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Tag

teenagers

48

How Do You Know if an IEP Addresses Transition Planning Requirements?

By | NESCA Notes 2024

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

As educators and professionals who support parents, having a checklist focused on transition planning requirements for students with disabilities can help to ensure that students are prepared for life after high school.

The most obvious source for such a checklist is Indicator 13, which is a compliance indicator required by the Individuals with Disabilities Education Act (IDEA) of 2004.

Every IEP must include a transition plan that addresses the student’s future goals, including postsecondary education, vocational training, employment, and independent living (when appropriate) and the steps needed to achieve those goals.

Here’s a checklist of what should be included in a transition-rich IEP:

  1. Age-appropriate Transition Assessment: Adequate transition assessment information (including input from the student) about the student’s strengths, preferences, interests, and needs.
  2. Measurable Postsecondary Goals: Clearly defined goals related to training, education, employment, and, where appropriate, independent living skills. These goals must be based on age-appropriate transition assessments and be updated annually.
  3. Transition Services: A detailed outline of the transition services (e.g., life skills training, job coaching, vocational training, career counseling, work-based learning, agency linkages, etc.) that will reasonably enable the student to meet their postsecondary goals.
  4. Course of Study: A multi-year description of the coursework that will reasonably enable the student to meet their postsecondary goals. Indication as to when the student is expected to exit public education and what type of completion document the student will attain.
  5. Annual IEP Goals: Specific, measurable, annual skill-based goals related to the student’s transition services needs. Skills that need to be addressed this year to ensure the student progresses toward their goals.
  6. Student Involvement: Indication that the student was invited to meetings where transition services were discussed. Documentation that the student has been involved in the transition planning process.
  7. Interagency Coordination: If appropriate, evidence that outside agencies (e.g., vocational rehabilitation, pre-employment transition service provider, department of developmental services, postsecondary education admissions or disability services, center for independent living) are involved in the transition planning with appropriate consent from the adult student and/or parent/family.

Remember: Transition planning is a collaborative effort. Student and parent/family involvement are vital to creating a successful roadmap for the student’s future.

For more detailed information, feel free to reach out or visit the IDEA website: https://sites.ed.gov/idea.

National Technical Assistance Center on Transition also has excellent Indicator 13 checklists and training resources: https://transitionta.org/i13-checklists/ (registration is required to use the site, but there is no paywall).

Together, let’s empower students to make a successful transition into adulthood!

 

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

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

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

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

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

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

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

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

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

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

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

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

48

Correct Pronoun Use Saves Lives

By | NESCA Notes 2024

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

Let me explain…

For anyone who is working with children, teenagers, or young adults in 2024, there is no question that we are working with more openly transgender and nonbinary youth than we were in 2004. Because of this, NESCA recently held a staff seminar led by Dr. Sebastian Barr, speaking about the Psychosocial Wellbeing of Trans & Nonbinary Youth.

As Dr. Barr eloquently identified, “more people are recognizing their trans and nonbinary identities earlier in life.” These youth “have more unique needs” and are “more likely to struggle and need services.” But, for most of us working in education or health care, our academic experiences taught us very little, if anything, about supporting trans and nonbinary youth. Fortunately, in current times, there is research and publishing around this topic. And I was lucky to be able to absorb some of that research in just 75-minutes listening to Dr. Barr.

I learn well in lectures, and there is a lot that will stick with me from the presentation, but the most impactful point made was that “correct pronouns are suicide prevention.” If we care about kids and people, we should do whatever work we need to ourselves in order to learn and use correct pronouns. Trans and nonbinary individuals, especially teens and young adults, are at much greater risk of experiencing mental health issues, and suicidal thinking. There are many studies identifying factors associated with this risk such as bias, non-affirmation, exclusion, marginalization, trauma, etc. Fortunately, there are also studies identifying protective factors that are associated with wellbeing. Some of these variables include:

  • Parental and sibling acceptance
  • General affirmation of gender, like correct pronoun use
  • Access to competent medical support
  • Community support

Importantly, research from the Trevor Project, indicates that “transgender and nonbinary youth who reported having pronouns respected by all or most of the people in their lives attempted suicide at half the rate of those who did not have their pronouns respected.” *

This is why Dr. Barr indicated that many people in the field will say “correct pronouns are suicide prevention.” He emphasized that if you do make a mistake, you should “correct it quickly, not draw attention, and practice so you don’t repeat the mistake multiple times.”

