Exciting announcement! NESCA is accepting clients for home- and/or community-based Real-life Skills and Executive Function Coaching with Leah Bridge, MSOT, OTR. Leah is available for in-person occupational therapy (OT) and coaching services in the Newton, MA and Central MA areas. NESCA’s team of coaches offer Real-life Skills, Executive Function, Functional OT and Parent/Caregiver Coaching remotely for those outside of the Newton area. To learn more or book coaching services, complete our Intake Form.

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speech language therapy

Welcoming Renee Cutiongco Folsom, Ph.D., Pediatric Neuropsychologist

By | Nesca Notes 2023

By: Jane Hauser
Director of Marketing & Outreach, NESCA

NESCA recently welcomed Pediatric Neuropsychologist Renee Cutiongco Folsom, Ph.D. to its clinical staff. Dr. Cutiongco Folsom brings a wealth of experiences and vast knowledge in assessing and diagnosing autism spectrum disorders (ASD) as well as conducting international evaluations. Take a moment to learn more about Dr. Cutiongco Folsom from my interview with her. 

Tell us about your background and how you got to NESCA.

I grew up in the Philippines. I started my career as a preschool teacher there for two years. At that point, I knew I wanted to work with children. I eventually got my master’s degree in psychology and took a neuropsychology class with a professor who was trained at Boston Children’s Hospital. I immediately fell in love with neuropsychology. I then came to the U.S. to pursue my Ph.D. and did my fellowship in neuropsychology at UCLA. I planned to go back to the Philippines but met my husband here in the U.S. and decided to stay here.

Since I did not go back to the Philippines, I was interested in practicing neuropsychology internationally, which I was able to do in Baltimore at Johns Hopkins. I was interested in the work NESCA has been doing internationally. The opportunity to work with a talented team at NESCA and the ability to do international evaluations was the right move for me.

What do you mean by looking beyond the data when conducting neuropsychological evaluations?

I refer to employing the “Boston Process Approach” in my evaluations and assessments because my mentor in the Philippines was trained in this approach when she did her postdoctoral work at Boston Children’s Hospital. She tried to ingrain this methodology in her trainees. What it means is that when we look at the data, we do not just look at a score. There is so much more to a child’s story than a number. As neuropsychologists, we are always looking at how the child comes up with an answer to a test. It is possible for a child to get a low score on a test of reproducing designs using blocks, for example, because the child threw or even ate the blocks! We must decipher what is behind the process by which the child produced the answer. This critical information falls outside of the data or what a score is. It tells us how the child learns, and what will help them at school, at home, and in their day-to-day life. This is the approach I take when I work with a child. I take a LOT of notes! I look to see what the child says and does, whether he or she is paying attention, and note other behaviors throughout the evaluation process. Then, I analyze all the data and look for patterns and discrepancies across various tests and measures.

When we see the data associated with the performance on a test, we must ask why, for instance, they achieved a low score. What other factors are at play? Is it anxiety or a visual-motor issue? What we observe throughout the evaluation can guide us to administer some tests that may not have been initially scheduled. Our knowledge, experiences, and careful observations help us to tease apart where a score came from and what it is telling us. We end up with a fuller picture of both the strengths and vulnerabilities of a child or adolescent.

What kind of international work were you doing previously?

After I completed my fellowship in neuropsychology at UCLA, my first job was with the Kennedy Krieger Institute at Johns Hopkins. Because so many families go there from other countries seeking answers, the organization assembled interdisciplinary teams to serve international patients. We conducted week-long intensive and comprehensive evaluations involving a neurologist, neuropsychologist, occupational therapist, speech-language pathologist, and social worker who could help them access resources in their home country. At the end of the week of intense evaluation, we came together as a team to make a diagnosis, if warranted, and provide recommendations for interventions. It was a challenging and intense program because we needed to develop our impressions immediately. And we often saw some of the most difficult and complex cases because the families had already exhausted all the resources available to them in their home countries before traveling overseas.

What do you find most rewarding about being a pediatric neuropsychologist?

I have been practicing neuropsychology for a long time. I chose to work in pediatric neuropsychology vs. adult because we can do so much more with children. We have a particularly good chance of making a bigger impact on their lives at such an early age.

What I find most rewarding is to have patients come back for a follow-up evaluation, and I can see how the child has progressed. Their parents often thank me for providing them with a diagnosis and helping them to access resources and attest how far their child has come. Working alongside families to change the trajectory of a child’s life is very powerful.

 You specialize in autism spectrum disorders (ASD). How do you make a diagnosis and differentiate ASD from its related challenges?

You rely on years of training, your knowledge and expertise, trust your clinical judgment, and factor in the wisdom of colleagues when needed. This is how you make meaningful conclusions and diagnoses that impact a child’s life.

What do you feel makes NESCA a unique environment and practice?

The beauty of a practice like NESCA is that we get a broad spectrum of clients who present with different challenges or diagnoses. We get to see a range of ages and draw clients from all over the New England region as well as internationally. That variety enriches your perspective and gives more insight into your clinical work.

I have been at NESCA for about a month, and they take collaboration to heart. My colleagues at NESCA are a giving group of professionals when it comes to sharing experiences and knowledge. The clinicians are humble, candid, open, and eager to help children, adolescents, and young adults. As a pediatric neuropsychologist, I also get to collaborate with transition specialists, educational consultants, OTs, SLPs, and more. The multidisciplinary approach, learning from other perspectives, is a refreshing addition to my work experience.

