Join our expert, collaborative team! NESCA is hiring full- and part-time pediatric neuropsychologists in our Newton, MA and Londonderry, NH locations. Read more about the position details, requirements, benefits, and how to apply on our Careers page: https://nesca-newton.com/neuropsychologists/.

Tag

Special Education

3

How to Use a Neuropsychological Evaluation Report from NESCA

By | NESCA Notes 2024

By: Erin Gibbons, Ph.D.
Pediatric Neuropsychologist, NESCA

A neuropsychological evaluation is a big investment of your time and financial resources. At the end of the process, you are provided with a lengthy report. You might think, “Now what? How do I use this report?”

At NESCA, we pride ourselves on writing reports that are comprehensive and highly individualized to each client. We always recommend sharing the report with people who work with your student, including pediatricians, schools, and private providers (e.g., therapists, speech-language pathologists, etc.). In many cases, the report includes a clinical diagnosis or diagnoses. Other providers often need to see those diagnoses in writing in order for the student to “qualify” for services.

In the short-term, the report should be used to seek services that the student needs. This often includes working with the student’s school to ensure that the student is receiving any necessary academic, social, or emotional supports. The report includes specific, explicit recommendations, such as the type of classroom the student needs, what interventions should be happening during the school day (e.g., reading instruction, speech/language therapy, occupational therapy), whether or not they need access to counseling services, and so on. By having all of those recommendations laid out in the report, families can then advocate for their student effectively.

Aside from the school setting, NESCA reports can be used to access services privately. This might include academic, therapeutic, or behavioral interventions. Managed care organizations often require specific types of documentation in order to access insurance-based services. By having a written report that includes clinical diagnoses and specific recommendations, this essentially acts as a prescription for services.

NESCA reports can also be useful for long-term planning and progress monitoring over time. The report captures the student’s current profile and provides recommendations for what should be done to address areas of weakness, with the goal of improving the student’s prognosis. An evaluation is typically considered to be valid for the next 2-3 years. At that point, it will be important for the student to be evaluated again to see whether there has been progress and, if not, what changes need to be made to the interventions in order for them to be more effective.

 

About the Author

Erin Gibbons, Ph.D. is a pediatric neuropsychologist with expertise in neurodevelopmental and neuropsychological assessment of infants,

children, and adolescents presenting with developmental disabilities including autism spectrum disorders, Down syndrome, intellectual disabilities, learning disabilities, and attention deficit disorders. She has a particular interest in assessing students with complex medical histories and/or neurological impairments, including those who are cognitively delayed, nonverbal, or physically disabled. Dr. Gibbons joined NESCA in 2011 after completing a two-year post-doctoral fellowship in the Developmental Medicine Center at Boston Children’s Hospital. She particularly enjoys working with young children, especially those who are transitioning from Early Intervention into preschool. Having been trained in administration of the Autism Diagnostic Observation Schedule (ADOS), Dr. Gibbons has experience diagnosing autism spectrum disorders in children aged 12 months and above.

If you are interested in booking an evaluation with a NESCA neuropsychologist/clinician, please fill out and submit our online intake form. 

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

47

If My Child Attends a Residential School, Will the State Pay for Housing When They Graduate?

By | NESCA Notes 2024

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

The goal of transition services is to help students who are on IEPs to progress toward their measurable postsecondary goals. This includes planning for future learning and work situations, and also planning for future living—as independently as possible. An enormous challenge that comes up in this planning process is that families (and sometimes the professionals supporting them) do not fully understand the realities of housing for adults who have exited public education.

There is a common misconception that if your child has qualified for residential special education programming, that will mean that your child will qualify for residential support as an adult. However, adult human service supports are not an entitlement like special education—these services are voted on by state legislature. The truth is that adult services and benefits are built to fill in the gaps of what you cannot physically or financially do to support your child. If you are alive and you can reasonably take care of your child, even with support, that is what you will be expected to do. If, instead, you want your child to be able to live in their own home or a shared home, then you and your child will be responsible for figuring out how to find and fund that living situation.

Hopefully, this data, shared by Cathy Boyle of Autism Housing Pathways in a January presentation, titled “Thinking About Housing,” will help to hammer home this point. Cathy shared numbers from fiscal year 2021 which quantified some of the residential supports awarded to young adults in Massachusetts who turned 22 during that fiscal year. Specifically, there were 1,233 students turning 22 who were served by the Department of Developmental Services (DDS) in Massachusetts. Of that number, only 263 received “residential supports.” However, the majority of those “residential supports” were provided in shared living situations where the housing was not being funded by DDS. It was only about 100 individuals statewide who turned 22 and entered into brick-and-mortar homes funded by DDS.

Regarding who is able to secure DDS housing in Massachusetts, it is typically only available to individuals who have an intellectual disability that was diagnosed before age 18 and (1) are a danger to themselves, and/or (2) are a danger to others, and/or (3) have pica (a condition in which a person eats items not usually considered food). There are some other criteria considered, including whether the caregiver can keep the individual healthy and safe (based on caregiver criteria, such as age, health, employment) and the judgment of the evaluator from the state. But, as previously described, housing is reserved for individuals with the most significant needs. Also, while there is funding through DDS for day services for adults with autism in Massachusetts, this budget explicitly does not cover residential services or housing. Only individuals with autism who also meet the intellectual disability criteria are eligible for housing under standard criteria.

If your child has a mental health condition, you may wonder about housing through Department of Mental Health (DMH). While it’s difficult to find current statistics on the number of young adults turning 22 and receiving group home services, there is a limited number of beds, and eligibility criteria for DMH services specifies that you can only be eligible for services if they are actually available. Also, the criterion for housing is quite similar to DDS in that an individual has to be entirely unable to live at home even with intensive in-home support. This often equates to the same variable of whether your child is actively at risk of harming themselves or another person.

