NESCA is currently accepting Therapy and Executive Function Coaching clients from middle school-age through adulthood with Therapist/Executive Function Coach/Parent Coach Carly Loureiro, MSW, LCSW. Carly specializes in the ASD population and also sees individuals who are highly anxious, depressed, or suffer with low self-esteem. She also offers parent coaching and family sessions when needed. For more information or to schedule appointments, please complete our Intake Form.

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speech therapy

154

The Importance of Play in Speech-Language Therapy

By | NESCA Notes 2021

By: Abigael Gray, MS, CCC-SLP
NESCA Speech-Language Pathologist

As a speech-language pathologist, I immediately think about toys and games when planning my therapy sessions. Parents may wonder why speech-language therapy often looks like “just playing.” Children learn about their world through play. It facilitates their cognitive, emotional, physical, and social development. As young children develop, they begin understanding, learning how to communicate, and socializing within the context of play.

As I discussed in my last blog post, Five Ways to Facilitate Language Growth at Home, motivation and interest are key in language development, and play is highly motivating and interesting for children. When children learn in the context of play, these new concepts, sounds, and words became relevant and meaningful to the child. This promotes retention and generalization, which both increase learning.

Symbolic play is especially important in the development of language. Symbolic play is the use of objects to represent other objects (e.g., using a block as a phone). Language itself is symbolic since signs, gestures, and words represent ideas, objects, or relationships. Early symbolic play helps children understand that objects can be used to represent another object. Development of symbolic play often correlates with development of language: children often start to use single words when they begin using one object to represent another, and they may begin combining words when they combine two symbolic play actions.

Speech-language pathologists may even use play within assessment. Play in evaluations “is a nonthreatening way to gather information about general symbolic skills, linguistic skills, behaviors skills (i.e., attention and organization), and task persistence in a child-friendly setting” (Fewell & Rich, 1987; Short et al., 2011). I also use play to take language samples, which allows me to look at language understanding and use in a naturalistic environment.

For my older elementary- or middle school-aged clients, play often looks like playing games in therapy. The turn taking of games mimics the social reciprocity that we see in conversation and social communication. This facilitates older children’s understanding of taking the lead when it is their turn and waiting, listening, and watching when it is the other person’s turn. I also find more willingness to participate in therapy when it is fun and centered around specific interests.

In my opinion, we are never too old to play! I’ve found that most people learn and retain information better within the context of fun and enjoyable activities, which is why play is such an important aspect of speech-language therapy.

References:

Jarrold C, Boucher J, Smith P. Symbolic play in autism: a review. J Autism Dev Disord. 1993 Jun;23(2):281-307. doi: 10.1007/BF01046221. PMID: 7687245.

Short EJ, Schindler RC, Obeid R, Noeder MM, Hlavaty LE, Gross SI, Lewis B, Russ S, Manos MM. Examining the Role of Language in Play Among Children With and Without Developmental Disabilities. Lang Speech Hear Serv Sch. 2020 Jul 15;51(3):795-806. doi: 10.1044/2020_LSHSS-19-00084. Epub 2020 May 13. PMID: 32402229.

Terrell, B. Y., Schwartz, R. G., Prelock, P. A., & Messick, C. K. (1984). Symbolic play in normal and language-impaired children. Journal of Speech & Hearing Research, 27(3), 424–429. https://doi.org/10.1044/jshr.2703.424

 

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.

 

To book an appointment with or to learn more about NESCA’s Speech & Language Therapy, please fill out our online Intake Form, email NESCA’s Director of Clinical Services Julie Robinson 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.

 

152

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.

 

154

Facilitating Language Growth at Home

By | NESCA Notes 2021

By: Abigael Gray, MS, CCC-SLP
NESCA Speech-Language Pathologist

I recently got to spend time with my 18-month-old nephew, after not having seen him in a year and a half due to the pandemic. It got me thinking about practical ways to help facilitate language throughout the day without feeling like you’re doing anything extra. Play and routines are great times to build language, and you can often find opportunities that are motivating for your child. Motivation and interest are key, because children are much more likely to participate and communicate. Below, I discuss tips to incorporate into your daily routine at home.

Five ways to facilitate language growth at home:

  1. Play!
    • Play the way your child is playing and imitate what they’re doing.
    • Even if you had a plan, don’t be afraid to change it to focus on their interests (i.e., follow their lead, as explained below).
    • Use fun sounds, words and gestures to go with what you’re doing (e.g., “beep beep” when playing with cars, “pop” when popping bubbles, “yummy/mmm” and rubbing your stomach when pretending to eat play food).
  2. Follow your child’s lead
    • Observe what they’re interested in, wait until they initiate or continue interaction, and listen to their words and sounds.
    • Get on their level so they know you are joining in.
    • If they are doing something unsafe, explain why it’s unsafe in simple terms and redirect them to a safe activity.
  3. Get silly
    • Repeat actions they think are funny.
    • Switch up routines in a silly way (e.g., “forget” their favorite bath toy, give them a fork with their yogurt). This encourages language when your child notices and wants to tell you something is different or missing.
    • Change song lyrics or words in stories to be about your child, their interests and/or what is happening around you in the moment.
  4. Pause
    • Slowly sing familiar nursery rhymes and songs and then pause at key words to encourage them to fill in a word or gesture.
    • Pause a familiar activity, such as pushing the swing, and wait for them to ask you to continue using words or gestures (e.g., “more,” “again,” “go”).
    • When looking for a response, stop talking, lean forward and look at them expectantly. You can count slowly to 10 silently, which gives your child time to respond.
  5. Expand
    • When your child uses one to two words, turn it into a short sentence. For example, if they say “up” wanting you to pick them up, you could say, “Ok, I’ll pick you up.”
    • Be sure to use correct grammar when expanding their message, even if your child is still using immature grammar.
    • Use a variety of words (e.g., describing words, action words, words for feelings, location words, etc.). Start with words your child would want to say to talk about the things they are interested in.