 

About the Author

Dr. Renee Cutiongco Folsom, Ph.D. has been working with families in the greater Boston area since 2015. Prior to this, she was on staff at Johns Hopkins University and trained at the University of California, Los Angeles (UCLA). She provides comprehensive neuropsychological evaluations of children, adolescents, and young adults who have learning, behavioral, and socio-emotional challenges. Her areas of expertise include Autism Spectrum Disorder and other conditions that usually co-occur with this diagnosis; Attention-Deficit/Hyperactivity Disorder; Dyslexia and other Specific Learning Disabilities; and Anxiety/Depression. She thinks that the best part of being a pediatric neuropsychologist is helping change the trajectory of children’s lives.

To schedule an appointment with one of NESCA’s pediatric neuropsychologists, 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 the greater Burlington, Vermont area, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

 

The SLP’s Role in Written Language Disorders

By | NESCA Notes 2022

By Olivia Rogers, MA., CCC- SLP
Speech-Language Pathologist, NESCA

A written language disorder is an impairment in fluent word reading (i.e., reading decoding and sight word recognition), reading comprehension, written spelling, and/or written expression (Ehri, 2000; Gough & Tunmer, 1986; Kamhi & Catts, 2012; Tunmer & Chapman, 2007, 2012). As written language disorders are quite complex, appropriate assessment and treatment often incorporates many members. Members of the interprofessional practice team may include, but are not limited to, reading specialists, occupational therapists, special educators, learning specialists, and more.

When you think of a speech-language pathologist (SLP), a few words probably come to mind; terms like articulation, language, or fluency. Often, SLPs are associated with spoken language only. Most people don’t think of reading or writing when they think of SLPs. However, in addition to the diagnosis and treatment of spoken language disorders, it is well within the scope of practice of a SLP to diagnose and treat written language disorders. In fact, spoken and written language have a reciprocal relationship; each builds on the other to result in general language competence. Children with spoken language problems frequently have difficulty learning to read and write, and children with reading and writing problems frequently have difficulty with spoken language. Children with speech and language deficits are at a higher risk for reading and writing difficulties. Higher rates of all forms of written language disorders have been documented in children with speech and/or language impairments. Take a look at these findings:

  1. Comorbidity between literacy difficulties and speech and language deficits occurred in as high as 50% of cases (Stoeckel et al. (2013).
  2. By the end of kindergarten, more than 25% of children with language impairment were reported to also be poor readers (Murphy et al., 2016).
  3. Approximately 20%-28% of children with speech sound disorders (SSD) have literacy difficulties (Overby, Trainin, Smit, Bernthal, and Nelson, 2012).

No matter the age, SLPs can assess and treat spoken and written language difficulties. SLPs bring knowledge of communication processes and disorders, and language acquisition to the literacy table. Additionally, SLPs are skilled in dynamic assessment and have clinical experience in developing individualized programs for children and adolescents. Here are just a few written language skills that SLPs work on:

Reading: Pre-reading Skills

Before a child can decode, or read, they must have an understanding that words are composed of smaller units and how these units operate separately and together. SLPs incorporate the following skills into sessions:

  • Rhyming (e.g., “flag and stag”)
  • Syllable segmenting (e.g., “student: stu/dent”)
  • Blending sounds into words (e.g., “sh/i/p says ‘ship’”)
  • Segmenting words into their sounds (e.g., “leg: l/e/g”)
  • Deleting sounds in words (e.g., “cup without the c is up”)
  • Substituting sounds in words (e.g., “change the ‘B’ in bat to an ‘M’”)

Reading: Language Comprehension

This is the biggest one for SLPs. To target language comprehension, we work on smaller goals, such as:

  • Grammar
  • Story Grammar Elements
  • Visualizing and Verbalizing
  • Vocabulary
  • Active Reading Strategies
  • Themes

Writing: Organization/Planning

Before writing, it is important to plan out what you will write. Many children with language disorders have trouble with these skills. Here are just a few ways that SLPs help children plan and develop their writing by:

  • Using visuals for story grammar components
  • Make and practice using graphic organizers
  • Teaching sentence, paragraph, and essay construction

Spelling

Yes, spelling! SLPs are equipped to work on spelling. After all, it is just another language skill. Some ways to target spelling include:

  • Working on phonological awareness and phonemic awareness
  • Teach students about morphology (the study of words and their parts)
  • Incorporation of working memory strategies, such as chunking, visualization, or mnemonics

If you have concerns about your child’s pre-literacy or literacy skills, or would like to support your child’s written language skills, please contact NESCA’s Olivia Rogers at orogers@nesca-newton.com or fill out our Intake Form, noting an interest in speech language pathology.

 

Sources:

Overby, Trainin, Smit, Bernthal, and Nelson, 2012) Preliteracy Speech Sound Production Skill and Later Literacy Outcomes: A Study Using the Templin Archive.

American Speech-Language-Hearing Association. (2001). Roles and responsibilities of speech-language pathologists with respect to reading and writing in children and adolescents [Position Statement]. Available from www.asha.org/policy.

Catts, H.W. & Weismer, S.E. (2006). Language Deficits in Poor Comprehenders: A Case for the Simple View of Reading. Journal of Speech, Language, and Hearing Research, 49, 278-293.

 

About the Author

Olivia Rogers received her Master of Arts in Speech-Language Pathology from the University of Maine, after graduating with a Bachelor of Arts in Communication Sciences and Disorders and concentrations in Childhood Development and Disability Studies.

Ms. Rogers has experience working both in the pediatric clinic setting as well as in public schools, evaluating and treating children 2-18 years of age presenting with a wide range of diagnoses (e.g., language delays and disorders, speech sound disorders, childhood apraxia of speech, autism spectrum disorder, social communication disorder, and Down syndrome). Ms. Rogers enjoys making sure therapy is fun and tailored to each client’s interests.