I am not sharing this with any interest in getting into a debate about feelings or beliefs. I am sharing this in hopes that someone reads this, finds it useful in their parenting or professional work, and makes an effort to use correct pronouns in order to potentially save a life.

Resources:

If you want more information about Dr. Barr or his work, you can visit: https://www.sebastianmitchellbarr.com/

To download a Pronoun Fact Sheet from the @American Psychological Association, you can click here: https://www.apadivisions.org/division-44/resources/pronouns-fact-sheet.pdf

*For more information and data regarding #LGBTQ Youth Mental Health, check out the National Survey on LGBTQ Youth Mental Health 2020: https://www.thetrevorproject.org/survey-2020/

 

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

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

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

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

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

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

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

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

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

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

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

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

9

When the Homeymoon Period Is Over: Signs of School Refusal

By | NESCA Notes 2021

By: Moira Creedon, Ph.D. 
Pediatric Neuropsychologist, NESCA

As we reach the end of our first month back to school, many of us may be reaching the end of that glorious honeymoon period – the phase when kids are excited to see friends, optimistic for the school year, and reviewing material they likely already know. For some, the return did not start this rosy; the bloom is falling off the rose and kids are getting tired. You and your child are not alone in this. My goal for today’s blog is to share with you some warning signs that your child may be struggling and ways to get support before they grow to become bigger problems. The biggest problem I want to avoid: school refusal.

Have you heard this yet? – “My tummy hurts. I have to stay home.” Or, “I hate school. Please don’t make me go.” Or, “I’m not going!” Or perhaps these messages are communicated more subtly with covers over their heads in the morning, difficulty getting out the door on time, tantrums or disruptive behaviors in the mornings, missed buses, or the overwhelming frustration of homework that erupts into nightly battles. According to researcher Christopher Kearney, these are signs to pay attention to as they can evolve into what he terms “school refusal behavior.” School refusal is an umbrella term used to describe behaviors that interfere with a child being in school for their expected and scheduled time. This is a problem that can impact anywhere between 28-35% of students! While there are the more extreme cases for children or teens who are out of school for months at a time, my purpose here is to address the smaller, but more likely, problems. When we address smaller problems, we can keep them small.

Risky signs that your child is struggling with school:

  • Consistent statements of hating school, their teacher, or specific peers. A casual mention of a bad day is not cause for alarm. We all have bad days. If the statements keep coming and they get louder and stronger, then parents should pay attention.
  • The outward behaviors are getting bigger in the mornings before school or over homework. Behavior is a way for children to communicate with us how they are feeling. So, explosions over homework or tantrums in the morning that lead to tardiness are warning signs. The occasional homework meltdown or rushed morning is normal; we are all human! But, the problem is in the pattern.
  • Avoidance rears its ugly head. While some kids show on the outside that they are uncomfortable through their explosions, others communicate very clearly through their withdrawal. Some kids and teens struggle to get out of bed, are constantly tired, not completing work, falling asleep in class, or sharing every somatic complaint or symptom available on Google. If medical causes are ruled out, anxiety can be a culprit.
  • Consider the role of a major transition. According to Kearney, the riskiest time for a child to develop a pattern of school refusal is during times of significant transition – like starting kindergarten or changing schools from middle to high school. In addition to the social and emotional jump that these transitions bring, there is also a massive leap in demands for academic independence. It is very common for kids to struggle with the leap initially.

Oh no. So now what?

