow, fast, moving, hitting their fingers, etc.? Then have them run in place and do the same thing. How has it changed? Have them describe it now. Once children understand how their heartrate may be affected by physical activity, a next step would be pointing out that strong emotions, such as anger or excitement, can also affect one’s heartrate. This is a simple activity that provides some biofeedback and teaches children how their actions can affect their bodies.
  • Mindfulness – Zen Master, Thich Nhat Hanh defines mindfulness by stating, “Mindfulness shows us what is happening in our bodies, our emotions, our minds, and in the world.” While not all mindfulness activities focus on interoception, many of the principles and activities build this skill. If you are looking for some resources to work on mindfulness with your child, explore these sites: org, susankaisergreenland.org, mindful.org, and drchristopherwillard.com. Additionally, consider some apps to use with your child: Mindful Powers, Smiling Mind, Breathe Think Do with Sesame and Headspace.
  • Breathing exercises – Breathing exercises are common in mindfulness and can help children to relax. If apps are not for you, consider researching breathing exercises, such as: five-finger breathing, lazy 8 breathing or bumblebee breathing.
  • Progressive muscle relaxation – This practice involves alternating tension and relaxation in different muscle groups in the body. Dr. Monica Fitzgerald provides an excellent script to use with children working to relax here. If you are interested in exploring this practice with children with disabilities, many resources can be found at org.
  • Yoga – Yoga focuses on intentionally moving the body, pairing body movement and breathing, and increasing the mind-body connection. There are many apps and online videos that make yoga accessible to children. Some options include Simply Yoga, Gaia.com and Cosmic Kids Yoga. For some of our children who may need yoga broken down and presented differently, consider com or childlightyoga.com.

 

About the Author

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

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

 

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

 

Interoception: The “Hidden Sense”

By | NESCA Notes 2020

By: Sophie Bellenis, OTD, OTR/L

Occupational Therapist; Real-life Skills Program Manager and Coach

Conventionally, children are taught that there are five different senses, and that these senses help them to experience and understand the world around them. These five senses are sight, sound, smell, taste and touch. Clinically, we refer to these sensory systems as the visual, auditory, olfactory, gustatory and tactile systems. Each system provides unique information and works to alert the brain about the environment around them. Children all develop these systems differently, and all have unique preferences, strengths and interpretations of the world around them. As adults, a sommelier likely has an incredibly refined gustatory system, while a classical musician’s strength lies in their auditory system.

As knowledge about the human body continues to expand, two additional sensory systems have started to make their way into the common lexicon—the vestibular system and the proprioceptive system—both of which describe body awareness. The vestibular system gathers information from the inner ear and tells us where our body is in space. It monitors movement, acceleration and deceleration, balance and any changes in position. A gymnast uses this sense constantly as they flip across a mat or balance on the beam. The proprioceptive system gathers information from our muscles and joints and tells our brains about our position in space and any strength or force that we are using. Proprioception allows us to touch our noses with our eyes closed! These seven senses are all generally acknowledged and frequently assessed by occupational therapists. But what is interoception? And why is it referred to as the hidden sense?

Interoception refers to the perception of information coming from inside the body. Organ systems and the autonomic nervous system provide information about heart rate, hunger, thirst, temperature, respiration and even emotion (Vaitl, 1996). This sense of interoception helps us meet our most basic needs, such as knowing when we need food and water, realizing that it is time to use the restroom and putting on a jacket if it is cold outside. It also helps us to gain a more nuanced understanding of ourselves, such as realizing that an activity is making us anxious by acknowledging heightened heart rate and perspiration. This sensory system is often referred to as the “hidden sense,” because it is completely unique to each individual and no one knows exactly what someone else is feeling internally.

Children develop this sense slowly, with the most basic cues, such as hunger being recognized first. As they continue to grow, different internal signals are more easily understood and start to impact behavior. For example, around the age of two or three, most children start the process of potty training when they begin to recognize what it feels like to have a full bladder. As children continue to grow through their elementary, middle and high school years, this sense continues to be refined. As is expected, this is easier for some children than others.