In her free time, she enjoys listening to podcasts and spending times with friends and families.

 

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.

 

To book an appointment with Olivia Rogers, please complete our Intake Form today. For more information about NESCA, please email info@nesca-newton.com or call 617-658-9800.

 

Learning with Executive Dysfunction—How Graphic Organizers Can Help

By | NESCA Notes 2022

By Olivia Rogers, MA, CCC-SLP
Speech-Language Pathologist, NESCA

When it comes to executive dysfunction, we often see students struggle with the organization of language. This presents differently in each student, but may be seen as difficulty comprehending information, and getting ideas out of their heads and organized into words or on paper. They might recognize the words when listening or reading, but they hit a wall when it comes to making sense of the message or describing it. This often results in students feeling lost, confused, and overwhelmed.

When students struggle to organize language and grasp concepts independently in the classroom, we need to break it down and teach it differently. Graphic organizers help us to do so.

What is a graphic organizer?

Graphic organizers are tools that use visual symbols to express knowledge, concepts, thoughts, or ideas, and the relationships between them. The main purpose of a graphic organizer is to provide a visual aid to facilitate learning and instruction. They help students see visually what is expected of them, what they should focus on, and break complex tasks down for them.

What does the evidence show?

There is plenty of evidence demonstrating the benefits of using graphic organizers. The results of most studies have voiced the positive effects of graphic organizers in mainly comprehension and writing, in addition to remembering course content. One such study recommended the use of graphic organizers for teaching expository text structures with students to improve reading comprehension. A popular strategy to help students understand expository texts is to teach the various types of text structures: cause-and-effect, compare/contrast, problem/solution, etc. When students know the underlying organization of the information, it helps them create a working model of it in their minds, resulting in a better understanding and ability to recall. (Pyle et al., 2017). Another study sought to investigate how pre-writing activities based on graphic organizers, such as webs, and beginning, middle and end charts, affect the overall quality of student writing. The results of the study indicate that using appropriate pre-writing strategies based on graphic organizers and giving enough time for the students lead to better quality writing (Servati, 2012).

How are Graphic Organizers Used in Speech Language Therapy?

1. Graphic Organizers Help Students Focus

Many students exhibit disorganized thinking processes, poor initiation skills, word recall difficulties, poor attention, and decreased task endurance. These weaknesses can impact a student’s ability to get started on a project, organize a writing assignment, or even complete a math task. Graphic organizers help students access prior knowledge and get them actively engaged in learning.

2. Graphic Organizers Provide a Visual Map and Help Clarify Abstract Concepts

Have you ever had so much information that you couldn’t hold onto it all? Graphic organizers bring together large pieces of information and tie the relationships together. The concepts and linguistic relationships flow better and make sense to students.

3. Graphic Organizers Help Build Vocabulary

Students benefit from graphic organizers as they expand their word knowledge and make connections. Graphic organizers are great for teaching concepts like descriptive adjectives, antonyms/synonyms, items in a category, part/whole relationships, and definitions.

4. Graphic Organizers Improve Expressive Language

Graphic organizers support oral and written language in all areas of academic learning. Some students have difficulty creating pictures in their head, retrieving words to verbalize their ideas, and putting their thoughts in order. Utilizing a graphic organizer can help students when they need to present information orally or develop a draft for writing.

 

Resources:

Architects For Learning. (2022, May 18). Helping students manage what’s hard about school and thrive as life-long learners. Retrieved June 21, 2022, from https://www.architectsforlearning.com/students-parents/about-us/

Erwin, L. (2017, May 26). 5 reasons to use graphic organizers in speech therapy. My Speech Tools. Retrieved June 21, 2022, from https://myspeechtools.blogspot.com/2017/05/5-reasons-you-should-use-graphic-organizers-speech-therapy-sessions.html

Servati, Katrina, “Prewriting Strategies and their Effect on Student Writing” (2012). Education Masters. Paper 242. https://fisherpub.sjfc.edu/education_ETD_masters/242

Sherman, H. (2017, December 23). Using Graphic Organizers is Essential in Speech Therapy. Speech Time Fun Speech and Language Activities. Retrieved June 21, 2022, from https://speechtimefun.com/using-graphic-organizers-is-essential-in-speech-therapy/

Pyle, N., Vasquez, A. C., Lignugaris, K., & B., Gillam, S.L., Reutzel, D.R., Olszewski, A., Segura, H., Hartzheim, D., Laing, W., and Pyle, D. (2017). Effects of expository text structure interventions on comprehension: A meta-analysis. Reading Research Quarterly, 52(5), 1–33. https:// doi. org/ 10. 1002/ rrq. 179

 

About the Author

Olivia Rogers received her Master of Arts in Speech-Language Pathology from the University of Maine, after graduating with a Bachelor of Arts in Communication Sciences and Disorders and concentrations in Childhood Development and Disability Studies. She holds a Certificate of Clinical Competence in speech-language pathology from the American Speech-Language-Hearing Association, as well as a professional license in speech-language pathology from the Commonwealth of Massachusetts.

Ms. Rogers has experience working both in the pediatric clinic setting as well as in public schools, evaluating and treating children 2-18 years of age presenting with a wide range of diagnoses (e.g., language delays and disorders, speech sound disorders, childhood apraxia of speech, autism spectrum disorder, social communication disorder, and Down syndrome). Ms. Rogers enjoys making sure therapy is fun and tailored to each client’s interests.

In her free time, she enjoys listening to podcasts and spending times with friends and families.

 

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.

 

To book an appointment with Olivia Rogers, please complete our Intake Form today. For more information about NESCA, please email info@nesca-newton.com or call 617-658-9800.