  • First and foremost, keep calm. It is far easier to keep small problems small when we have a clear-headed approach. Pull in anxiety management techniques like deep breathing, sleep, and exercise to support your own anxiety as a parent.
  • Reach out to your child’s teacher or school psychologist. Let them know your child is struggling with homework or coming to school. This is a great chance to gather information on what is going on in your child’s day and put your child on their teacher’s radar. This is critical as the only effective approach to remedy a problem with school refusal is a team approach.
  • Talk to your child honestly about what is going on. This has to include a chance for kids to talk about what might be happening to make them feel stressed or why they dislike school. Don’t shortcut this step. If your child has trouble explaining what is going on (which can be especially true for younger kids), try this approach: you and your child are both going to be detectives to learn together what is making school feel hard. We can’t solve a problem until we understand it. By joining with your child in gathering information, you are demonstrating great empathy and validating that their feelings are real.
  • Be careful of your language and conversation about school. It can be tempting to go too far in validating a child to give the message that the assignment really is stupid or their teacher really is unreasonable and mean. It’s best to stick to the feeling (“that must feel so frustrating”) without reinforcing negative messages about school.
  • Hold the line. As you gather more information, it is really important to maintain the message that it is your child’s job to go to school. It might feel conflicting to both validate the feelings of hating school and give the message to attend school. It might feel something like this: It’s either “I love and support my child OR I’m going to force them to go to school even when it’s hard.” Let’s change that OR to AND. Reframe the thought to: “I love and support my child AND they have to go to school AND they can do hard things.”

For more information, please check out:

Kearney, C.A. (2007). Getting your child to say “yes” to school: A guide for parents of youth with school refusal behavior. New York: Oxford University Press.

 

About the Author

Dr. Creedon has expertise in evaluating children and teens with a variety of presenting issues. She is interested in uncovering an individual’s unique pattern of strengths and weaknesses to best formulate a plan for intervention and success. With experiences providing therapy and assessments, Dr. Creedon bridges the gap between testing data and therapeutic services to develop a clear roadmap for change and deeper of understanding of individual needs.

 

If you are interested in booking an evaluation with Dr. Creedon 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.

39

Making the Most of Summer – Setting a Few Life Skill Goals (for College and Life in General after High School)

By | NESCA Notes 2022

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

Summer in the United States is in full swing. If you have teenagers, they may be working, completing driver’s education, visiting colleges, travelling, or even getting started with their college application this summer. No matter what your teenager is doing, this is great time to sit down and set a few “simple” life skill goals for the summer.

In 2020, I wrote a two-part blog series focused on eight life skills that are critical to build before college:

  1. Getting up “on time” each morning
  2. Washing, drying, and putting away laundry—including sheets
  3. Basic kitchen skills
  4. Using basic tools (e.g., screwdriver, hammer, measuring tape, etc.)
  5. Medication management
  6. Money management
  7. Routine exercise
  8. Using a calendar for scheduling

For teenagers in high school or heading off to college, these are great skills to begin tackling over the summer months. For example, getting up by a certain time is something that can be especially important to work on when consequences are low. For instance, it is hard to let a teen sleep in when they are going to miss an AP exam, but it can be easier to let them practice using an alarm (and possibly oversleeping) when they are going to a movie with a friend or attending a camp. Summer is a great time for teens to be able to experience natural consequences as they practice taking on new risks and responsibilities associated with some of the life skills above.

A challenge when working with, or parenting, teenagers who have a lot of skills to develop is figuring out where to start or how to gain “buy-in.” One of the ways that I like to work with students to set life skill goals is to have the student take a basic life skills inventory, such as the Casey Life Skills Toolkit, Life Skills Inventory, or Adolescent Autonomy Checklist. After a student rates their own skill levels, I ask them to review skills that they cannot already do and identify how important those skills are on a scale of 1 to 10. Then, we go through the list again, and I ask which skills they would like to learn in the next 2 months, 6 months, and year. Once the teenager has identified the importance of a skill and the desire to work on the skill in the near future, it is much easier to set short-term goals. We can work out a skill-building plan for the summer. including how much time to dedicate on a daily or weekly basis. We can also talk about the types of barriers or challenges that might get in the way of the teenager practicing these skills. Additionally, we can set expectations for how often the teen is going to report back to me on the skill so that there is built-in accountability, and the teen knows to expect the check-ins rather than feeling like someone is checking up on them.