Recent research shows that there is a strong connection between interoception and emotional/self-regulation. Individuals with low interoception often have more difficulty with both understanding and regulating their bodies and emotions (Zamariola et al., 2019). It appears that the ability to truly understand our body allows us to more intentionally control our responses. Luckily, as with other sensory systems, there are ways to increase interoceptive awareness and help children to notice the information that their bodies are feeding to their brains. In our next OT Tuesday blog, we will discuss some tips and strategies for helping children to perceive, understand and appropriately respond to this internal information.

 

References

Vaitl D. (1996). Interoception. Biol. Psychol. 42 1–27. 10.1016/0301-0511(95)05144-9

Zamariola G., Frost N., Van Oost A., Corneille O., Luminet O. (2019). Relationship between interoception and emotion regulation: new evidence from mixed methods. J Affect Disord  246:480–5. doi: 10.1016/j.jad.2018.12.101

About the Author

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

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

 

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

 

YES! COVID-19 May be Making Basic Daily Tasks More Difficult: The Link Between Executive Function Difficulties and Anxiety/Stress

By | NESCA Notes 2020

By: Sophie Bellenis, OTD, OTR/L

Occupational Therapist; Real-life Skills Program Manager and Coach

As our country continues to adapt to life in the era of COVID-19, it is quite well established that there has been a rise in anxiety and stress among our population. According to the Centers for Disease Control and Prevention (CDC), the mental health effects of the current pandemic have been substantial and include difficulty sleeping, worsening chronic health problems, changes in eating patterns, fear about personal health and the health of loved ones, and increased use of tobacco and alcohol (CDC, 2020). Many of these fears and new challenges are expected and understandable. They are responses that intuitively make sense to us as humans, as many of us experience them on a small scale throughout a typical year. Most people can name a time when they could not fall asleep before a big test or did not take excellent care of their physical health when they were hugely stressed or anxious. However, one effect of this newly heightened stress and anxiety that is less frequently mentioned is the decrease in executive function skills.

The term executive function refers to the brain processes that allow someone to stay organized, initiate tasks, maintain focus and attention, and manipulative information in their mind. As NESCA Pediatric Neuropsychologist Dr. Alissa Talamo describes in her piece, “What is Executive Function?,” this group of skills can be thought of as the conductor of the brain, similar to the conductor of an orchestra. They are keeping time, telling us when to start and stop tasks and helping us to stay regulated through the ups and downs of the day. You may have noticed that through stay at home orders and social distancing regulations, organizing daily tasks has become increasingly difficult. You may find yourself missing calls or meeting times, forgetting to respond to emails or misplacing items that are usually easy to track. You are not alone. Some people have started to describe a brain fog and a perceived inability to stay focused on a task for more than a short period of time.

While maybe not as intuitive as a lack of sleep, this decrease in executive function is to be expected as we collectively move through this stressful experience. Substantial research has described the correlation between depression, anxiety and stress, and executive function deficits. This seems to be particularly strong for adolescents with depressive and anxious symptoms, who have trouble with cognitive flexibility (Han, Helm, Iucha, Zahn-Waxler & Hastings, 2016). Similarly, university students are another population vulnerable to these effects, as described by Ajilchi and Nejati in 2017, who found specific difficulties with sustained attention and decision making. It is no surprise that one diagnostic criteria for generalized anxiety disorder is “difficulty concentrating or mind going blank” (APA, 2013). When reviewing the literature, it is clear that the brain fog and inability to focus through COVID-19 is not only unsurprising, for many people, it was inevitable.

So, what do we do? How do we soldier on through this incredibly unique time, despite the feeling that everything takes just a bit more time and effort?

It is increasingly important to cut ourselves some slack and stop expecting perfection. Focusing on self-care and taking care of each other emotionally will potentially lead to a natural return to successful executive function. By creating habits and routines that promote positive mental health, we are more likely to mitigate the feelings of being overwhelmed and the potential for burnout. Additionally, using technology and digital reminders to help take over the tasks of initiation and organization can give our over-extended brains a bit of a rest.

Finally, it is imperative that we think about the adolescents and students in our communities who are just starting to build these skills. Building executive function skills comes from a combination of direct instruction and opportunity to practice. Currently, students are being provided ample opportunity to practice, with limited direct instruction and guidance. Consider teaching your children and adolescents the tricks that you have learned to stay organized, prepared and productive. If you feel like teaching these skills is outside of your wheelhouse, or at all daunting, look into the prospect of an executive function coach. With all of the uncertainty about what education will look like this fall, helping students feel ready to tackle learning is one way to mitigate the anxiety and stress of this transitional time.