 

Changes to the Developmental Milestones Guidelines Cause Confusion and Conflict

By | NESCA Notes 2022

By Olivia Rogers, MA, CF-SLP
Speech-Language Pathologist, NESCA

Recently, the Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics (AAP) updated guidelines for developmental milestones in the Learn the Signs. Act Early program for the first time since its initial release in 2004. This program provides free checklists of developmental milestones and outlines warning signs of developmental delays in the following areas: social/emotional, language/communication, cognition, and movement/physical.

One of the biggest CDC developmental milestone changes involves language development. Since 2004, the CDC has stated a 24-month-old should have a vocabulary of 50 words. Now, that milestone of 50 words has been pushed back to 30-months-old. This new standard clashes with the American Speech-Language-Hearing Association (ASHA) guidance, which states that saying fewer than 50 words at 24 months is a potential red flag for a language delay or disorder.

Confusion regarding the recent changes may impact the (already) difficult decision that many parents are faced with in the first few years of their child’s life: whether or not to seek professional support for their child.

Despite the changes to the outlined milestones, the intentions behind this checklist remain consistent—early identification and intervention is key. When it comes to your child’s speech and language development, we suggest not taking the “wait and see” approach. The first three years of your child’s life—when the brain is developing and maturing—is the most intensive period for acquiring key speech and language skills.

Though children vary in their development of speech and language skills, they do follow a natural progression for mastering these skills of language. If you’re worried your child isn’t meeting milestones and wondering when the right time or the best age is for speech/language therapy, take action sooner than later. Contact a local speech-language pathologist. The earlier a child is identified with a delay, the better, as treatment and learning interventions can begin.

We urge parents to follow their instincts and seek guidance when there is a concern. You will either get much needed help for your child or peace of mind, and your local speech-language pathologists are happy to help.

If your pre-school-aged child is having difficulty with any of the following, concerns can be addressed through a speech/language assessment and/or therapy:

  • Saying first words or combining words into sentences
  • Using gestures
  • Naming and describing objects, ideas, and experiences
  • Pronouncing words or being understood by family or others
  • Interacting socially or playing with others
  • Understanding words, concepts, or gestures
  • Listening, following directions, or answering questions
  • Knowing how to take turns when talking or playing with others
  • Using correct grammar, such as pronouns and verb forms

Resources:

Centers for Disease Control and Prevention. (2022, January 31). CDC’s Developmental Milestones. Centers for Disease Control and Prevention. Retrieved February 24, 2022, from https://www.cdc.gov/ncbddd/actearly/milestones/index.html

The National Institute on Deafness and Other Communication Disorders. (2000). Speech and Language Developmental Milestones. NIH Publication No. 00-4781.

 

About the Author

Olivia Rogers received her Master of Arts in Speech-Language Pathology from the University of Maine, after graduating with a Bachelor of Arts in Communication Sciences and Disorders and concentrations in Childhood Development and Disability Studies.

Ms. Rogers has experience working both in the pediatric clinic setting as well as in public schools, evaluating and treating children 2-18 years of age presenting with a wide range of diagnoses (e.g., language delays and disorders, speech sound disorders, childhood apraxia of speech, autism spectrum disorder, social communication disorder, and Down syndrome). Ms. Rogers enjoys making sure therapy is fun and tailored to each client’s interests.

In her free time, she enjoys listening to podcasts and spending times with friends and families.

 

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.

 

To book an appointment with Olivia Rogers, please complete our Intake Form today. For more information about NESCA, please email info@nesca-newton.com or call 617-658-9800.

 

Thematic Instruction in Speech-Language Therapy

By | NESCA Notes 2021

By Olivia Rogers, MA, CF-SLP
Speech-Language Pathologist, NESCA

What exactly is a theme and why would we use them in speech therapy? A theme can be defined as the creation of various meaningful activities planned around a central topic or idea. For example, using activities that are all about the ocean, sports, or winter. Themed activities can be great for working on speech and language skills.

Here are some benefits of using thematic instruction (Hadley et al., 2018; Wallach, 2014):

  • Thematic instruction is a meaningful and motivating method of learning concepts.
  • Knowledge on different themes and categories supports a child in making connections between various concepts. It also provides the opportunity to teach and practice new skills by building on a child’s existing knowledge of the topic.
  • Teaching words linked in thematic groups allows for a deeper understanding of functions, categories, and features. Thematic instruction can improve vocabulary and increases a child’s understanding and use of synonyms and antonyms.
  • Activating prior knowledge and engaging students in prior knowledge activities increases the comprehension and retention of information. This, in turn, supports story retelling skills, as well as ability to answer “WH” questions – who, what, where, when and why.
  • Themes are relevant to a child’s real-life experiences; therefore, thematic instruction improves a child’s ability to make inferences and predictions. Children can make better inferences and predictions about situations they may encounter on a daily basis with this knowledge of various themes and categories.
  • Thematic instruction promotes generalization outside the therapy room.

Thematic instruction can result in improvements in overall language skills. Additionally, using themes can keep speech-language therapy interesting and help increase engagement. This is key, as it’s been shown that when a child receives eight more minutes of engaging therapy, there is significantly greater improvement than with regular therapy (Schmitt, 2020).

What can you do at home?