Every teenager is different. If you are a parent wanting to help your child make the most of summer, you may find that you can go through the same process that I do to help your child set a few short-term goals. Other teenagers will be able to work on goals themselves—once they have gone through the exercise of setting them. And others, may benefit from having a coach who can build a relationship, support development of executive function and coping skills, and partner with the teen in making the most of summer. If you think your child would benefit from some coaching or an “expert” to work with them, we have a great team of professionals here at NESCA who are ready to help.

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

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, call 617-658-9800 or complete our online Intake Form.

9

When the Homeymoon Period Is Over: Signs of School Refusal

By | NESCA Notes 2021

By: Moira Creedon, Ph.D. 
Pediatric Neuropsychologist, NESCA

As we reach the end of our second month back to school, many of us may be reaching the end of that glorious honeymoon period – the phase when kids are excited to see friends, optimistic for the school year, and reviewing material they likely already know. For some, the return did not start this rosy; the bloom is falling off the rose and kids are getting tired. You and your child are not alone in this. My goal for today’s blog is to share with you some warning signs that your child may be struggling and ways to get support before they grow to become bigger problems. The biggest problem I want to avoid: school refusal.

Have you heard this yet? – “My tummy hurts. I have to stay home.” Or, “I hate school. Please don’t make me go.” Or, “I’m not going!” Or perhaps these messages are communicated more subtly with covers over their heads in the morning, difficulty getting out the door on time, tantrums or disruptive behaviors in the mornings, missed buses, or the overwhelming frustration of homework that erupts into nightly battles. According to researcher Christopher Kearney, these are signs to pay attention to as they can evolve into what he terms “school refusal behavior.” School refusal is an umbrella term used to describe behaviors that interfere with a child being in school for their expected and scheduled time. This is a problem that can impact anywhere between 28-35% of students! While there are the more extreme cases for children or teens who are out of school for months at a time, my purpose here is to address the smaller, but more likely, problems. When we address smaller problems, we can keep them small.

Risky signs that your child is struggling with school:

  • Consistent statements of hating school, their teacher, or specific peers. A casual mention of a bad day is not cause for alarm. We all have bad days. If the statements keep coming and they get louder and stronger, then parents should pay attention.
  • The outward behaviors are getting bigger in the mornings before school or over homework. Behavior is a way for children to communicate with us how they are feeling. So, explosions over homework or tantrums in the morning that lead to tardiness are warning signs. The occasional homework meltdown or rushed morning is normal; we are all human! But, the problem is in the pattern.
  • Avoidance rears its ugly head. While some kids show on the outside that they are uncomfortable through their explosions, others communicate very clearly through their withdrawal. Some kids and teens struggle to get out of bed, are constantly tired, not completing work, falling asleep in class, or sharing every somatic complaint or symptom available on Google. If medical causes are ruled out, anxiety can be a culprit.
  • Consider the role of a major transition. According to Kearney, the riskiest time for a child to develop a pattern of school refusal is during times of significant transition – like starting kindergarten or changing schools from middle to high school. In addition to the social and emotional jump that these transitions bring, there is also a massive leap in demands for academic independence. It is very common for kids to struggle with the leap initially.

Oh no. So now what?