While I’m providing data from Massachusetts in order to exemplify these housing challenges, the struggles are similar, if not more difficult, across the United States. The reality is that if you have a child with a disability, you and your child are more than likely going to have to plan for and figure out how to pay for their housing in adulthood. This is one of the ways that our children are treated 100% similarly to nondisabled adults. Although having a disability may help your child to qualify for accommodations in adulthood, living accommodations are most often not part of that right.

Resources:

NESCA offers many services designed to help students bridge the transition from high school to college including executive function coaching, pre-college coaching, transition planning, and neuropsychological evaluation. To learn more specifically about our transition planning services, visit https://nesca-newton.com/transition/. To learn about other coaching services, visit: https://nesca-newton.com/coaching-services/. To schedule an appointment with one of our expert clinicians or coaches, please complete our intake at: https://nesca-newton.com/intake/.

 

About the Author
Kelley Challen, Ed.M., CAS, is an expert transition specialist and national speaker who has been engaged in evaluation, development, and direction of transition-focused programming for teenagers and young adults with a wide array of developmental and learning abilities since 2004. While Ms. Challen has special expertise in working with youth with autism, she enjoys working with students with a range of cognitive, learning, communication, social, emotional and/or behavioral needs.

Ms. Challen joined NESCA as Director of Transition Services in 2013. She believes that the transition to postsecondary adulthood activities such as learning, living, and working is an ongoing process–and that there is no age too early or too late to begin planning. Moreover, any transition plan should be person-centered, individualized and include steps beyond the completion of secondary school.

Through her role at NESCA, Ms. Challen provides a wide array of services including individualized transition assessment, planning, consultation, training, and program development services, as well as pre-college coaching. She is particularly skilled in providing transition assessment and consultation aimed at determining optimal timing for a student’s transition to college, technical training, adult learning, and/or employment as well as identifying and developing appropriate programs and services necessary for minimizing critical skill gaps.

Ms. Challen is one of the only professionals in New England who specializes in assisting families in selecting or developing programming as a steppingstone between special education and college participation and has a unique understanding of local postgraduate, pre-college, college support, college transition, postsecondary transition, and 18-22 programs. She is additionally familiar with a great number of approved high school and postsecondary special education placements for students from Massachusetts including public, collaborative, and private programs.

Ms. Challen enjoys the creative and collaborative problem-solving process necessary for successfully transitioning students with complex profiles toward independent adulthood. As such, she is regularly engaged in IEP Team Meetings, program consultations, and case management or student coaching as part of individualized post-12th grade programming. Moreover, she continually works to enhance and expand NESCA’s service offerings in order to meet the growing needs of the families, schools and communities we serve.

When appropriate, Ms. Challen has additionally provided expert witness testimony for families and school districts engaged in due process hearings or engaged in legal proceedings centering on transition assessment, services and/or programming—locally and nationally.

Nearly two decades ago, Ms. Challen began her work with youth with special needs working as a counselor for children and adolescents at Camp Good Times, a former program of Milestones Day School. She then spent several years at the Aspire Program (a Mass General for Children program; formerly YouthCare) where she founded an array of social, life and career skill development programs for teens and young adults with Asperger’s Syndrome and related profiles. Also, she worked at the Northeast Arc as Program Director for the Spotlight Program, a drama-based social pragmatics program, serving youth with a wide range of diagnoses and collaborating with several school districts to design in-house social skill and transition programs.

Ms. Challen received her Master’s Degree and Certificate of Advanced Graduate Study in Risk and Prevention Counseling from the Harvard University Graduate School of Education. While training and obtaining certification as a school guidance counselor, she completed her practicum work at Boston Latin School focusing on competitive college counseling.

Ms. Challen has worked on multiple committees involved in the Massachusetts DESE IEP Improvement Project, served as a Mentor for the Transition Leadership Program at UMass Boston, participated as a member of B-SET Boston Workforce Development Task Force, been an ongoing member of the Program Committee for the Association for Autism and Neurodiversity (AANE), and is a member of the New Hampshire Transition State Community of Practice (COP).

She is also co-author of the chapter, “Technologies to Support Interventions for Social-Emotional Intelligence, Self-Awareness, Personality Style, and Self-Regulation,” for the book Technology Tools for Students with Autism: Innovations that Enhance Independence and Learning.

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

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

5

Neurodevelopmental Evaluations for Children under Age 5

By | Nesca Notes 2023

By: Lauren Halladay, Ph.D.
Pediatric Neuropsychologist, NESCA

Many families are curious about neurodevelopmental testing. Neuropsychologists who specialize in working with young children are often asked about when it is appropriate to pursue an evaluation, what the evaluation process entails, and where to go.

Why Would a Young Child Need an Evaluation?

There are developmental milestones across several domains that children are expected to achieve within certain timeframes. When children are showing delays in achieving those milestones within expected age ranges, seeking an evaluation may be warranted. From birth to 5 years of age, the areas of development that are especially important to monitor include:

  • Speech and Language (e.g., use of single words/phrases, following directions)
  • Social Skills (e.g., eye contact, social smile, interest in others, imaginative play skills)
  • Motor Skills (e.g., crawling, walking, using a pincer grasp)
  • Cognition/Early Problem Solving Skills (e.g., matching shapes and objects, completing simple puzzles)

If delays in any of the areas listed above are observed, pursing an evaluation sooner rather than later is recommended, as research has shown that early diagnosis and intensive treatment are the most important factors in determining rapid progress and long-term prognosis.

What Does a Neurodevelopmental Evaluation Entail?

Within a comprehensive neurodevelopmental evaluation, the child is administered tests that look at the developmental areas listed above. Information should also be collected from parents, teachers, and other caregivers who know the child well. These evaluations help to provide a better understanding of the child’s developmental profile, including areas of relative strength and weakness. In other words, the evaluation can provide more information about where the child’s skills currently fall when compared to their same age peers. Such information can provide diagnostic clarification, as well as help to inform recommendations for services if needed.