Fortunately, thematic instruction can be easily incorporated into daily life or special occasions at home – and can be adapted for any age. October is one of my favorite months as it is packed with themes. I like to dedicate the first part of October to autumn and leaves, as well as fire safety and occupations. Then it’s time to dive into all things Halloween! Here are some Halloween-themed activities you can do at home to support your child’s language development:

  • Read different Halloween stories while increasing the understanding of Halloween-associated vocabulary (e.g., pumpkin, leaves, haunt, eerie, costume, cauldron, ghost, broomstick, etc.) and Halloween lingo (e.g., “trick or treat,” “boo,” “hair-raising,” “if you dare,” “pumpkin carving,” etc. Some great books to help you with these words and phrases are:
    1. Room on the Broom by Julia Donaldson
    2. There was an Old Lady Who Swallowed a Bat by Lucille Colandro
    3. Goodnight Goon by Michael Rex
  • Encourage your child to recall details and retell the stories you read. Have them:
    1. Describe the setting of the story.
    2. Tell you about one story character.
    3. Identify their favorite part of the story.
    4. Say what happened at the end of the book.
  • Encourage the use of Halloween-associated vocabulary by going on a neighborhood walk and playing I Spy with your child (e.g., “I spy something orange, that you can carve during Halloween,” or “I spy something that changes colors then falls from trees,” etc.).
  • Discuss the history of Halloween and where it originated.
    1. Make predictions regarding this upcoming Halloween and Halloweens to follow.
    2. Compare and contrast Halloween traditions over the years.
  • Create a hands-on activity (e.g., carving pumpkins, drawing a haunted house, collecting leaves for a craft, etc.) where your child/children follow directions to cooperatively complete the project. This encourages problem solving, reasoning and use of appropriate social skills.
  • Engage in a pretend play scenario about Halloween using all the information your child has learned throughout your thematic intervention.

Resources:

Hadley, E. B., Dickinson, D. K., Hirsch-Pasek, K., & Golinkoff, R. M. (2018). Building semantic networks: The impact of a vocabulary intervention on preschoolers’ depth of word knowledge. Reading Research Quarterly.

Schmitt, M. (2020). Children’s active engagement in public school language therapy relates to greater gains. American Journal of Speech-Language Pathologyhttps://doi.org/10.1044/2020_AJSLP-19-00157

 

About the Author

Olivia Rogers received her Master of Arts in Speech-Language Pathology from the University of Maine, after graduating with a Bachelor of Arts in Communication Sciences and Disorders and concentrations in Childhood Development and Disability Studies.

Ms. Rogers has experience working both in the pediatric clinic setting as well as in public schools, evaluating and treating children 2-18 years of age presenting with a wide range of diagnoses (e.g., language delays and disorders, speech sound disorders, childhood apraxia of speech, autism spectrum disorder, social communication disorder, and Down syndrome). Ms. Rogers enjoys making sure therapy is fun and tailored to each client’s interests.

In her free time, she enjoys listening to podcasts and spending times with friends and families.

 

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.

 

To book an appointment with Olivia Rogers, please complete our Intake Form today. For more information about NESCA, please email info@nesca-newton.com or call 617-658-9800.

 

Speech-Language Pathology at NESCA with Olivia Rogers, MA, CF-SLP

By | NESCA Notes 2021

Speech-Language Pathologist Olivia Rogers, MA, CF-SLP, joined NESCA in June, working with clients in the Newton, Massachusetts office, and is scheduling new clients now. We sat down with Olivia to learn more about her, what her passions in speech and language are and why she joined NESCA.

By Jane Hauser
Director of Marketing & Outreach

How did you initially get interested in Speech-Language Pathology (SLP)?

I started my undergraduate education as a bioengineering major. A project I was assigned to required me to research devices that related to the medical side of bioengineering. After some research, I came upon cochlear implants, which led me to learn more about Audiology and Speech-Language Pathology (SLP). Ultimately, I knew I desired to work with people and make an impact in the healthcare field, but I didn’t feel like bioengineering was where I belonged. After I switched my major to Communication Sciences and Disorders, I knew I had made the right decision.

Additionally, I am the oldest of five children, so was always around kids. Once I stumbled upon this major, I realized it was a great way to combine my desire to work with kids and a career that really fulfilled me.

In what settings have you worked previously?

I’ve done a few clinical rotations in different settings. I spent a semester in a K-8 public school, and a year in pediatric private practice.  Those opportunities allowed me to work with children with various speech and language challenges. I also spent some time in a hospital working with adults in the inpatient acute care unit. All of these experiences strengthened my passion for working with the pediatric population and implementing therapy that is both functional and personal to each individual.

What brought you to NESCA?

Last summer, I was a student intern with NESCA’s Speech-Language Pathologist Abbey Gray, MS, CCC-SLP, as part of my third clinical placement. When the opportunity to work with Abbey and also some of the kids we worked with together again came to my attention, I jumped at the opportunity to work with all of them again.

It’s exciting to work at NESCA in the clinic setting where the Speech-Language team is expanding, and collaboration is so important. Here, I get to be a part of a great team of therapists, clinicians and neuropsychologists. I also appreciate that NESCA is so open to and supportive of its clinicians continuing to learn. For example, I am hoping to gain feeding therapy experience alongside the other feeding therapists here at NESCA.

What part of being a SLP do you enjoy the most?

Being able to communicate is one of the most important life skills, and giving others the tools they need to do so effectively is amazing in itself. However, no two clients are the same and it is up to me to be creative in catering to each individual to make sure that therapy is motivating and beneficial. As a SLP, creativity and play are not only allowed but encouraged. I really enjoy that part of my job.

I really love all of the work I do with children, especially working with kids on receptive and expressive language therapy. With the older children I work with, I enjoy working on the social pragmatic aspects of communication. With the younger kids, I love play-based therapy and working with parents and families to ensure that the language we are targeting is practical.

How do you partner with families when you are working with a child at NESCA?