  • First and foremost, keep calm. It is far easier to keep small problems small when we have a clear-headed approach. Pull in anxiety management techniques like deep breathing, sleep, and exercise to support your own anxiety as a parent.
  • Reach out to your child’s teacher or school psychologist. Let them know your child is struggling with homework or coming to school. This is a great chance to gather information on what is going on in your child’s day and put your child on their teacher’s radar. This is critical as the only effective approach to remedy a problem with school refusal is a team approach.
  • Talk to your child honestly about what is going on. This has to include a chance for kids to talk about what might be happening to make them feel stressed or why they dislike school. Don’t shortcut this step. If your child has trouble explaining what is going on (which can be especially true for younger kids), try this approach: you and your child are both going to be detectives to learn together what is making school feel hard. We can’t solve a problem until we understand it. By joining with your child in gathering information, you are demonstrating great empathy and validating that their feelings are real.
  • Be careful of your language and conversation about school. It can be tempting to go too far in validating a child to give the message that the assignment really is stupid or their teacher really is unreasonable and mean. It’s best to stick to the feeling (“that must feel so frustrating”) without reinforcing negative messages about school.
  • Hold the line. As you gather more information, it is really important to maintain the message that it is your child’s job to go to school. It might feel conflicting to both validate the feelings of hating school and give the message to attend school. It might feel something like this: It’s either “I love and support my child OR I’m going to force them to go to school even when it’s hard.” Let’s change that OR to AND. Reframe the thought to: “I love and support my child AND they have to go to school AND they can do hard things.”

For more information, please check out:

Kearney, C.A. (2007). Getting your child to say “yes” to school: A guide for parents of youth with school refusal behavior. New York: Oxford University Press.

 

About the Author

Dr. Creedon has expertise in evaluating children and teens with a variety of presenting issues. She is interested in uncovering an individual’s unique pattern of strengths and weaknesses to best formulate a plan for intervention and success. With experiences providing therapy and assessments, Dr. Creedon bridges the gap between testing data and therapeutic services to develop a clear roadmap for change and deeper of understanding of individual needs.

 

If you are interested in booking an evaluation with Dr. Creedon 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.

151

Appreciating and Responding to The New York Times article, For Some Teens, It’s Been a Year of Anxiety and Trips to the E.R. by Benedict Carey

By | NESCA Notes 2021

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

As an occupational therapist working almost exclusively with teenagers and young adults over the past year, the title of Benedict Carey’s article jumped out at me like a tired and worn flag, waving frantically for acknowledgement. Our teens are anxious, tired, and dealing with living through the proverbial “unprecedented times” without the developmental capabilities needed to quickly adapt in this era of remote learning, remote social interaction, and remote extracurriculars. Remote everything!

It is important for me to note that I really enjoy working with teenagers. I find myself in constant awe of their resiliency, their willingness to confront hard truths that many of us shy away from, and their ability to push forward despite having huge questions about who they truly are. All of these things are tough and require immense emotional fortitude, but this year many of these challenges feel impossible.

Carey has taken the time to gather perspectives from multiple stakeholders. He provides a platform for parents, educators, professors, therapists, pediatricians, and directors of hospital programs to explain the struggles of supporting these kids without adequate resources. Parents describe the fear of supporting their children as they struggle with mental health. Doctors discuss the frustration of having inadequate resources and support in emergency rooms around the country. Carey highlights that, according to the Centers for Disease Control and Prevention (CDC), the proportion of adolescent emergency admissions for mental problems, like panic and anxiety, is up 31 percent. Some of my clients add to this statistic and are navigating their own path through chaotic hospitalizations and overwhelmed support systems. Carey’s article is absolutely worth taking the time to read, if only to see the ubiquity of these issues and how they are happening all around our country. Simply put, we have a clear problem. Less clear, is the solution.

When meeting with adolescents and young adults themselves, I hear three main fears popping up week after week. Here are a few thoughts and suggestions on how to support these specific fears or feelings.

  1. “I can’t get this done, (and therefore) I am going to completely ruin my future.”

When looking at future success through a transition lens, we consider the areas of independent living, community participation, post-secondary education, and employment. In the school setting, most students’ curricula are focused solely on academic success. Sometimes, we do a poor job of teaching students about multiple intelligences or emphasizing the importance of hard work. While grades are important, they are not everything, and while standardized testing is returning to students’ schedules, they should not serve as students’ measure of self-worth. We know this, but do they? We have to teach our children that if they are hardworking, kind, and truly doing their best, the threat of “ruining their future” is much less likely than they fear. Let’s highlight the undeniably true narrative that everyone’s path can look different and still lead to success.

  1. “I’m so tired. All of the time.”