 

References

Ajilchi, B., & Nejati, V. (2017). Executive Functions in Students with Depression, Anxiety, and Stress Symptoms. Basic and clinical neuroscience8(3), 223–232. https://doi.org/10.18869/nirp.bcn.8.3.223

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Center for Disease Control and Prevention. (2020) Coronavirus disease 2019: Coping with stress. Retrieved from: https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/managing-stress-anxiety.html

Han, G., Helm, J., Iucha, C., Zahn-Waxler, C., Hastings, P. D., & Klimes-Dougan, B. (2016). Are Executive Functioning Deficits Concurrently and Predictively Associated with Depressive and Anxiety Symptoms in Adolescents?. Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 5345(1), 44–58. https://doi.org/10.1080/15374416.2015.1041592

 

 

About the Author

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

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

 

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

 

From School to Summer – Life Rolls Along in the Era of COVID19

By | NESCA Notes 2020

By: Sophie Bellenis, OTD, OTR/L

Occupational Therapist; Real-life Skills Program Manager and Coach

This past March, families were thrown into the world of remote learning, Zoom classrooms, digital assignments and school at home. With little to no time to prepare, teachers and parents alike have worked tirelessly to provide a sense of routine and academic focus, while handling the social and emotional fallout of the COVID19 pandemic. As schools start to wrap up their years and families start to look ahead at what is sure to be a notably unique summer, there is a bit more time to plan, think proactively and chart a positive course for our children.

As summer camps, childcare options, volunteer opportunities, and internships are either cancelled, transitioning to an online format, or significantly limiting capacity, the need for children to manage and plan self-directed activities is becoming more and more apparent. With such an extended period of time ahead of us, let’s highlight some ways that we can create environments that allow our children autonomy while building important skills and leavings lots of room for fun.

Set Firm Boundaries

There is evidence that tells us our children most successfully build and demonstrate their executive function skills when they are allowed freedom and opportunities to make their own choices, within boundaries and limits set by their parents (Schroeder & Kelley, 2010). Consider what aspects of summer life are non-negotiable for your family. This may be a certain limit on hours of screen time per day, a time that all children are expected to be up and out of bed, or chores and expectations that they must meet as a part of the family unit. Make sure that these are clearly communicated and agreed upon by everyone in the home.

Set Goals

Helping children set and work on completing goals can provide a concrete representation of the accomplishments that they have achieved over the summer. There are many ways to organize and format this process, but one consistent theme should be creating goals that are measurable, achievable and specific. Consider the SMART goal format as a template. One way to help children to choose their goals is to have them focus on three categories: personal, family and community. Some examples are:

  1. Personal Goals – Develop a consistent exercise routine; try out a new form of exercise, such as running, yoga or Pilates; incorporate a mindfulness meditation into a weekly schedule; consistently wake up independently with an alarm; or drink the recommended amount of water per day for their age, etc.
  2. Goal to Benefit the Family – Cook dinner for the family once a week; commit to weeding a family garden; deep clean one room per week; learn which cleaning supplies are used for the bathroom and for the kitchen; add a new chore each week; or teach a grandparent or family friend how to use a new technology, etc.
  3. Goal to Benefit the Community – Collect box-tops from all of the food items in the home to give to their school once it’s back in session; take a walk and pick up trash on a road or beach; do a food drive for a local pantry; mow the lawn for a neighbor; or reach out to vulnerable people in the community and ask if they can do anything to help, etc.

Create an Activity Bank

Pediatric Neuropsychologist Dr. Angela Currie of NESCA recently explained why telling kids to simply, “find something to do,” rarely leads to positive results (Currie, 2020). One suggestion that Dr. Currie gives is to create an activity bank or “menu.” It is often difficult to come up with suggestions in the moment when a child mentions that they are bored or feel there is little to do. Take the proactive step of creating a list of activities that your child can go to when they are having a hard time deciding how to fill their time. This makes it easy to prompt them to independently choose something to do. The response, “Why don’t you go take a look at the activities bank and see if there is something that would be a great choice for today?” gives a child a concrete first step. Some families have used creative ways to help children decide between options, such as an activity dice, an activity grab-bag or a personal activity “menu” with specific options for each child.