Integrating real life and therapy is one of the most important aspects of what I do as a SLP. It’s essential for parents or other family members/caregivers to be involved in a child’s therapy to make sure that there is carryover into the home setting. Building functional language skills is a full-time venture involving therapy sessions and practice at home. I strive to have family involved either in the weekly therapy sessions and/or taking notes on what we are working on to further support that child in reaching their goals.

And regarding goals, it’s so important to have parent/caregiver input on the goals we work toward. With the older kids I work with, they are often able to communicate what they’d like to or need to work on. With the younger children, it’s critical for parents and families to help communicate a child’s challenges in order for us to establish the goals we work toward together.

What is one of the most inspiring milestones you have experienced as a Speech-Language Pathologist?

While I was working in the K-8 school, most of the children I worked with were deaf or hard of hearing. There was one 10-year-old boy who was profoundly deaf and utilized cochlear implants. He was essentially nonverbal, and our goal was to help him to auditorily recognize and verbally produce a couple of functional words that could support him in the classroom and at home. In particular, we were trying to get him to interact verbally with his dog; this was a personal goal of his. After months of work, his mom let us know that at home he said, “Sit,” and his dog followed his command! He was so motivated to learn more words since he saw how language could help him to function more easily and successfully. It was such an inspiration and really solidified my strong desire to work with kids to help them in speech and language, and in life.

 

About Speech-Language Pathologist Olivia Rogers

Olivia Rogers received her Master of Arts in Speech-Language Pathology from the University of Maine, after graduating with a Bachelor of Arts in Communication Sciences and Disorders and concentrations in Childhood Development and Disability Studies.

Ms. Rogers has experience working both in the pediatric clinic setting as well as in public schools, evaluating and treating children 2-18 years of age presenting with a wide range of diagnoses (e.g., language delays and disorders, speech sound disorders, childhood apraxia of speech, autism spectrum disorder, social communication disorder, and Down syndrome). Ms. Rogers enjoys making sure therapy is fun and tailored to each client’s interests.

In her free time, she enjoys listening to podcasts and spending times with friends and families.

 

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.

 

To book an appointment with Olivia Rogers, please complete our Intake Form today. For more information about NESCA, please email info@nesca-newton.com or call 617-658-9800.

 

Mind the Gap: Why You Should Consider Summer OT and Speech Services at NESCA

By | NESCA Notes 2021

By: Julie Robinson, OT
Director of Clinical Services; Occupational Therapist, NESCA

It has been a challenging school year, with ever-changing schedules, routines, and unfortunately with a good deal of inconsistency in the provision of therapeutic services through the schools, due to the many impacts of COVID. Parents, caregivers and students have all experienced differing levels of anxiety about what progress has been and is being made, with many children experiencing some level of regression with regard to behavior, self-regulation, motor skills or language development. In anticipation of many of our children returning to school in-person in April, parents have expressed concerns that their children may be lagging behind or that they have not had ample support throughout the earlier parts of their school year to ensure they can keep up with the other children in their class. Over the months of April, May and June, we will all get to see firsthand where the gaps might arise. And then when school is over, many of us might be concerned that the gains of just a few short months will be lost again over summer. This is why those of us at NESCA perceive that the benefits of summer services will be an important part of ensuring progress and the ability to jump right back into learning – as we hope all school will be in-person again in the fall.

NESCA is available to provide summer services, as we do consistently for our weekly patients. In addition, we are offering short-term services to those children who may not qualify for them through their school systems, or for those families who would simply like to supplement what their children are receiving in-district to give them a boost before school begins again in the fall.

Our occupational therapists (OTs) can work on the following areas of focus with your child:

  • self-regulation and coping skills
  • how best to transition from the quiet of home to the multiple stimuli of a classroom full of children
  • how to cope with longer hours of wearing a mask
  • how to follow social distancing requirements, when they long for a closer physical connection with their peers

We can also help to ease the anxiety some children may have about becoming sick or how NOT to feel fearful of getting back into the classroom when sensory processing issues push them to feel uneasy. Our OTs can continue work on handwriting and motor development work started throughout the school year to ensure there is no regression or to improve the speed and automaticity of written expression and legibility. We can teach organizational and executive functioning skills to encourage kids to be independent, prioritize assignments and manage their time. OTs can address self-care skills of dressing, shoe tying, feeding and hygiene, which are likely to require more independence with social distancing requirements. While it’s summer, we help build outdoor skills, such as bike riding and greater self-confidence on the playground to elicit more social connections with peers. Our OTs are providing services in-person in our Newton and Plainville, Massachusetts clinics, by teletherapy or outdoors in the community as appropriate.

Our speech therapists at NESCA can also help to continue and supplement the hard work children have been putting in throughout the school year. They can work on social pragmatics and help with the skills needed to transition from so much time alone, to being in groups with their peers once again. NESCA’s speech therapists can support children on how to:

  • initiate play
  • find shared interests
  • be flexible thinkers
  • communicate with kindness and an appropriate level of voice
  • read gestures and non-verbal communication (especially while wearing masks, which can impede the ability to properly read another person’s mood, reactions or emotions)

We can continue to work on the established goals from school, regarding both expressive and receptive communication, language articulation and language as it pertains to written communication. Our speech therapists are currently providing all services via teletherapy while we work on a transition back to in-person therapy.

If you are interested in seeking out summer services at NESCA, or any of our assessments and services, please contact NESCA’s Director of Clinical Services Julie A. Robinson. She can be reached at jrobinson@nesca-newton.org and will conduct a phone intake with you to help you best determine your needs.

 

About the Author

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

To book an appointment or to learn more about NESCA’s Occupational Therapy Services or other clinical therapies, 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.