Many of my clients tell me they are not sleeping. If they are sleeping, they fall asleep late with a phone in their hand, constantly refreshing apps or trying to maintain communication with their peers. In our current remote world, the phone can feel like a lifeline. Sleep is a foundational need for mental and physical health. Students who are 15 or 16 years old often have a limited understanding of how holistic the effects of decreased sleep can be. Sleep is not their priority. Recently, I have seen parents disable the internet or have their teenagers put their phones into a lockbox from midnight until 6:00am. This new boundary is often met with anger or frustration at the beginning, but then these students start to sleep. They are better able to manage their emotions. They have more energy. They start to see the benefits despite their skepticism. If a tech break doesn’t feel quite right for your family, it is still worth opening up a conversation about the need for strong sleep hygiene and modeling a routine that promotes calming down by limiting screens before bed, which can have hugely positive effects.

  1. “This is never going to end.”

In many ways, a year feels much longer to a 17 year-old than it does to an older adult. Working at a job for four years never feels as long or as formative as the four years of high school. And objectively, a year to a 17 year-old is over five percent of their life, while it’s only two percent of 50 year old’s life. Let’s acknowledge that. Let’s verbalize the fact that teenage years are also full of milestones that have been constantly cancelled or changed to fit social distancing recommendations and safety precautions. There is a sense of loss and grief surrounding many events that these students have been looking forward to since elementary school. Encourage students to do their own research into what the next six months may look like as we start to open back up. Help them to understand the vaccine rollout and the pitfalls and successes that we have had as a nation tackling a novel disease.

Adolescent mental health is going to be an on-going challenge that we tackle as a community. As we slowly forge out of isolation, let’s center our conversations around the mental health of our teens and honestly acknowledge the unique position that they have found themselves in.

References

Carey, B. (2021, February 23). For some teens, it’s been a year of anxiety and trips to the e.r. The New York Times. https://www.nytimes.com/2021/02/23/health/coronavirus-mental-health-teens.html

Leeb, R.T., Radhakrishnan, L., Martinez, P., Njaj, R., Holland, K.M. (2020, October 27). Mental health-related emergency department visits among children aged <18 during the covid-19 pandemic. MMWR Morbidity and Mortality Weekly Report 2020:1675-1680. DOI: http://dx.doi.org/10.15585/mmwr.mm6945a3

 

About the Author

Sophie Bellenis is a Licensed Occupational Therapist in Massachusetts, specializing in educational OT and functional life skills development. 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. 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, 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.

 

5

Teens Online: Participation vs. Observation

By | NESCA Notes 2021

By Yvonne M. Asher, Ph.D. 
Pediatric Neuropsychologist

As we enter the beginning of 2021, the COVID-19 pandemic continues to shape our world. More and more, events, activities and interactions are pushed online – onto videoconferencing apps, social media and academic learning  platforms. Online social interactions are not new, and they won’t disappear anytime soon. With this, how do we, as adults, understand and navigate these oddly draining electronically-mediated gatherings, and how do we help our teens do the same?

One unique characteristic of online interaction is the ability to be present without being visible. In traditional social settings, to be present with the group is to be seen and, often times, noticed. Joining a Zoom or Google Meet offers one the ability to listen, watch and take the information presented without offering anything of yourself – no one has to see you, hear you, know where you are or know what you are doing. As many adults have noticed, this gives incredible freedom to the multi-taskers – listen to your meetings while getting the dishes done or the laundry folded.

For some adolescents, though, this is an opportunity to bypass many of the core tasks of social development, while still engaging with the material needed to accomplish one’s academic goals. A high schooler, acutely aware of how they are perceived and what others think of them, can sit silently, invisibly in social studies class. They can hone in on the economic impacts of World War I without the crushing anxiety of worrying about being teased or ostracized. However, that same high schooler may never have to confront the developmentally-expected challenges of venturing out of their “comfort zone” socially. They may not learn to ask someone out on a date, explore a new friendship or show up to the first meeting of a club.