Many of these ideas are things you may already be doing throughout the day, but it is good to think about how doing so helps your child learn to understand and use language. If you feel that your child may be behind in their language understanding or production, it is helpful to schedule an evaluation with a speech-language pathologist. If therapy is warranted, your speech-language pathologist can make recommendations specific to your child and family and show you how to best encourage language growth in the home environment.

References:
Weitzman, E. (2017). It takes two to talk: A practical guide for parents of children with language delays (5th ed.). Toronto: Hanen Centre.

 

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.

 

To book an appointment with or to learn more about NESCA’s Speech & Language Therapy, please fill out our online Intake Form, email NESCA’s Director of Clinical Services Julie Robinson 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.

 

152

Literacy-based Speech Therapy: Winter Edition

By | NESCA Notes 2021

By: Abigael Gray, MS, CCC-SLP

NESCA Speech-Language Pathologist

Books are a great speech-language therapy tool. They can be used to target many different goals for a variety of ages and profiles. With books, children are given context for learning vocabulary, concepts and important story elements. Literacy-based therapy is not only more fun, but research also supports its use in teaching children with speech and language disorders:

  • Teaching story elements has been shown to improve oral language production and reading comprehension.
  • Teaching within a narrative context can make language learning less demanding, more meaningful and more authentic.
  • Students’ comprehension and story retelling/generation skills improved more with contextualized (literacy-based) intervention than decontextualized intervention.

Books can easily be incorporated into life at home, if they are not already a part of the daily routine. Just grab your or your child’s favorite book, or find a YouTube read aloud of it, and have your child help you read it! Be sure to pause throughout the book to talk about the pictures, make inferences about why events are happening and ask a few questions. Don’t be afraid to change the words to match your child’s level of understanding or interests.

My top three favorite winter books to use in speech-language therapy are:

  1. Sneezy the Snowman by Maureen Wright

A story about a cold and sneezy snowman who melts several times while trying to get warm. His human friends help him by rebuilding him and sharing their winter clothes.

Amazon: https://www.amazon.com/Sneezy-Snowman-Maureen-Wright/dp/1477810544

YouTube Read Aloud: https://youtu.be/iUsHnKSyDH0

Skills that I target and can be incorporated into shared book reading at home:

  • Producing subject-verb-object or complex sentences to talk about what is happening.
  • Predicting what will happen before and throughout reading (e.g., “Sneezy is drinking hot chocolate, what do you think will happen?”).
  • Answering detail (what, where, who, when) and inferential (why) questions.
  • Discussing story parts (e.g., characters, setting, problem, solution) and retelling the story.
  • Writing using different prompts, such as “My snowman melted because…” or “When I’m cold, I…”.
  1. The Mitten by Jan Brett

A traditional story about a boy whose grandmother knits him new mittens. He loses one mitten when he is outside playing, and many different animals climb inside to stay warm.

Amazon: https://www.amazon.com/Mitten-Jan-Brett/dp/0399231099

YouTube Read Aloud: https://youtu.be/duhj0Op_slo

Skills that I target and can be incorporated into shared book reading at home:

  • Sequencing events by talking about the order of animals that climbed into the mitten.
  • Creating a craft by printing a mitten and animals, coloring the animals and putting them inside the mitten as you retell the story.
  • Watching a different rendition of The Mitten on Vooks.com and comparing and contrasting the two stories using a Venn diagram.
  • Producing past tense verbs to describe what happened.
  • Making inferences about characters’ emotions and motivations.
  1. The Snowy Day by Ezra Jack Keats

A Caldecott Medal-winning book about a boy’s adventures in the snow when he puts on his snowsuit and goes outside to play.

Amazon: https://www.amazon.com/Snowy-Day-Board-Book/dp/0670867330

YouTube Read Aloud: https://youtu.be/FmZCQfeWjeQ

Skills that I target and can be incorporated into shared book reading at home:

  • Telling an original story together by covering up the words on the pages.
  • Finding words that contain the child’s target speech sound (i.e., if your child is working on producing the “R” sound, find all the words that contain “R” and practice those).
  • Describing character traits of Peter, the main character.
  • Discussing cause and effect (e.g., cause: Peter smacked a snow-covered tree, effect: snow fell on Peter’s head).
  • Writing using different prompts, such as “On a snowy day, I like to…” or “I can save a snowball by…”.

 

References:

Davies, P., Shanks, B., & Davies, K. (2004). Improving narrative skills in young children with delayed language development. Educational Review, 56, 271 – 286.

Gillam, S. L., Gillam, R. B., & Reece, K. (2012). Language outcomes of contextualized and decontextualized language intervention: results of an early efficacy study. Language, speech, and hearing services in schools, 43(3), 276–291. https://doi.org/10.1044/0161-1461(2011/11-0022)

Tomasello, M. (2003). Constructing a language. A usage-based theory of language acquisition. Cambridge, MA: Harvard University Press

 

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.

 

 

 

To book an appointment or to learn more about NESCA’s Speech & Language Therapy, please fill out our online Intake Form, email NESCA’s Director of Clinical Services Julie Robinson 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

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

By | NESCA Notes 2020

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

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

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

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

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

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

Who is a candidate for these new OT services?

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

How does the process of getting OT services start?

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

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

How do the services work?

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

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

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

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

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

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

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

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

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

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

Does NESCA accept insurance for its new services?

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

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

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

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

 

About the Interviewer

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

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

 

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

 

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