 

The Intention to Thrive

By | NESCA Notes 2021

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

As I reflect on the year that we have all come through, my overwhelming emotion (aside from exhaustion) is pride in the NESCA team for working together in an extraordinary manner under incredibly challenging circumstances. Just before closing the doors at NESCA in mid-March, I wrote to all staff:

NESCA is going to not only survive through this pandemic but we are going to thrive as an organization and show leadership in the special education community. The needs of our clients have not gone away; in fact, they are likely increasing.  School systems are scrambling to meet their obligations for students with special needs. We will continue to do the work we have always done, albeit in a somewhat modified fashion. 

Each of the NESCA staff—clinical and administrative—immediately rose to the occasion to help me realize this vision for navigating the pandemic. We increased the frequency our blog posts and introduced regular webinars, gearing them towards the needs of parents facing the challenges of the pandemic and increased our social media following from 4,000 to more than 40,000 by offering supportive and helpful content. NESCA clinicians offered multiple, free online support groups for parents and professionals related to topics they were now experiencing due to COVID-19. We acknowledged and addressed the unprecedented COVID-19-related concerns and challenges professionals and educators who support those with autism were experiencing through our free Autism Educator Hangouts.

After a great deal of research and discussion about how to conduct evaluations in a manner that ensured the safety of staff and clients while producing valid results, we settled on our “two office model,” renovating our space with plexiglass panes so that clients and clinicians would be able to work together in separate but adjoining offices. We collaborated with Massachusetts Advocates for Children (MAC), Massachusetts Department of Elementary and Secondary Education (DESE), The Federation for Children with Special Needs (FCSN) and the Massachusetts Urban Project, Inc., providing information about assessments and other services during the pandemic.

NESCA grew by adding new staff and service offerings this past year. We welcomed Dr. Moira Creedon to our pediatric neuropsychology staff. Tabitha Monahan, M.A., CRC, and Becki Lauzon, M.A., CRC, both joined NESCA’s Transition Services team. Julie Robinson, OT, joined NESCA in September with three occupational therapists to offer insurance-based, sensory-motor therapy. Abigael Gray, MS, CCC-SLP, also joined at that time to offer insurance-based speech/language and feeding therapy at NESCA. These staff have been incredibly innovative in their use of teletherapy to continue providing services to clients remotely.  And, they and their clients have experienced some surprising benefits stemming from the delivery of services via telehealth. 2020 also saw the introduction of NESCA’s ASD Diagnostic Clinic, helping families to diagnose children with Autism Spectrum Disorder as early as possible so they may gain access to critically important interventions.

Over the last decade, NESCA has had a strong commitment to international work, seeing clients for evaluation and consultation in the NESCA offices as well as abroad. With travel severely limited by the pandemic, we have instituted teletherapy for international work and are pleased to continue to assist  families abroad. NESCA was honored to be a Gold Sponsor for the annual SENIA conference (Special Education Network & Inclusion Association) that was held virtually. I was pleased to present about the differences between testing and assessment with professionals from schools all over Asia.

In the midst of the global pandemic, we continued to do the work that we have always done. We continued to support each other and became even more closely bonded as a team. We contributed to the community. No matter how challenging it has been, we are motivated by the knowledge that children with special needs and their parents need our support now more than ever.

 

About the Author: 

NESCA Founder/Director Ann Helmus, Ph.D. is a licensed clinical neuropsychologist who has been practicing for almost 20 years. In 1996, she jointly founded the  Children’s Evaluation Center (CEC) in Newton, Massachusetts, serving as co-director there for almost ten years. During that time, CEC emerged as a leading regional center for the diagnosis and remediation of both learning disabilities and Autism Spectrum Disorders.

In September of 2007, Dr. Helmus established NESCA (Neuropsychology & Education Services for Children & Adolescents), a client and family-centered group of seasoned neuropsychologists and allied staff, many of whom she trained, striving to create and refine innovative clinical protocols and dedicated to setting new standards of care in the field.

Dr. Helmus specializes in the evaluation of children with learning disabilities, attention and executive function deficits and primary neurological disorders. In addition to assessing children, she also provides consultation and training to both public and private school systems. She frequently makes presentations to groups of parents, particularly on the topics of non-verbal learning disability and executive functioning.

To book an evaluation with Dr. Helmus, NESCA Founder and Director, or one of our many other expert neuropsychologists or therapists, 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, as well as Londonderry, New Hampshire. NESCA serves clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

Meet Abigael Gray, NESCA’s Speech-Language Pathologist & Feeding Specialist

By | NESCA Notes 2020

This Fall, NESCA debuted its new feeding, speech and language and direct sensory/motor occupational therapy services. Leading NESCA’s feeding and speech and language therapy is Abigael Gray, MS, CCC-SLP. In today’s blog, we sat down with Abbey to learn about her role as a Feeding Specialist; Speech-Language Pathologist.

What led you to your interest in speech and language and feeding, in particular?

I received an undergraduate degree in psychology from Syracuse University. After graduating, I worked in a preschool for children with autism and developmental delays. This is really what made me interested in speech and language pathology (SLP), since all of the children there were receiving speech-language therapy. While I was working there, I observed quite a bit and decided I wanted to learn and do more in this area. After five years of working there, I enrolled at Emerson College to earn my Master’s in Communications Sciences and Disorders. While there, I discovered that Emerson has a great program for feeding. Many schools don’t have a focus on swallowing and feeding in pediatrics, like Emerson does. I had a placement with one of my professors at her practice in Needham. I eventually took a position with this clinic and received great training in pediatric feeding therapy there during my clinical fellowship. This is where I became passionate about feeding therapy. I eventually moved into a multidisciplinary practice for two more years and then joined the team at NESCA.

Why were you attracted to NESCA?