How can we help our teens learn to take the best from online interactions while also pushing them to fully engage with others? There is no one, clear-cut answer – no “10 things…” or similar checklist. In any situation, we must look holistically at the teen, the context and the goals, and, from there, determine the best path forward. Sometimes, the anonymity of the online world is a welcome respite for teens looking to explore a new facet of their identity. Other times, it undercuts the core tasks of adolescence – building deep bonds with peers, taking responsibility for one’s social relationships and developing independence. Having direct, open conversations with our teens helps them understand and begin to own the challenges of the online world. If cameras are always off and microphones are always on mute, maybe it is time for a chat about participation versus observation.

 

About the Author

Dr. Yvonne M. Asher enjoys working with a wide range of children and teens, including those with autism spectrum disorder, developmental delays, learning disabilities, attention difficulties and executive functioning challenges. She often works with children whose complex profiles are not easily captured by a single label or diagnosis. She particularly enjoys working with young children and helping parents through their “first touch” with mental health care or developmental concerns.

Dr. Asher’s approach to assessment is gentle and supportive, and recognizes the importance of building rapport and trust. When working with young children, Dr. Asher incorporates play and “games” that allow children to complete standardized assessments in a fun and engaging environment.

Dr. Asher has extensive experience working in public, charter and religious schools, both as a classroom teacher and psychologist. She holds a master’s degree in education and continues to love working with educators. As a psychologist working in public schools, she gained invaluable experience with the IEP process from start to finish. She incorporates both her educational and psychological training when formulating recommendations to school teams.

Dr. Asher attended Swarthmore College and the Jewish Theological Seminary. She completed her doctoral degree at Suffolk University, where her dissertation looked at the impact of starting middle school on children’s social and emotional wellbeing. After graduating, she completed an intensive fellowship at the MGH Lurie Center for Autism, where she worked with a wide range of children, adolescents and young adults with autism and related disorders.

 

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 Dr. Yvonne Asher, please complete our Intake Form today. For more information about NESCA, please email info@nesca-newton.com or call 617-658-9800.

 

14

Teenage Stress and Executive Functioning

By | NESCA Notes 2019

By Renée Marchant, Psy.D.
Pediatric Neuropsychologist

It is increasingly clear to educators, parents, clinicians and the like that teens are experiencing high levels of stress. Why? There are, of course, many reasons stemming from family, social, historical, and systemic “forces” that impact a teen’s personal day-to-day experience.

As an evaluator, I am very aware of one “force” affecting our teens: the “mis-match” between what teens are expected to do and what their executive function skills can handle. I recently participated in a panel discussion along with professionals from Summit Education Group, Engaging Minds and Beyond BookSmart to discuss this “mis-match,” a large contributing factor to student stress. Here are a few important “take-aways” from the discussion:

First, what is executive functioning?  Executive functioning skills are a “family” of skills that operate in a “top-down” process, controlling and regulating brain regions associated with attention, impulse control, emotion regulation and meta-cognition or “thinking about thinking.” A helpful analogy is that executive function skills are the CEO or the “boss” in the brain that monitors, plans, organizes and makes decisions. Here is a useful diagram from ADD Vantages describing executive function skills.

This depicted “family” of executive function skills develops throughout our development. A six year-old is not expected to plan multi-step assignments and check for errors when they write. A six year-old is expected to begin controlling impulses (e.g. waiting their turn in a game) and respond to adult prompts to organize belongings. As a child grows, their brain develops, and executive function skills expand.

However, higher-level metacognition and executive function skills do not simply “magically appear in the brain” or develop “in a vacuum.” Akin to learning a subject, such as math or science, children and teens need to learn executive function skills through teaching, modeling, observing and doing.

We know that teens face a number of responsibilities, particularly in high school – whether that be studying for exams, working on projects, participating in extra-curricular activities, participating in community-run volunteer opportunities, considering academic options post-high school, following their family’s weekly schedule, manage their social media page – and all while getting enough sleep, eating three meals a day and having self-care or “me time.” That adds up to a lot of expectations and demands. Some may posit that these are higher expectations for teens than in decades prior. Yet, what we know is that all teens are unique and develop executive function skills at different speeds. It is therefore logical to expect that many teens will become stressed…stressed because there is a “mis-match” between their daily expectations and the executive function skills that are required to carry out and manage those activities.

