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

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

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149

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.

 

149

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.

 

149

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.

 

149

Visual Motor Integration Deep Dive – Part 1

By | NESCA Notes 2020

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

If your child is currently receiving occupational therapy services in either a sensory clinic or a school-based setting, it is likely that you have heard the phrase “visual motor integration (VMI).” It has possibly been described as the ability to “see something and then recreate it with a pencil,” or “coordination between the eyes and the hands to create an intended outcome.” While these phrases or simple definitions do give some insight into the skill, there are layers to understanding the intricacies of VMI and how it may affect someone in a classroom setting. Why is visual motor integration important? Why does this skill affect a child’s ability to successfully access their curriculum? And really, why do occupational therapists seem to be so focused on this foundational skill?

Let’s start by dissecting the phrase visual motor integration, as each word truly highlights an important aspect.

Visual.

In this sense, “visual” refers to the functional visual skills and visual perception. Functional visual skills include being able to follow along a horizontal, vertical or diagonal line with one’s eyes, as well as being able to account for depth by focusing on objects that are both close to the face (a book) and far away (the whiteboard). Clinically, these skills are referred to as visual tracking and convergence respectively. Visual perception is the brain’s ability to interpret the data that the eyes are seeing and turn it into meaningful information. This is not simply the ability to clearly see something, a skill that is often assessed by school nurses or optometrist. It is the ability to understand it. Visual perception is complex in its own right, but the specific details are for another time, or potentially another blog.

Motor.

Similar to visual skills, “motor” refers to one’s overall motor skills. This includes:

  • Fine motor control – the ability to use the small muscles in the hands to make coordinated movements;
  • Gross motor – the ability to use the large muscles in the body; and
  • Postural stability – the ability to create a supported foundation when sitting or standing; a child’s postural stability is hugely affected by their core muscles and their position when sitting.

Integration.

Some students have visual motor dysfunction because of a deficit in either their visual skills or their motor skills. They find using these two skills together difficult simply because one foundational piece is already affected. Conversely, some students have trouble with VMI simply because of this integration piece. Being able to use these two skills in conjunction with intention and coordination is a skill within itself. Through standardized assessment and clinical observation, occupational therapists should be able to determine the root cause of a child’s VMI dysfunction. This helps to guide appropriate intervention and accommodation. In some ways, visual motor integration is similar to hand-eye coordination.  Being able to recreate something that a child sees, such as a square, the letter “A” or a horizontal line is truly using VMI skills.

Next week, we’ll dive further into VMI and how it serves as a foundational skill for academics, its impact on learning and the output students produce.

 

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.

 

148

Five Tips for Promoting Fine Motor Development in the Home!

By | NESCA Notes 2020

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

  • Writing on a vertical surface is a great way to promote proper hand/wrist positioning and fine motor growth – try taping paper to an easel or to the wall and allowing them to try writing on this plane.
  • Skip the fat pencils for our little learners. While specific adapted writing utensils for children with fine motor needs can be best assessed by an occupational therapist, for the majority of our young learners, the rule “the object promotes the grasp!” is applicable. If we want our learners to be building strength and learning proper hand positioning, I suggest trying either a standard number 2 pencil or a mini golf pencil.
  • Let your children peel off and stick on their own stickers! In reality this could end up with some ripped stickers or extra time spent on a project, but peeling off stickers promotes a pincer grasp, bilateral coordination and visual motor integration. If your child is too young to find the edge and begin to peel, consider starting the sticker and then letting them finish peeling it off independently.
  • Use scissors to cut anything and everything! While supplies of construction paper and worksheets sent home from school may be dwindling, consider letting your children cut up junk mail (make sure it’s sanitized), old magazines, newspapers and scraps of old cloth. Some of our kids will want to use these scraps to create a collage or other art projects, while others will simply enjoy the act of shredding. You can make this activity accessible for really young kids by simply having them tear the paper with both hands.
  • Bring out the tool box! Twisting a bolt onto a screw, using a wrench to tighten a hex-nut and using a hammer to pull nails out of a block of wood all help with fine motor and increasing strength. For more of a visual perception task, considering mixing all of the screws, nails and bolts together and having your child sort them into different bowls or containers.

 

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.

 

12

Transition Planning at IEP Team Meetings – The Good, The Fun and The Beautiful

By | NESCA Notes 2019

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

Transition planning is a complicated process for schools, families and related service professionals. It is not something that can be done well without key ingredients, such as open minds, collaboration and creative brain power… not to mention time. But when good transition planning happens in the context of a team meeting, it is a really powerful and awesome process – and even, dare I say, fun!