I saw this as a great opportunity to bring speech-language pathology and feeding therapy to NESCA. I loved the  multidisciplinary aspect to the practice and thought I could strengthen what NESCA already offers by adding feeding and SLP to it. I like how all of the various services are built into one practice right here. Many of the  kids being seen at NESCA can also benefit from the therapies that I offer. Having those services available to parents and children right in the same location is a huge plus for them.

After meeting Ann Helmus, Ph.D., NESCA’s founder and director, I knew that it was the right cultural fit for me, being so collaborative. It also gave me the opportunity to continue to work with Julie Robinson, OT, who oversees this new clinical offering. It’s great to be able to continue with my working relationships with the occupational therapists who also joined when I did. The seamless communication between all of us in the clinical therapy practice makes for really well-rounded therapy for the children we treat as well as more convenient for their parents/caregivers.

What are the most exciting and the most challenging parts of your role?

The most exciting part of my new role at NESCA is being able to offer speech-language and feeding  services in-house. Often the recommendations from neuropsychologists through their assessment is to have some SLP support, whether it’s having to do with reading, writing, social skills, expression or comprehension. Being able to offer that right in the same practice allows for continuity of care among clinicians on behalf of the child. It’s exciting for me because I can go back to the neuropsychologist or other clinician at NESCA who referred the client with any new observations or questions I may have. This makes the process much smoother for the parents and our clinicians. There’s just a lot less “red tape” to go through to be able to communicate and collaborate.

It’s also exciting to build this service offering from the ground up. I can take all of the experiences I have had and knowledge I’ve gained through my years in various positions and make our services our own at NESCA.

As far as challenges go, right now as we build out this new service, I am currently the only SLP on board. While that is the case for now, I have a great network of past colleagues and friends who are SLPs to bounce thoughts off of. Our plan is to have other SLPs join our team as we grow the practice.

What are your clinical interests?

Feeding is my big passion area. Within feeding, I am currently completing a lactation counseling training to become a certified lactation counselor. Babies can struggle with breast feeding, then can have even more difficulties transitioning from the breast to solid foods. I love working with infants and toddlers, and having this certification will round out my knowledge about feeding for this age range.

Within speech, I love working on articulation with kids who have speech sound disorders, phonological disorders and childhood apraxia of speech. Within language, I really enjoy working on social pragmatic communication with kids who are on the higher functioning side of the autism spectrum, or Asperger’s, or those who have social pragmatics difficulties.

I also really enjoy working on early literacy skills, sound letters, identification, rhyming and phonological awareness. When it comes to kids who may be in their older elementary school or early middle school years, I love to work on writing skills with them.

One characteristic among NESCA clinicians is that they are all lifelong learners. In what ways are you a lifelong learner?

I loved that having the curiosity to continue to learn is a draw here at NESCA! That’s really important to me. Right now, I’m currently working my way through three different courses:

  • The lactation counseling certification that I mentioned previously
  • A “Feed the Peds” course, which is a refresher course on feeding therapy with some new approaches in the areas of tethered oral tissues (i.e., tongue ties, lip ties) and how those impact feeding. The course covers how to assess and treat these issues. What’s interesting is that these new approaches are appropriate for people across the lifespan – not just for young children. There is also a module on treating those with medical complexities. Often times, medically complex patients have issues with feeding and/or are tube-fed, and can then go on to have challenges progressing through age-appropriate feeding skills or transitioning off of tube-feeding.
  • The third area I am currently in training for is with orofacial myofunctional disorders, including tethered oral tissues and the impact on speech and feeding. This covers anything that structurally or functionally impairs speech, the airway or feeding. This is a growing area in our field, so it’s important to be current and well-informed on this topic.

How has Covid-19 impacted the way you treat patients and families?

Right now, we are delivering speech-language and feeding therapy via teletherapy. While it’s always great to work with a child and/or family in-person, the plus side of teletherapy is that we get to see the child in their natural home environment as well as how the child communicates with family members. Sometimes, when we see the child in this setting, we can detect and observe a feeding or speech-language issue as the family sees it on a regular basis. It’s also nice to be able to work with parents in their own setting. We can better understand their priorities for therapy since we are talking directly with them. It also allows the child to generalize the skills they would normally learn in the clinic setting right into their home. As therapists, we can see what a typical meal at home looks like, which is obviously a more natural setting than the clinic. We used to have to ask parents to send us videos of mealtimes. Now, it’s like we are at a meal with them over Zoom!

Covid-19 was the catalyst for us to offer teletherapy, which has helped parents who work and have to travel to get to therapy tremendously. They are now able to be more hands-on in the therapy sessions. Also, for some medically complex kids, it’s just hard to get out of the house and drive to therapy. And, parents don’t have to cancel appointments if a sibling is home sick or even quarantining. And, we can stay on track with therapy via telehealth even in inclement weather that makes it challenging to drive to the clinic.

Covid-19 has certainly had its drawbacks, but we’re seeing some of the upsides in teletherapy as well.

 

About the Author

Abigael Gray has over six years of experience in assessment and treatment of a variety of disorders, including dysphagia, childhood apraxia of speech, speech sound disorder, receptive and expressive language disorder, autism spectrum disorder and attention deficit hyperactivity disorder. She has a special interest and experience in working with children with feeding and swallowing disorders, including transitioning infants to solid foods, weaning from tube feeding, improving sensory tolerance, developing chewing skills, increasing variety and volume of nutritional intake and reducing avoidance behaviors during mealtimes.

 

 

 

 

If you are interested in learning more about NESCA’s speech-language therapy or feeding therapy, please complete our online intake form, or email NESCA’s Director of Clinical Services Julie Robinson at jrobinson@nesca-newton.com.

 

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

 

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