Encourage Independent Learning

The old adage states that anyone can be an expert at something, if they spend 10,000 hours practicing. Teach this theory to your children and ask them what truly makes them feel excited and curious. What would they like to explore? Children are used to viewing themselves through the lens of a student; however, they rarely make decisions about exactly what they would like to learn. Help your child explore their personal interests and choose something they would like to learn about over the course of the summer. This could look like a 1st grader collecting sea shells at the beach and bringing them home to draw; a 5th grader spending a couple of hours a week researching underwater caves; an 8th grader learning how to keep a sourdough starter alive and bake bread; or a junior in high school doing a deep dive into the current cultural shift developing in the United States. The topic should be completely chosen by the child, with suggestions and support facilitated by their parents.

 

References

Currie, A. (2020). Why “find something to do” doesn’t work – Teaching independent play skills during quarantine, NESCA Notes. Retrieved from https://nesca-newton.com/why-find-something-to-do-doesnt-work-teaching-independent-play-skills-during-quarantine/

Schroeder, V. & Kelley, M. (2010) Family environment and parent‐child relationships as related to executive functioning in children, Early Child Development and Care, 180:10, 1285-1298, DOI: 10.1080/03004430902981512

 

About the Author

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

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

 

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

 

Multi-sensory Learning: Bringing it into the Home

By | NESCA Notes 2020

Sophie Bellenis, OTD, OTR/L

By: Occupational Therapist; Real-life Skills Program Manager and Coach

In our last OT Tuesday blog, we delved into the topic of multi-sensory learning: what it is, what it looks like in the classroom and what it intends to do. We reviewed the fact that this technique consists of targeting children’s auditory, visual, tactile and kinesthetic systems with hands-on learning activities. This week we will further discuss multi-sensory learning and brainstorm ways that this approach can be incorporated by parents into home-based learning. Multi-sensory learning is hugely variable and can be applied in a plethora of creative ways. Here are some tips to help tailor this approach to your child at home.

  1. Consider Your Child’s Learning Profile. It is common knowledge that both children and adults tend to have a unique style of learning, as well as preferences for how information is presented. Think about how your child has learned from you in the past. Did she learn to wash her hands thoroughly by singing a song? Watching a timer? Observing you demonstrate the best way first? Information from teaching simple tasks like these can help you suss out how your child may best learn and take in academic information. If you are unsure, consider reaching out to teachers and professionals who have worked with your student in the past. Teachers are excellent at determining the ideal way to present information to each child. They may be able to help you better understand your child’s unique learning profile and give suggestions for activities.
  2. Create Manipulatives. Manipulatives, or things that children can hold, feel and manipulate with their hands, are tools that help solidify concepts for many of our tactile learners. While school buildings are often full of creative manipulatives, many of these are easy to make using household objects. Have your child cut up cereal boxes to make letter cards. Write numbers on bottle caps or rocks and have your children count them out or create math equations. Cut up paper plates into slices to help visually represent fractions. Use an egg carton with ten cups to build a homemade ten frame. Write out words using pipe cleaners or clay. If you are not feeling particularly “DIY,” many manipulatives can be purchased online. Here are few options for manipulatives, by subject:
  1. Consider Learning Opportunities in Your Community. There are, of course, universal lessons and aspects of curricula that are consistent across the Unites States. Children all work to learn their letters, the basics of addition and subtraction, and eventually how to write a paragraph. In contrast, the unique fabric of the varied communities across our country, allows for specific education through hands-on experiences in our environments. In New England, we have access to the coast, historic sites relating to the Revolutionary War, and many state and national parks. Teach environmental science by exploring tidepools and looking at sea creatures. Involve kinesthetic learning by having your children walk along part of the Freedom Trail. Get your children outside and show them physical representations of the things that they read about and see in pictures.
  2. Tap into Online Resources. Some of the most effective multi-sensory learning tools are quite simple. Having a child follow along in a book as they listen to someone read out loud targets both the visual and auditory systems. Kids both review their spelling and focus on reading comprehension while they listen. Videos and audio recordings of educators and parents reading children’s books aloud can be found on YouTube, Audible and many other internet sites. Look at your personal library and search the titles to see whether this option is readily available. Additionally, with this teaching method becoming increasingly evidenced-based and popular, sites such as Pinterest, TeachersPayTeachers and Understood.org have excellent ideas and examples of activities to incorporate into your day.
  3. Use What You Have. Many of the multi-sensory learning activities, especially for younger children, invite kids to get their hands dirty and feel. We prompt children to practice writing their letters in bins of beans or rice. We practice patterns with popsicle sticks or blocks. We use playdough or clay to both make art projects and forms letters. Look around your house and see what you already have available. If you do not have rice or beans, but you do have some sand outside, write letters in sand! If your supply of popsicle sticks ran out back in March, have your children step outside and collect 20 small sticks each. Use those sticks to spell out words. Color them with markers and then line them up to create patterns. Have your child dip them in water mixed with food coloring and practice writing letters on a piece of paper. Multi-sensory learning is all about having children learn from the complex and rich environments around them, while using multiple sensory pathways within their bodies. Teaching materials are all around us!