I recently worked with a young woman – let us call her Julie – who had spent four years of high school in a small therapeutic program. It took Julie, with great support from her team, a lot of effort to get through the academic demands of high school while simultaneously managing and remediating social and emotional complexities. As Julie progressed through her senior year, her school team recognized that she had not had the time or opportunities to build some critical life skills, including the self-advocacy and executive function skills she would need to manage post-secondary, real-world activities. Everyone agreed that she needed another year to build and generalize the functional skills that are essential for being a student in a post-secondary learning environment and to be deemed employable. With no option available for Julie to continue in her therapeutic school program, the team agreed to set up a meeting to create a new IEP that focused largely on Julie’s remaining transition-focused needs. Due to time constraints, the team meeting occurred at the start of this school year.

I was fortunate to be invited to consult at this meeting. After introductions, we dug in together to review Julie’s most recent transition evaluation. Julie had a thorough evaluation that had been completed by the school district, which provided a lot of information about her disability-related needs as well as her vision and interests. We talked about the most pressing areas to address in developing the IEP goals and debated options for creatively writing the annual goals in the IEP document (i.e. whether to focus annual goals on life, vocational and college participation skills with objectives related to social, emotional, executive functioning and self-advocacy issues in each arena or whether to employ a more traditional IEP format with seven goal areas).

We discussed objectives that would be most useful in the context of Julie’s long-term goals – attaining a college degree and working as a nutritionist. Julie’s mom had done a great deal of work prior to the team meeting, helping Julie apply to Massachusetts Rehabilitation Commission (MRC) Vocational Rehabilitation (VR) Services, connecting with the local agency contracted to provide Pre-Employment Transition Services (Pre-ETS), and setting up Julie’s first internship experience for the summer. She also helped Julie to sign up for an adaptive driver’s education class to occur on weekends throughout the fall. Julie’s mother had also researched options for college classes that Julie might be able to participate in, even though she had missed the start of many fall classes.

Julie’s Special Education Director had worked equally hard in looking into resources within the school district and community that could provide Julie with meaningful activities and experiences and assist her in making progress with the skills outlined in the transition assessment. One such resource identified by Julie’s Special Education Director was a non-profit social skills group. Another resource was a coach who could provide hands-on support on a college campus and was already in place as part of a postgraduate program run through a nearby district. The Director also identified several staff withing the school district who were experienced in supporting transition-age students – the school social worker and lead teacher within the school’s therapeutic program – who could work with Julie.

We gathered in a room together not to talk about a program that already existed, but to design the individualized, unique transition program that Julie required. We brainstormed options for shoring up her writing skills with such approaches as drafting an independent research paper on being a nutritionist and participating in a dual enrollment college writing class. We thought of ways to build money management skills through an online personal finance class with school support and real-life practice by visiting her local bank and several ATMs with her school’s occupational therapist.

When we left the meeting, we had designed a brand new program for Julie that would satisfy her needs in the areas of social, emotional, self-advocacy, executive functioning, adaptive and vocational skills development through a combination of school-, community- and home-based activities, with defined support from the school district, community agencies and her family. Everyone left the meeting ready to carry out the next steps of planning for Julie, with roles and responsibilities clearly outlined to initiate the activities that would hopefully propel Julie toward greater independence and satisfaction in her adult life.

This is just one example of a great team meeting that I have been a part of this school year. Over the years, I’ve been fortunate to have had the opportunity to contribute to many of these meetings as well as some of the more challenging ones. After this meeting, I drove all the way home smiling about how much can be accomplished in a 75-minute team meeting when everyone comes to the table thinking about the student, willing to brainstorm, interested in collaborative problem-solving, thinking outside the box, and eager to share responsibility in supporting the student.

Certainly, there are many times when a school district or local collaborative already has a great program and peer group that will work for a student’s post-12th-grade needs, but, as a Transition Specialist, it is truly a lot of fun when everyone is ready to roll their sleeves up and pitch in to create a new tailored individualized education program that taps into the internal resources available to the student and school, while adding community supports and services as appropriate.

In thinking about what makes transition planning at IEP team meetings, such as Julie’s, notably successful, the following “ingredients” stand out:

  • The meeting focuses on the student, with the student’s vision presented at the start of the meeting (ideally by the student), and the team is in agreement about supporting that vision;
  • Team members come to the table eager to work with one another, willing to problem-solve, ask questions, listen to feedback and build on one another’s ideas;
  • There is good assessment data to inform the team process, whereby the team has a good sense of the student’s strengths, preferences and needs, and works together to prioritize what has to be addressed through the IEP; and
  • Team members come to the table knowing what resources exist inside and outside of the school program, with parents and educators having researched and reached out to invite new team members who may know about internal and external resources.