Where to Go

There are several options for where families can pursue evaluations, each with their benefits and drawbacks:

  • Early Intervention (EI): EI is meant to support families of children birth to three years of age who have developmental delays or are at risk of developmental delays. The goal of the Massachusetts EI program is to collaboratively promote skill acquisition based on the family’s priorities and child’s individual needs. Evaluations are typically conducted within the home setting to determine the child’s eligibility for EI services. While these evaluations can provide valuable information about the child’s strengths and weaknesses, a diagnosis will not be provided.
  • Hospital-based Setting: These evaluations are structured differently depending on the hospital system. In most cases, these evaluations are interdisciplinary, meaning that they involve a team of providers from different disciplines (i.e., psychologist, medical provider (pediatrician, nurse practitioner) speech and language pathologist, occupational therapist, etc.). While outcomes of these evaluations can include diagnosis and recommendations for services when appropriate, waitlists are often long, and reports tend to be brief.
  • Independent Setting/Private Practice: Independent evaluations usually involve several visits with a pediatric psychologist or neuropsychologist, rather than with a team of providers. Similar to the hospital-based evaluations, independent evaluations can result in diagnosis when appropriate. Specific recommendations based on the child’s individual profile are offered. These evaluations tend to be more detailed and comprehensive than those conducted by EI and within hospital-based settings. Clinicians also have the option to observe the child in other settings (e.g., daycare, preschool, elementary school), as well as attend school-based meetings.

Relatedly, NESCA is currently providing evaluations for children 12 months to 3 years of age who are showing early signs of an autism spectrum disorder (ASD). The wait time is 1 month or less – by design –  so children who meet criteria for an ASD diagnosis can access the appropriate interventions for them. If you are interested in learning more about ASD Diagnostic Testing through NESCA’s ASD Diagnostic Clinic, please visit our website at https://nesca-newton.com/asd-diagnostic-clinic-2/ and/or complete our online Intake Form.

Related resources and links to help track developmental milestones:

 

About Lauren Halladay, Ph.D.

Dr. Halladay conducts comprehensive evaluations of toddlers, preschoolers, and school-aged children with a wide range of developmental, behavioral, and emotional concerns. She particularly enjoys working with individuals with Autism Spectrum Disorder, Intellectual and Developmental Disabilities, and complex medical conditions. She has experience working in schools, as well as outpatient and inpatient hospital settings. She is passionate about optimizing outcomes for children with neurodevelopmental disabilities by providing evidence-based, family-oriented care.

 

If you are interested in booking an appointment for an evaluation with a Dr. Halladay or another NESCA neuropsychologist/clinician, please fill out and submit our online intake form. 

 

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

44

October is Gap Year Exploration Month – Why Should Teens on IEPs Care?

By | Nesca Notes 2023

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

On September 12th, I received an email from a colleague with the title May I nominate you? The body of the email described that October is Gap Year Exploration Month (GYEM) and asked if I would be willing to be a GYEM Amplifier, meaning would I be willing to share information with my personal and professional network to create awareness about gap years and increase student consideration of gap years as one of their post-secondary options. This was an easy “YES!” for me because I have spent the majority of my career trying to help students and families who I work with to understand that there are many other options besides college, or before college, for students to pursue after high school. Just last week, I was in an IEP meeting for a 10th grade student recommending that the student have an IEP goal and objectives that would help to enhance his understanding of a variety of post-12th grade options so that he could make an informed and active choice about his post-high school activities.

In the United States, every student who is on an IEP has the right to postsecondary transition planning. This is a process by which a young person is supported in the setting of goals and expectations for themselves and in building the skills and resources that will enable them to reach those goals. This should be a completely individualized process. However, in working with a large number of clients in Massachusetts and other Northeast states, I have observed that most middle and high school students have the same postsecondary vision: College. There is a strong consensus that college is the only goal to reach after high school, rather than an important step that leads to gainful employment in an area of strength, interest, or aptitude. Students with and without disabilities often know that they want to go to college (or that they are expected to go to college), but they have no career goals or sense about whether a college degree will actually benefit them in finding employment related to their aptitudes. Despite the data, most young people (and their parents) simply take as fact that college is what you do after high school. So how do we empower students to better manage the transition process? First and foremost, we need to start discussing career development, and to help our youth to understand the wide range of postsecondary options available to them, at earlier ages. A bachelor’s degree is one academic pursuit that has a place for many students, but for a great number of students, it is not the best immediate option available after high school. There are many other options worth exploring, such as two-year college programs, vocational or certificate programs, apprenticeships, military, employment, and gap year programs. So today, let’s talk about those gap year programs!

What is a gap year? A gap year is a deliberate period of personal growth typically taken by students after high school and before post-secondary education or career. During a gap year, individuals engage in various activities that foster personal growth, skill development, and exploration of different paths before committing to further education or career choices. These activities may include volunteering, interning, traveling, working, learning new skills, or pursuing other forms of experiential learning. The purpose of a gap year is to gain valuable life experiences, expand one’s perspective, and make informed decisions about future educational and career endeavors.

What can you do on a gap year? The options are endless! Gappers can choose from structured programs like service learning or volunteer projects, or pursue independent activities, such as interning, hiking, or working on organic farms. There are opportunities both within the US and abroad.

Is a gap year expensive? A meaningful gap year can be planned on various budgets. Students can offset costs through work, fundraising, scholarships, and financial aid. Some gap year programs accept funds from 529 Plans. Moreover, gap year students often graduate from college in less time, potentially saving families money in the long run. Explore a comprehensive list of scholarships here.

What are the evidence-based benefits of taking a gap year?

  • Academic Success: Recent studies show that gap year students outperform traditional students academically when they enter college.
  • Employability Boost: 88% of gap year graduates report that their experience significantly enhances their employability.
  • Personal Development: 98% of gap year graduates claim that their gap year helped them grow as a person.
  • Career Exploration: 60% of gap year graduates credit their experience with either confirming their choice of career or setting them on their current path.

References for these statistics can be found here.

Can you still attend college after a gap year? According to the best data on this question, 90% of gap year students who intended to go to college enroll within a year of graduating high school.