 

About the Author

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

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

 

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

 

Multi-sensory Learning: More than Just a Buzz Word!

By | NESCA Notes 2020

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

As teaching methods continue to become more and more creative, and learning is being facilitated through interventions that target all types of students, the term “multi-sensory learning” has started to cement its place in the educational lexicon. You may have seen a line in an evaluation, such as, “This student would benefit from a multi-sensory learning approach,” or “The use of multi-sensory teaching methods will help this student to solidify their learning.” In some ways this phrase is easy to interpret. Multi means many. Sensory refers to the body’s different senses, the tools we use to interpret and experience the environment around us. Reason would tell us that this phrase means using all of these senses to acquire knowledge, information, and skills, and….it does! But what does this look like in practice? How are professionals actually using this method to help our children learn?

If you picture a typical classroom from a few decades ago, there is a teacher standing up at the front of the room providing students with information to copy down into their notebooks. These students are receiving information through the auditory system only. They are being expected to listen, comprehend and retain the lesson using one sense, their hearing.

Now let’s picture the classroom of a teacher using multi-sensory learning techniques. Often, students are clustered in different areas with a teacher checking in at every table to provide each small group with support. Students are looking at images or pictures of the object they are studying, both reading information and hearing it clarified by their teacher, and are likely using manipulatives, or things they can feel to help understand the content. These students are learning through their visual, auditory and tactile systems.

Humans grow, evolve and learn in complex, multi-sensory environments that are constantly targeting all of our senses. Our brains are built to learn through a combination of visual, auditory, tactile and kinesthetic data (Shams & Seitz, 2008). Using visual methods helps children learn through the sense of sight; auditory through the sense of hearing; tactile through the sense of touch; and kinesthetic through body movement. Children display greater performance when learning activities target all of these systems, as opposed to when they are taught using one modality (Broadbent, White, Mareschal, & Kirkham, 2018).

As an example, let’s look at teaching Kindergarten students their letters. A robust multi-sensory approach to teaching the alphabet includes looking at pictures of the letters, saying the sounds out loud as a class, tracing the letters in the air with one finger, making each letter out of playdough, writing the letters in bins of rice, making the student’s bodies into the shape of individual letters, and finally picking up a pencil to attempt to form the letters on the page independently. Students gain a comprehensive understanding of the letters as their brains have been targeted across multiple sensory systems.

There is substantial research for using this multi-sensory approach for another foundational academic skill: reading (Walet, 2011). Many of the most well-known phonics and reading programs, such as Orton-Gillingham and the Wilson Reading System, use these strategies to help students who learn differently to master this skill (AOGPE, 2012 & Wilson, 2017). When using some programs students learn to tap out syllables and letters on their fingers as they read, incorporating tactile feedback. Others focus on including books on tape so that students both see and hear each word as it is read aloud.

Other excellent examples of multi-sensory learning in the classroom include:

  • Songs and rhythm to solidify content
  • Base ten cubes as math manipulatives
  • Fieldtrips!
  • Games involving movement, such as flashcard races, Around the World and clapping games
  • Paper with raised or highlighted lines for tactile or visual feedback
  • Video clips to review concepts
  • Real coins and dollars when learning about money
  • Science experiments in a high school lab

While students are currently all at home receiving their lessons and assignments through a digital medium, many are missing out on the creative ways that their fabulous teachers use these strategies in their classrooms. In my next blog, we will discuss some ways to incorporate these strategies in the home!