If you are interested in working with a transition specialist at NESCA for consultation, planning or evaluation, please complete our online intake form: https://nesca-newton.com/intake-form/.

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. 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.

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.

4

Mindfulness: It’s Not Just for Grown-ups

By | NESCA Notes 2019

By: Cynthia Hess, PsyD
Pediatric Neuropsychologist Fellow

There has been increasing interest in intervention strategies that target self-regulation in childhood. Self-regulation is the process through which the systems of emotion, attention and behavior are controlled in response to a situation, stimulus or demand. It develops rapidly in the early years of life. Self-regulation is necessary for social development because it supports and enhances peer acceptance and social success. Furthermore, it increases academic performance, particularly in elementary school. Problems with self-regulation and the accompanying executive functioning have been shown to correlate with a number of behavioral and emotional problems, particularly depression and anxiety. Mindfulness is emerging as an effective intervention for children struggling with self-regulation, especially when implemented at a time when children are acquiring these foundational skills.

Mindfulness is a way of paying attention, on purpose and non-judgmentally, to the experience of the present moment. Being mindful involves reflecting on the current internal experiences such as thoughts or emotions and the current external environment, such as sights and sounds, both clearly and objectively. This act of purposeful reflection enhances and facilitates self-regulation by promoting control, such as sustained attention and cognitive flexibility. Furthermore, it helps to reduce the incidences of such things as snap judgments, emotional reactivity or distressing thoughts.

Mindfulness-based social-emotional training has been shown to be effective in reducing stress, improving coping skills and building resilience when used with children. Mindfulness teaches children the skills needed to improve focus, calm themselves, plan and organize, and behave in a thoughtful manner. Research on adult populations shows that practicing mindfulness may reduce symptoms of anxiety and depression, and limited number of studies show some of the same benefits in children. Mindfulness is well tolerated by children and has been proven to improve psychological well-being. Introducing mindfulness practices to children has the potential to make a positive impact on a child’s ability to self-regulate, and thus facilitate their social, emotional and educational growth.

There are a number of ways to introduce children to mindfulness. One activity that children have responded positively to is being challenged to sit still and silent for as long as they possibly can. I have used this strategy in classrooms of children from pre-k to high school, as well as individually with children of all ages. Sometimes they are able to sit for 15 seconds, but they embraced the challenge of trying to beat their record by trying it again. Another mindful technique that works well with children is called “grounding.” Grounding techniques use the five senses to bring ourselves into the present moment. One grounding technique is finding five things in the room – they can be 5 things of the same color or any five things; four things the child can feel; three things the child can hear; two things the child can smell; and one thing the child can taste. Mindfulness can be playful and fun for children and families while effectively reducing stress, improving coping skills, improving ability to self-regulate and building resilience in children.

 

Helpful resources for families:

Mindful Games Activity Cards: 55 Fun Ways to Share Mindfulness with Kids and Teens. Susan Kaiser Greenland and Annaka Harris

A Still Quiet Place: A Mindfulness Program for Teaching Children and Adolescents to Ease Stress and Difficult Emotions By Amy Salzman, MD

I am Peace: A Book of Mindfulness By Susan Verde and Peter H. Reynolds

Breathe Like a Bear: 30 Mindful Moments for Kids to Feel Calm and Focused Anytime, Anywhere By Kira Willey

 

References:

Britton, W. B., Lepp, N. E., Niles, H. F., Rocha, T., Fisher, N. E., & Gold, J. S. (2014). A randomized controlled pilot trial of classroom-based mindfulness meditation compared to an active control condition in sixth-grade children. Journal of School Psychology, 52(3), 263-278.

Masten, A. S., Best, K. M., & Garmezy, N. (1990). Resilience and development: Contributions from the study of children who overcome adversity. Development and psychopathology, 2(4), 425-444.

Schonert-Reichl, K. A., Oberle, E., Lawlor, M. S., Abbott, D., Thomson, K., Oberlander, T. F., & Diamond, A. (2015). Enhancing cognitive and social–emotional development through a simple-to-administer mindfulness-based school program for elementary school children: A randomized controlled trial. Developmental psychology, 51(1), 52.

Schonert-Reichl, K. A., & Lawlor, M. S. (2010). The effects of a mindfulness-based education program on pre-and early adolescents’ well-being and social and emotional competence. Mindfulness, 1(3), 137-151.

Sibinga, E. M., Webb, L., Ghazarian, S. R., & Ellen, J. M. (2016). School-based mindfulness instruction: an RCT. Pediatrics, 137(1), e20152532.