How can I learn more about planning a gap year?

Seek guidance from your school counselor.

Attend local USA Gap Year Fairs or online events to meet with programs and gather more information.

Check out some of the following Articles/Videos:

Visit the web sites below:

Listen to a Podcast

Read a Book

Is a transition program the same thing as a gap year program? Not exactly. Postsecondary transition programs are typically programs for young adults with disabilities that target skill development in one or more transition planning areas: life skill development, vocational skill development, and/or readiness for college. Often, developing executive function and social skills is a strong emphasis of these programs. Some of these programs are therapeutic and target the mental health needs of the young adult while supporting skill development in transition planning areas. While some students will participate in transition programs or transitional living programs as gap experiences, transition programs are typically a different category of program. At NESCA, we specialize in helping families determine whether transition programming is needed beyond 12th grade and support families to find – or create –

postsecondary transition programs. We also coordinate with local specialists – Gap Year Consultants, College Consultants, and Therapeutic Educational Consultants—when students may need special expert support in any of those areas.

REFERENCE: Several of the FAQs in this blog are copied directly from GYEM: Digital Dispatch materials created by the Gap Year Association of America and distributed to Gap Year Exploration Month Amplifiers throughout the world.

 

About the Author
Kelley Challen, Ed.M., CAS, is NESCA’s Director of Transition Services, overseeing planning, consultation, evaluation, coaching, case management, training and program development services. Ms. Challen also provides expert witness testimony in legal proceedings related to special education. She is also the Assistant Director of NESCA, working under Dr. Ann Helmus to support day-to-day operations of the practice. Ms. Challen began facilitating programs for children and adolescents with special needs in 2004. After receiving her Master’s Degree and Certificate of Advanced Study in Risk and Prevention Counseling from Harvard Graduate School of Education, Ms. Challen spent several years at the MGH Aspire Program where she founded an array of social, life and career skill development programs for teens and young adults with Asperger’s Syndrome and related profiles. She additionally worked at the Northeast Arc as Program Director for the Spotlight Program, a drama-based social pragmatics program, serving youth with a wide range of diagnoses and collaborating with several school districts to design in-house social skills and transition programs. Ms. Challen is co-author of the chapter “Technologies to Support Interventions for Social- Emotional Intelligence, Self-Awareness, Personality Style, and Self-Regulation” for the book Technology Tools for Students with Autism. She is also a proud mother of two energetic boys, ages six and three. While Ms. Challen has special expertise in supporting students with Autism Spectrum Disorders, she provides support to individuals with a wide range of developmental and learning abilities, including students with complex medical needs.

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

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

43

Building Independence—How Independent Living Centers Can Help Youth with Disabilities

By | Nesca Notes 2023

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

Good transition planning is about building a “team” that can outlast special education and using resources wisely. There is often talk of “maximizing benefits” so that private funds can be reserved and made to last. In order to create an effective and individualized transition plan, you have to know what resources are available in your local community as well as on the state and federal levels. One resource that may be overlooked or underused is your local Center for Independent Living (CIL). In Massachusetts, and some other states, these are often named Independent Living Centers (ILC).

Across the United States, CILs are free community-based agencies that provide a range of services designed to help individuals with disabilities build skills for living more independently. The barrier to entry is typically very low as the intake process may sometimes just be a phone call and acknowledgement of having a disability.

At a minimum, each center is charged with providing the following core services:

  • Information and referral: Learning about services, providers, benefits, and programs within your local community that can help you achieve your goals (e.g., advocacy, daily living, housing, recreation, etc.). Also, learning about resources offered through state and national organizations.
  • Skills training: Explicit instruction of self-advocacy and/or life skills that can help you to live, learn, and work more independently. Examples areas for skill development include accommodations, personal care, housing and household management, managing finances, interview preparation, etc.
  • Peer counseling/mentoring: Talking with a peer by phone, video conference, or in person for mutual support, confidence building, and ultimately to make more independent and informed choices.
  • Advocacy: Learning to advocate on both individual and systems levels. Building skills to advocate for oneself, including filing complaints or taking legal action to remove barriers when needed.
  • Transition services: Services to facilitate transition to postsecondary adult life, services to facilitate transition from institutions to the community, and services to assist individuals at risk of needing to be in institutions.

Additionally, ILCs/CILs may have developed services that are specifically useful for consumers in their local community or state. And there is generally no age requirement for accessing services. For example, many ILCs in Massachusetts have specific youth programming or Transition to Adulthood Programs (TAPs) which offer advocacy, skills training, and peer counseling specifically tailored to students.

ILCs/CILs are awesome agencies run by, and for, individuals with disabilities. However, in my experience, they are not talked about or accessed nearly enough as part of transition planning. If you are reading the blog and interested in building independence at home and in the community for yourself, your child, or a youth you work with—I strongly recommend you look up your local Center for Independent Living and call to find out more about accessing services today.

Resources:

Administration for Community Living – What is Independent Living?  https://acl.gov/programs/aging-and-disability-networks/centers-independent-living

ILRU Directory of Centers for Independent Living and Associations – https://www.ilru.org/projects/cil-net/cil-center-and-association-directory

Massachusetts Independent Living Centers – https://www.mass.gov/independent-living-centers

 

About the Author
Kelley Challen, Ed.M., CAS, is NESCA’s Director of Transition Services, overseeing planning, consultation, evaluation, coaching, case management, training and program development services. Ms. Challen also provides expert witness testimony in legal proceedings related to special education. She is also the Assistant Director of NESCA, working under Dr. Ann Helmus to support day-to-day operations of the practice. Ms. Challen began facilitating programs for children and adolescents with special needs in 2004. After receiving her Master’s Degree and Certificate of Advanced Study in Risk and Prevention Counseling from Harvard Graduate School of Education, Ms. Challen spent several years at the MGH Aspire Program where she founded an array of social, life and career skill development programs for teens and young adults with Asperger’s Syndrome and related profiles. She additionally worked at the Northeast Arc as Program Director for the Spotlight Program, a drama-based social pragmatics program, serving youth with a wide range of diagnoses and collaborating with several school districts to design in-house social skills and transition programs. Ms. Challen is co-author of the chapter “Technologies to Support Interventions for Social- Emotional Intelligence, Self-Awareness, Personality Style, and Self-Regulation” for the book Technology Tools for Students with Autism. She is also a proud mother of two energetic boys, ages six and three. While Ms. Challen has special expertise in supporting students with Autism Spectrum Disorders, she provides support to individuals with a wide range of developmental and learning abilities, including students with complex medical needs.