 

References

Academy of Orton-Gillingham Practitioners and Educators (AOGPE). (2012). The Orton-Gillingham

Broadbent HJ, White H, Mareschal D, Kirkham NZ. Incidental learning in a multisensory environment across childhood. Dev Sci. 2018;21(2):e12554. doi:10.1111/desc.12554

Shams, L., and Seitz, A.R. Benefits of multisensory learning. Trends in Cognitive Sciences, 60, November 2008, pp. 411-17.

Walet, J. (2011). Differentiating for Struggling Readers and Writers: Improving Motivation and Metacognition through Multisensory Methods & Explicit Strategy Instruction. Journal of the American Academy of Special Education Professionals,83-91.

Wilson, B. (2017). Teaching total word structure. Wilson Language Training Corporation.

 

About the Author

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

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

 

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

 

Visual Motor Integration Deep Dive – Part 2

By | NESCA Notes 2020

 

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

Last week’s blog taught us the nuts and bolts of Visual Motor Integration. Let’s jump into the what VMI really means for students who struggle with VMI.

Research has shown a statistically significant correlation between performance on visual motor integration assessments and teachers’ assessments of early elementary school students’ reading, mathematics, writing and spelling ability (Optometry and Vision Science, 1999; Pereira, D., Araujo, R., & Braccialli, L., 2011). Now that we understand what visual motor integration is as a concept and that it is a foundational skill for academics, let’s look at some areas of education that may be difficult for children with visual motor dysfunction.

  • Written Output – Beginning in preschool, children start to learn how to draw vertical, horizontal and diagonal lines. They practice circles, squares, crosses and drawing an X. All of these are considered pre-handwriting practice. As a child moves along in their academic career, they start incorporating these movements into letters and eventually words. Children who struggle with VMI have particular difficulty recreating the images that they see. This often manifests itself in letter reversals, illegible written output and inability to judge whether their copy looks like the model or not. As children get into later grades, visual motor dysfunction may include difficulty copying information from a whiteboard, trouble staying on the line or within the space provided, and a simple lack of fluidity when writing. Tasks, such as filling out graphic organizers and brainstorming, feel tedious and tiring, as opposed to helpful.
  • Math – While math is not typically thought of as a motor-based task, substantial portions of current math curriculums rely on visual motor integration. For younger students, drawing shapes, writing equations and recognizing patterns may be particularly tough. As students get older, geometry requires them to write out proofs and draw shapes, while calculus requires graphing and drawing lines based on complex equations. Building on VMI helps students to access more than simple written output.
  • Using Classroom Tools – While this may not seem as academically focused as the other areas that are affected by VMI, classroom tools are frequently used throughout the school day. Scissors, a stapler, a hole puncher and a mouse/keyboard all require some level of visual motor function.

It’s difficult to briefly sum up all of the ways that students are incorporating their visual motor integration skills into a typical school day, or realistically a day in general. They use these skills without even realizing it, which means they unintentionally practice them all day. VMI is something that can continue to develop all through the lifespan. Artists pick up new tools and build mastery, adult calligraphy classes have become a new fad as people learn to modify and improve their handwriting, and even Tom Brady continues to work on perfecting that spiral. Targeted intervention can help children build on their foundation and find confidence in their abilities. If you feel that VMI might be affecting your child’s education, reach out to an occupational therapist and see if they can help you better understand your child’s individual profile.

 

References

Optometry and Vision Science: March 1999 – p 159-163. Retrieved from https://journals.lww.com/optvissci/Abstract/1999/03000/Relationship_between_Visual_Motor_Integration.15.aspx

Pereira, D., Araujo, R., & Braccialli, L. (2011) Relationship between visual-motor integration ability and academic performance. Journal of Human Growth and Development, 21(3), 808-817. Retrieved_from https://www.researchgate.net/publication/317462934_Relationship_analysis_between_visual-motor_integration_ability_and_academic_performance

 

About the Author

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

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

 

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