 

About the Author

Dr. Cynthia Hess recently graduated from Rivier University with a PsyD in Counseling and School Psychology. Previously, she earned an M.A. from Antioch New England in Applied Psychology. She also worked as an elementary school counselor and school psychologist for 15 years before embarking on her doctorate. During her doctorate, she did her pre-doctoral internship with RIT in Rochester, N.Y. where she worked with youth ages 5-17 who had experienced complex developmental trauma. Dr. Hess’s first post-doctoral fellowship was with The Counseling Center of New England where she provided psychotherapy and family therapy to children ages 5-18, their families and young adults. She also trained part-time with a pediatric neuropsychologist conducting neuropsychological evaluations. Currently, Dr. Hess is a second-year post-doctoral fellow in pediatric neuropsychological assessment, working with NESCA Londonderry’s Dr. Angela Currie and Dr. Jessica Geragosian.

 

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

 

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

 

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What Does Autism Look Like? Exploring the Differences among Girls and Boys

By | NESCA Notes 2019

 

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

In 2018, the Centers for Disease Control and Prevention (CDC) determined that approximately 1 in 59 children is diagnosed with Autism Spectrum Disorder (ASD). Boys are still four times more likely be diagnosed with ASD; however, research indicates that the diagnosis is often missed in girls, especially those who have average intelligence and “milder” forms of ASD. To understand why ASD is more often missed in girls, let’s explore the differences between boys and girls with ASD. This discussion will focus on children with average to above average intelligence (about 50% of all children diagnosed with ASD).

 

Boys Girls
Poor impulse control, more acting out Likely to be quiet and withdrawn
Disruptive behaviors in the classroom setting Tend to be reserved and cooperative at school
Frequent repetitive motor behaviors that are directly observable Lower frequency of these motor behaviors
Lack of interest in imaginary play Very much engaged in imaginary play
Restricted interests may seem unusual – e.g., train schedules, maps, windmills Restricted interests may seem “age appropriate” – e.g., horses, unicorns, ballet
Trouble making friends Might have a few friends
Likely to exhibit angry outbursts when frustrated/anxious Likely to engage in self-harm or other behaviors that are not observed by others when frustrated/anxious
Lack of awareness of being different or not fitting in More motivated to fit in and “hide” social difficulties – might try to imitate the behavior of a peer that is perceived as popular

 

Due to these differences, the diagnosis of ASD is often missed in young girls. Adults might agree that a girl is “odd” or “quirky,” but dismiss these concerns because she has good eye contact, has some friends, and does not engage in hand flapping or other unusual behaviors. Unfortunately, other girls might be misdiagnosed, which could lead to ineffective or inappropriate treatment interventions. Most commonly, they might be misdiagnosed with ADHD or Anxiety Disorder.

In many cases, girls with ASD have increasing difficulties with social interactions as they get older and demands get higher. A young girl with ASD might be able to “get by” in social interactions but by the time she reaches adolescence, she is not able to navigate the intricacies of the social milieu. This can lead to social isolation and high risk of being bullied or rejected by peers.

Unfortunately, a missed diagnosis of ASD for a young girl can have long-reaching ramifications. She might experience depression, anxiety and/or low self-esteem, wondering why she doesn’t “fit in” and “feels different” from other girls. She might start to struggle in school or disconnect from activities that she used to enjoy. Moreover, missing the diagnosis in childhood means that she did not receive services to support her social and peer interaction skills during her formative years.

As always, when parents or other caregivers have concerns about a child’s development, it is important to seek an evaluation from a professional. And if the findings do not feel quite right, parents should never feel uncomfortable about seeking a second opinion.

 

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 Dr. Gibbons or another NESCA neuropsychologist, 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, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

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Interview with Erin Gibbons, NESCA Pediatric Neuropsychologist

By | NESCA Notes 2018

 

By:
Ashlee Cooper
Marketing and Outreach Coordinator, NESCA

 

What is neuropsychology? How did you get interested in this field?

My first introduction to neuropsychology was as a college student when I took coursework in neuroscience and cognition and found it to be fascinating. However, when I started graduate school, I was initially intimidated by neuropsychology courses as I feared they would be too “medical” or focused on research. I specialized in pediatric psychology, but always assumed I would become a therapist. It was not until I took an internship with a pediatric neuropsychologist that I really understood the field and fell in love with this work.