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

NESCA is a pediatric neuropsychology practice and integrative treatment center with offices in Newton 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.

15

On-the-Ground Parent & School Consultation in Honduras

By | Nesca Notes 2023

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

NESCA’s International Work
NESCA is well regarded as an expert in providing neuropsychological evaluations for children and teens from around the globe as part of its International Evaluation program. To date, NESCA has provided evaluations to clients from more than 20 countries across Europe, Asia, Africa, South America, and North America.

Many families bring their child/children to our offices in New England to be evaluated, and NESCA’s founder and director Ann Helmus, Ph.D., has traveled to many countries to provide evaluations overseas. She also has a long-standing history training neuropsychologists in the Philippines. Our Transition and Coaching Services teams also conduct transition assessments for international clients as well as virtual executive function coaching to many young adults overseas.

Based on a neuropsychological evaluation conducted by NESCA this past year, I began providing consultation with a 5th grade boy from Honduras who is a student at a non-profit, bilingual, independent, private PK-12 college preparatory school there. Because of my work with this student, his family recommended NESCA’s services to another Honduran family and their child’s school. As a provider, knowing that a family trusts us and finds what we do so beneficial that they recommend us to another family is extremely rewarding.

Setting the Stage: The Special Education Landscape in Honduras
The special education system in Honduras is very different than in the U.S. in that they do not have the variety of resources we are accustomed to in the U.S., and there are not many evaluators in Honduras in any discipline (i.e., neuropsychologists, speech/language, OT, etc.). For instance, there are only six neuropsychologists in the entire country. Another major difference is that it is the parents’ responsibility – not the school’s – to hire a 1:1 paraprofessional or aide if needed for their child. Paraprofessionals function similarly to their U.S. counterparts, but since they are not employed by the school, they are separate from the school.

The special education teachers and counselors also function similarly to those in the U.S.; however, there are unfortunately not enough of them, limiting treatment services. They work from documents similar to IEPs but that are qualitatively are very different from our IEPs.

There are only a couple of special education models used for students: 3 times a week for general special education support or 5 times a week for pull-out reading or math instruction. The 5 times a week options ends at 6th grade. Some of the teachers we worked with reportedly had training in Wilson and Orton-Gillingham, but there are no SLPs or OTs at the schools, and families pay for these services to be provided at the school or after school. Since there are so few professional service providers in the country, these interventions are extremely limited.

Parent & School Consultation in Honduras
As these consulting engagements progressed, both families asked for NESCA to consult to staff at each of the student’s schools in-person in Honduras, and the schools welcomed this support. The families were hoping that my expertise as an educational consultant focusing on inclusion, program design, and autism could greatly benefit the educators and service providers at the schools – ultimately having a positive influence on the students and their classmates.

Both schools are international, bilingual, non-profit, tuition-based college preparatory schools, and are accredited by the Honduran National Ministry of Education, AdvancED, and the International Baccalaureate Organization. One is a Christian faith-based school. Both serve students from nursery through high school and use N-12 American standards of Core Curriculum. They are similar to American schools in that they have a wide choice of classes/electives as students move up in the grades, as well as sports and after school clubs and activities. Upon completion of their high school careers, students at these schools have the opportunity to earn three diplomas: each school’s typical high school diploma, the Honduran Bachillerato, and the International Baccalaureate diploma. A high percentage of graduates go on to higher education in the United States and abroad. They accept students with a variety of “moderate” special needs and have special education teachers and mental health counselors to support them.

For these in-person school consults, I teamed up with another professional who was also already consulting at these schools. She is a Board Certified Behavior Analyst (BCBA) and speaks Spanish – a welcomed addition, as I do not. She is very skilled at providing behavioral support and is not overly rigid in her approach with students. Together, we presented Professional Development trainings for the two schools on the ground in Honduras. We brought a combined, well-rounded knowledge base to our work with the families and schools, offering lessons in a variety of topics, such as Universal Design in Learning (UDL), Differentiated Instruction (DI), Social Skills training/approaches, Mindset and Mindfulness, Sensory Integration, and Positive Behavioral Intervention and Supports (PBIS), along with the ABCs (antecedent-behavior-consequence) and functions of behavior (EATS: escape-attention-tangible-sensory). In this first engagement, we provided a broad overview of these topics, giving the staff much to think about regarding their instructional practices, behavior management, classroom design, and teaching styles. We will continue to provide both virtual and in-person consults this coming school year so their learning can continue to grow and deepen.

This is an ongoing training/learning process for the staff at these schools. As mentioned, we will continue providing ongoing training to help the staff implement Universal Design principles in developing their lessons. We will continue our discussion about viewing student aberrant behavior through multiple lenses – not just as “breaking the rules and needing consequences” (i.e., neurology-sensory, cognitive disconnect, attention, etc.), instead thinking about what the student is trying to communicate through their behavior. This education helps them to think differently about prevention and antecedents, thus impacting behavior management and discipline practices.

The Experience
Staff at both schools were willing to learn and collaborate, and welcomed our input, with one school attending the training the week before their school year started, because we were scheduled to be in-person! The Honduran teachers we worked with throughout the year, prior to our in-person visit, were so open to instruction, feedback, and learning more, often reaching out to us between our scheduled virtual meetings preceding our visit. They were eager to figure out how to support their neurodiverse (a new word for them) learners and allowed me to join their classes remotely so I could model different techniques and practices. They were willing to share their successes, questions, and challenges, making consultation both productive and powerful. They were open to the many “homework assignments” (i.e., articles/books to read, videos to watch, visuals to make, etc.) given to them and the recommendations provided. They implemented new class-wide and individual behavior plans (self-awareness plans) and benefited from the modeling of strategies I demonastrated.

It was a wonderful experience for them and us, and I am happy that our relationship is continuing and will deepen well into this new school year. I am looking forward to watching their continued growth – directly impacting the two students who started it all, as well as their classmates and those to come in future years.

If you are interested in learning more about NESCA’s international evaluation, transition, consultation, and coaching services, complete our online Intake Form.

 

About the Author

NESCA’s Director of Consultation and Psychoeducational Services Dot Lucci has been active in the fields of education, psychology, research and academia for over 30 years. She is a national consultant and speaker on program design and the inclusion of children and adolescents with special needs, especially those diagnosed with Autism Spectrum Disorder (ASD). Prior to joining NESCA, Ms. Lucci was the Principal of the Partners Program/EDCO Collaborative and previously the Program Director and Director of Consultation at MGH/Aspire for 13 years, where she built child, teen and young adult programs and established the 3-Ss (self-awareness, social competency and stress management) as the programming backbone. She also served as director of the Autism Support Center. Ms. Lucci was previously an elementary classroom teacher, special educator, researcher, school psychologist, college professor and director of public schools, a private special education school and an education collaborative.

Ms. Lucci directs NESCA’s consultation services to public and private schools, colleges and universities, businesses and community agencies. She also provides psychoeducational counseling directly to students and parents. Ms. Lucci’s clinical interests include mind-body practices, positive psychology, and the use of technology and biofeedback devices in the instruction of social and emotional learning, especially as they apply to neurodiverse individuals.

 

To book a consultation with Ms. Lucci or one of our many expert clinicians, complete NESCA’s online intake form. Indicate whether you are seeking an “evaluation” or “consultation” and your preferred clinician/consultant/service in the referral line.

 

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.

 

42

Transition Assessment: What Are You Testing that Hasn’t Already been Tested?

By | Nesca Notes 2023

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

Transition planning is a complex process centered around helping students, typically who receive special education services, to set goals for their postsecondary adult lives and to engage in learning, services, and experiences that will help them to ultimately reach those goals. Assessment is a critical aspect of this process, both as a means for collecting baseline information about the student and measuring progress throughout the planning process. Transition planning is federally mandated for students at age 16. However, some states require schools to start the process earlier. For instance, transition planning is required as part of the IEP process for students turning age 14 in Massachusetts.

Transition assessment is therefore required in middle school or early high school for most students in the United States. By this point in time, students on IEPs have often participated in lots of testing. Students may have had academic testing, psychological evaluation, speech and language testing, occupational and physical therapy assessments, functional behavioral assessment, and even home or health assessments. They have participated in so much previous testing, that some parents or professionals may ask, “What could a transition specialist be testing that has not already been addressed through other evaluations?”

The answer is, “A lot!” There are many areas that can and should be evaluated as part of an informed transition planning process, but which are not frequently evaluated when creating earlier IEPs. This is because initial IEPs and early reevaluations focus on helping students to access education and school life, but transition planning is about helping students to develop necessary skills for accessing learning, living, community, and employment as an adult. The following tables are based on on the Transition Assessment Planning Form developed by the Transition Coalition at the University of Kansas in 2008. These highlight many areas of assessment that can and should be considered as part of a comprehensive transition assessment and planning process. These also indicate which areas have usually not been considered for evaluation prior to a thorough transition assessment process.

Please note that every student on an IEP is an individual with unique strengths and disability-related needs and so these tables are offered as a general picture of what has been observed at NESCA in the majority of cases. Additionally, while all of the areas above are considered as part of a comprehensive transition assessment and planning process, they may not need direct assessment depending on student profile, postsecondary goals, and existing evaluation or report data.

For more information about transition assessment and transition planning at NESCA, visit our transition services page and our transition FAQs.

 

About the Author
Kelley Challen, Ed.M., CAS, is NESCA’s Director of Transition Services, overseeing planning, consultation, evaluation, coaching, case management, training and program development services. Ms. Challen also provides expert witness testimony in legal proceedings related to special education. She is also the Assistant Director of NESCA, working under Dr. Ann Helmus to support day-to-day operations of the practice. Ms. Challen began facilitating programs for children and adolescents with special needs in 2004. After receiving her Master’s Degree and Certificate of Advanced Study in Risk and Prevention Counseling from Harvard Graduate School of Education, Ms. Challen spent several years at the MGH Aspire Program where she founded an array of social, life and career skill development programs for teens and young adults with Asperger’s Syndrome and related profiles. She additionally worked at the Northeast Arc as Program Director for the Spotlight Program, a drama-based social pragmatics program, serving youth with a wide range of diagnoses and collaborating with several school districts to design in-house social skills and transition programs. Ms. Challen is co-author of the chapter “Technologies to Support Interventions for Social- Emotional Intelligence, Self-Awareness, Personality Style, and Self-Regulation” for the book Technology Tools for Students with Autism. She is also a proud mother of two energetic boys, ages six and three. While Ms. Challen has special expertise in supporting students with Autism Spectrum Disorders, she provides support to individuals with a wide range of developmental and learning abilities, including students with complex medical needs.

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

NESCA is a pediatric neuropsychology practice and integrative treatment center with offices in Newton 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.

4

Explaining Neuropsychological Testing to Your Child

By | Nesca Notes 2023

By: Lauren Halladay, Ph.D.
Pediatric Neuropsychologist, NESCA

Neuropsychological testing can be confusing for adults to understand and explain, let alone children. Some of the most common questions that parents ask our neuropsychologists prior to their in-person appointments include:

  • “How do I explain the evaluation to my child?”
  • “How can I best prepare my child for what to expect when they are in the office?”