Although the field of neuropsychology is extensive, what we do at NESCA is focus on its practical applications. An evaluation is comprised of a set of tests that seek to assess students’ skills in a variety of areas such as intelligence, memory, organization, learning/academics, and social skills. The data being generated by those tests are then considered within the context of the student’s developmental history and current challenges. Ultimately, the goal is to provide parents with a complete picture of their child’s learning profile – helping to understand where their child might excel and where he or she might struggle. Moreover, recommendations will be provided in an effort to help each student meet his or her innate potential and to experience success.

What do you like about your job?

I love the opportunity to work with many different children and families from across the state and, in some cases, from other countries. Families place a lot of trust in me by sharing very difficult stories about their children’s struggles and I feel privileged to be a member of their team. For me, the most impactful part of the evaluation is often the parent feedback session when I explain the results of the testing and lay out my recommendations. Through this process, I hope to provide parents with an understanding of their child’s learning profile in a way that helps them establish a road map for the next several years. 

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

At NESCA, we see a wide variety of students presenting with all types of issues. My caseload is always varied and never boring! That said, I tend to see younger clients and have extensive training in evaluating children under 5 years of age. I also enjoy working with students who have developmental disabilities such as autism spectrum disorders or intellectual impairments. I often evaluate students who are considered “difficult to test”; for example, those who are nonverbal, have vision impairments, or significant motor delays. 

What brought you to NESCA?

After completing my doctorate, I spent two years working in a hospital setting. Although I learned an extraordinary amount during my time there, I had very little opportunity to interact with parents as they were typically followed by their child’s physician. I really wanted to work in a place where I could see an evaluation through from start to finish, and working at NESCA allows me to do this. I also appreciate the opportunity to observe students in settings outside of the office and work closely with teachers and other providers. Through the entire process, I get to know each student very well, and I am also able to establish a meaningful relationship with their parents.

What do you enjoy about working at NESCA?

NESCA has a wonderful work culture that is extremely collaborative, supportive, and enriching. Everyone truly enjoys each other’s company and we often have social gatherings to celebrate milestones such as weddings, graduations, and births. Aside from that, our director Dr. Ann Helmus is committed to having all clinicians stay up to date on current research and treatment in the field of neuropsychology. Every other week, we have outside professionals provide staff training, allowing us to learn about local resources, which we can then share with our clients. We also frequently share new information with one another as we attend conferences or read new articles.

What do you think sets NESCA apart? Why should a parent bring their child here when there are so many other neuropsychologists in Massachusetts and New Hampshire?

Every clinician at NESCA is extraordinarily dedicated to providing the best care to their clients. We have case conferences every week during which clinicians discuss challenging cases and seek input from our colleagues. With each new presentation, it is clear that the clinician has genuine compassion for the child and family and is striving to help in every way possible.

Further, our evaluations are remarkably in depth, and we often ask students to return for additional appointments if we feel that we need more information to help round out our understanding of a particular case. Every clinician conducts school or community observations on a regular basis as well; these are often essential in order to see how a student is functioning on a daily basis since test scores do not always tell the “whole story.” Along with these very detailed evaluations, the reports that are provided by NESCA clinicians are outstanding. I have the opportunity to read many, many neuropsychological reports, and I can honestly say that I believe NESCA reports are the best. They describe the student as a whole, including both strengths and weaknesses. Recommendations are consistently specific, detailed, and thoughtful. I often hear parents say that after reading the report, they have a better understanding of their own child.

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

The best first step is to have a consult with one of our clinicians. These one-hour appointments give parents the opportunity to describe their concerns and seek advice on next steps. While a neuropsychological evaluation might be necessary in order to answer their specific questions and address their concerns, this is not always the case. Having the chance to talk things out with an expert can be extremely helpful in terms of creating the most sensible plan.

 

 

We are very excited to announce that on October 1, 2018, NESCA will open a bright new, satellite office in Plainville, MA! To schedule an appointment with Dr. Erin Gibbons in Plainville, please complete our online intake form: https://nesca-newton.com/intake-form/  The address of NESCA-Plainville is 60 Man Mar Drive, Suite 8, Plainville, MA 02762.

 

 

About the Author: 

As Marketing and Outreach Coordinator, Ashlee oversees marketing campaigns and develops community relationships through various programming activities – all of which expand NESCA’s well-respected reputation in New England. Ashlee brings a wide range of marketing, design and communications experience in the social service and non-profit industry. She lives in Newton with her husband and their beloved dog, Winnie. In her free time, she enjoys doing yoga, watching documentaries and promoting her and her husband’s housewares startup.

Get in touch with Ashlee with any questions you may have about NESCA’s programs and events at acooper@nesca-newton.com. She looks forward to hearing from you!

 

 

 

 

 

 

 

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

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