The answers vary depending on several factors. To name a few, your child’s age, level of awareness of areas they are struggling, and your child’s language abilities guide decision-making about the best way to discuss their upcoming evaluation experience. It is important to talk with your neuropsychologist to plan the most appropriate approach for your child. However, below is some standard guidance.

When describing the evaluation itself, I advise parents to use language that reduces pressure on the situation. In other words, it is best to frame the evaluation as a low stakes experience. For example, using words like “testing” or “evaluation” can create unnecessary worry. I often recommend describing the evaluation experience as a variety of “activities,” some of which may include looking at pictures, playing with toys, drawing, and answering questions. Other activities may seem similar to what your child is asked to do in school, such as reading stories, completing math problems, and writing.

Oftentimes, when children hear they are going to the “doctor” they may worry about medical exams. For this reason, it can be helpful to reassure your child that they are not going to be getting poked and prodded; and definitely will not be getting any shots!

To explain the reasons for doing the evaluation, some key phrases to use with your child include:

  • We want to understand how you learn, because everyone learns differently. It’s great that everyone learns differently because it keeps life interesting!
  • Everyone has things they are really good at and other things that are more challenging for them. This will help us understand what comes easy to you and what might be a little trickier, so that we can help you with things like schoolwork, completing activities around the house, and play.
  • We can also share this information with your teacher so they can better understand your learning style and support you at school.
  • Some activities might seem easy and others might be hard, but your job is just to try your best!

For more helpful tips, please see Dr. Gibbons’ previous blog posts, “How Do I Prepare My Child for a Neuropsychological Evaluation?” and “Preparing our Kids to Reenter the Community.”

 

About Lauren Halladay, Ph.D.

Dr. Halladay conducts comprehensive evaluations of toddlers, preschoolers, and school-aged children with a wide range of developmental, behavioral, and emotional concerns. She particularly enjoys working with individuals with Autism Spectrum Disorder, Intellectual and Developmental Disabilities, and complex medical conditions. She has experience working in schools, as well as outpatient and inpatient hospital settings. She is passionate about optimizing outcomes for children with neurodevelopmental disabilities by providing evidence-based, family-oriented care.

 

If you are interested in booking an appointment for an evaluation with a Dr. Halladay or another NESCA neuropsychologist/clinician, please fill out and submit our online intake form. 

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton and Plainville, Massachusetts, 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.

5

Getting to Know NESCA Pediatric Neuropsychologist J. Michael Abrams, Ph.D.

By | Nesca Notes 2023

By: Jane Hauser
Director of Marketing & Outreach

I recently spoke with J. Michael Abrams, Ph.D., pediatric neuropsychologist practicing in NESCA’s Londonderry, New Hampshire office. Dr. Abrams joined NESCA last fall. Take a few minutes to learn more about him in today’s blog interview. 

How did you became interested in neuropsychology?

Back in the mid-80s, I worked at McLean Hospital, in the Child & Adolescent Inpatient program. They had an educational program set up for the kids that was run by psychologists who were embedded in the classrooms. There was a fair amount of test development going on at that time that used a lot of materials to build executive function and cognitive skills among the students. I was always interested in education and special education, but it was this experience that changed my career mindset toward psychology. So, I went back to school to study psychology.

Tell us about your career journey.

I always wanted to work with children and adolescents. That desire stemmed from my initial interest in special education and education in general, and I was on that path. I spent about seven and a half years at McLean, with the first couple of years working on an inpatient unit. Then I transferred to the psychologist-run education program, where I was a classroom educator.

After switching to psychology, my original clinical interest was with children who had experienced abuse and neglect and those who were involved in children’s eyewitness testimony. The focus was on how the experiences they had been through affected their memory, attention, and cognitive development. The more I worked with children and adolescents, the more I recognized how these neuropsychological factors impacted all aspects of their lives. It became much more than what I saw in the context of a legal case; instead, I saw how their experiences affected the management of themselves, their image of themselves, their hopes and aspirations, etc. I became really interested in how their neuropsychology intersected with their opportunities and experiences.

What segment of children and adolescents do you primarily work with? What is your specialty area?

I am particularly interested in working with children from age eight through 14, when their cognitive development is really taking off and they are trying to master this whole new set of skills. This time is filled with questions and challenges concerning self-esteem, mood, relationships, family relationships, etc. It’s a time when they are asking themselves what they are good at, where they struggle, and what those strengths and challenges say about them as a person. There is a great opportunity to have a big impact on kids in this age range. It’s such a gift to allow them to see themselves as successful and have that lead to future success.

What do you find most rewarding and most challenging about your profession?

The rewarding part is two-fold. The first is the interpersonal emotional piece. On a personal level, it’s rewarding to be able to contribute to other peoples’ success, whether it’s the clients, the practice, or the field overall. The second piece is more personal and intellectual. It’s intellectually stimulating to be able to integrate all of the information we gather or identify about a person, and to be able to communicate those findings or revelations to a child and their parents or caregivers. The intellectual reward lies in the ability to effectively communicate a child’s cognitive complexity in a way that they understand and can use to help reach their goals.

The challenging part has to do with the mental health landscape overall. As someone who is involved in neuropsychological assessments, it can feel like operating within a silo in the overall landscape. So many of the systems, such as insurance and education, are not set up for seamless collaboration with psychology practices or other areas of behavioral health. Unfortunately, this can make getting the appropriate mental health care or educational/therapeutic interventions a cumbersome, sometimes adversarial process. It’s the frustration that accompanies the much larger, more overarching need to develop a genuine collaboration among all the pieces within the health and mental health care settings.

What interested you about NESCA?

I was drawn to the opportunity NESCA provides to interact with other psychologists and affiliated clinicians on an ongoing basis. Professionally, I am not operating in a silo. At NESCA, there is more regular consultation and collaboration on how to put together a comprehensive and coherent plan for these kids. I was very excited to have a team of highly qualified, very experienced professionals, within the same organization, who can provide a range of supports and services for the kids we work with. Having this as a resource is a great opportunity for our clients and our staff, alike.

 

About Pediatric Neuropsychologist J. Michael Abrams, Ph.D.

Dr. J. Michael Abrams has over 30 years of experience in psychological, educational, and neuropsychological assessment and psychotherapy in various settings. A significant aspect of Dr. Abrams’ continuing interest and experience also includes the psychological care and treatment of children, adolescents, and young adults with a broad variety of emotional and interpersonal problems, beyond those that arise in the context of developmental differences or learning-related difficulties.

 

To book a neuropsychological evaluation with Dr. Abrams in Londonderry, NH, or to book with another expert NESCA neuropsychologist, complete NESCA’s online intake form. 

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton and Plainville, Massachusetts, 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.

5

Why a Task is Never “Just a Simple Task” – a compassionate perspective on executive functioning difficulties

By | Nesca Notes 2023

By Jasmine Badamo, MA
Educational Counselor; Executive Function Tutor

I’ve often experienced the frustration of a student being given a task–whether it be at home or school–and struggling to complete it. Teachers and parents alike have said to me, “I just don’t understand why they can’t get it done. It’s a simple task.” I’d like to challenge the concept of a “simple task.” Once we begin to dig beneath the surface, we start to see all the hidden demands that every task requires of us and our brains.

As a trained Special Education teacher and executive function coach, I was taught to search for the hidden demands in the academic tasks I give my students. For example, asking a student to write a story about a time they were sad involves a multitude of mini-tasks that present varying levels of challenge depending on the student and their learning needs:

  • Recognize what sad feels like to you
  • Activate your memories to recall a time you felt what sad feels like to you
  • Remember the order of events of a memory that may be more visceral than cerebral
  • Determine which details are important vs. less important to include in your story
  • Decide who your audience is, and remember what the purpose of this story is
  • Perspective take and infer what would make your story interesting to your audience
  • Identify words that will accurately convey your experience to your audience
  • Utilize your knowledge of grammar, spelling, and punctuation to craft intelligible writing
  • Understand and implement a proper story arc so that your story flows

All of this is not even including the related emotional demands:

  • Decide if you’re even motivated to do this, and if your relationship with your teacher is worth all this headache
  • Manage the frustration that comes up at every.single.step.along.the.way.
  • Self-soothe when your insecurities bubble up and you start to question your identity as a writer, student, and/or good person

Oh wait, you thought we were done? There is also a myriad of executive function demands such a task places on a student:

  • Understanding the steps you needs to take, and determining where to start
  • Motivating yourself to take the first step despite feeling extremely stuck
  • Deciding which parts of the writing process to prioritize and spend more time on
  • Knowing how long this will take you, and managing your time respectively
  • Maintaining focus on a task that involves doing the most laborious and LEAST interesting thing a teacher could ask you to do…write
  • Managing the impulse to turn to your friend next to you and talk about what you’re really interested in, which is obviously Minecraft

The above lists are far from comprehensive, and even so, they help demonstrate how a “simple” task is in fact a much more complex–and demanding–series of mini-tasks to complete. Depending on the student, they may easily breeze through these mini-tasks, hardly experiencing them as demands, or they may acutely feel the weight of each mini-task. Students with executive function struggles are more likely to fall into the latter category.

While the best way to support your student or child will vary, the first step is the same for everyone: awareness. The more aware teachers and parents can be about the hidden demands involved in the tasks we assign, the better prepared we can be to support students in overcoming those demands. Acknowledgement and compassion go a long way. Start by reflecting on all the mini-tasks involved in each of your own daily activities, and your ability to identify hidden demands will steadily improve. You can extend this new self-awareness to your students or child, helping them to understand that every task contains a series of smaller steps to follow, and all these steps can make a task feel complicated and draining. Soon, both you and your child will be pros at seeing what lies beneath the surface, and you’ll never label something “a simple task” again!

If today’s post resonates with you or your child, consider reaching out to NESCA; we’re here to help with life’s “simple” tasks! For more information about NESCA’s executive function coaching, visit: https://nesca-newton.com/coaching-services/detailed/#coaching-executive-function.

 

About the Author

Jasmine Badamo, MA, is an educational counselor and executive function coach who works full-time at NESCA supporting students ranging from elementary school through young adulthood. In addition to direct client work, Ms. Badamo provides consultation and support to parents and families in order to help change dynamics within the household and/or support the special education processes for students struggling with executive dysfunction. She also provides expert consultation to educators, special educators and related professionals.

Ms. Badamo is a New York State Certified ENL and Special Education teacher. She has more than 10 years of teaching experience across three countries and has worked with students and clients ranging in age from 7 to adulthood. She earned her bachelor’s degree in Biological Sciences from Cornell University and her master’s degree in TESOL from CUNY Hunter College. She has also participated in graduate coursework focusing on academic strategies and executive function supports for students with LD, ADHD, and autism as part of the Learning Differences and Neurodiversity (LDN) certification at Landmark College’s Institute for Research and Training. In addition to being a native English speaker, Ms. Badamo is also conversationally fluent in verbal and written Spanish.

Having worked in three different New York City public schools, Ms. Badamo has seen firsthand the importance of executive function skills in facilitating student confidence and success. Her coaching and consultation work focuses on creating individualized supports based on the specific needs and strengths of each client and supporting the development of metacognition (thinking about one’s own thought processes and patterns), executive function skills, and independence. She will guide clients to generate their own goals, identify the barriers to their goals, brainstorm potential strategies, advocate for support when needed, and reflect on the effectiveness of their applied strategies.

Ms. Badamo is a highly relational coach. Building an authentic connection with each client is a top priority and allows her to provide the best support possible. Additionally, as a teacher and coach, Ms. Badamo believes in fostering strong collaborations with anyone who supports her clients including service providers, classroom teachers, parents, administrators, and community providers.

 

To book executive function coaching with Jasmine Badamo or another EF or Real-life Skills Coach at NESCA, complete NESCA’s online intake form. 

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton and Plainville, Massachusetts, 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.