As an evaluator, I have worked with a number of teens who experience this “mis-match.” They haven’t yet learned the tools and strategies needed to manage their academic, social and personal responsibilities, and this contributes to low self-confidence, academic underperformance, limited independence, depression and worries about the future. They not only need support and teaching to grow executive function skills to study, work and live more efficiently now and in the future, they also need this “mis-match” and the stress it produces identified and acknowledged by the adults around them.

This “mis-match” can be identified by parents, teachers and/or through a comprehensive neuropsychological evaluation, which is oftentimes critical for determining a teen’s unique learning strengths and challenges. This “mis-match” is also sometimes identified by teens themselves – who are often highly aware of their own needs and simultaneously aware of difficulties that are impacting their vision and goals. As educators, clinicians and professionals who work with stressed teens, we have a responsibility to recognize when executive function “mis-matches” may be a source of stress and support our teens in developing an individualized, collaborative action plan.

 

About the Author:

Dr. Renée Marchant provides neuropsychological and psychological (projective) assessments for youth who present with a variety of complex, inter-related needs, with a particular emphasis on identifying co-occurring neurodevelopmental and psychiatric challenges. She specializes in the evaluation of developmental disabilities including autism spectrum disorder and social-emotional difficulties stemming from mood, anxiety, attachment and trauma-related diagnoses. She often assesses children who have “unique learning styles” that can underlie deficits in problem-solving, emotion regulation, social skills and self-esteem.

Dr. Marchant’s assessments prioritize the “whole picture,” particularly how systemic factors, such as culture, family life, school climate and broader systems impact diagnoses and treatment needs. She frequently observes children at school and participates in IEP meetings.

Dr. Marchant brings a wealth of clinical experience to her evaluations. In addition to her expertise in assessment, she has extensive experience providing evidence-based therapy to children in individual (TF-CBT, insight-oriented), group (DBT) and family (solution-focused, structural) modalities. Her school, home and treatment recommendations integrate practice-informed interventions that are tailored to the child’s unique needs.

Dr. Marchant received her B.A. from Boston College with a major in Clinical Psychology and her Psy.D. from William James College in Massachusetts. She completed her internship at the University of Utah’s Neuropsychiatric Institute and her postdoctoral fellowship at Cambridge Health Alliance, a Harvard Medical School teaching hospital, where she deepened her expertise in providing therapy and conducting assessments for children with neurodevelopmental disorders as well as youth who present with high-risk behaviors (e.g. psychosis, self-injury, aggression, suicidal ideation).

Dr. Marchant provides workshops and consultations to parents, school personnel and treatment professionals on ways to cultivate resilience and self-efficacy in the face of adversity, trauma, interpersonal violence and bullying. She is an expert on the interpretation of the Rorschach Inkblot Test and provides teaching and supervision on the usefulness of projective/performance-based measures in assessment. Dr. Marchant is also a member of the American Family Therapy Academy (AFTA) and continues to conduct research on the effectiveness of family therapy for high-risk, hospitalized patients.

 

To book an evaluation with Dr. Marchant or one of our many other expert neuropsychologists, 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, 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.

 

2

10 Everyday Financial Literacy Activities to Build Skills

By | NESCA Notes 2019

By Kathleen Pignone, M.Ed., CRC
Transition Specialist

Financial Literacy is a much-discussed topic in the field of transition planning and life skills acquisition. Basically, we want our teenagers and young adults to have competence or knowledge in this broad area. Who is responsible for teaching this? Schools, parents, other community providers? The simple answer is all of the above.

Here are 10 quick, easy and hopefully engaging ways to support financial literacy and lots of other life skills in teenagers and young adults while juggling all of our other many parental responsibilities.

  • Plan a preferred meal or dessert and make a budget for ingredients – learn cost comparison and cooking
  • Calculate a tip in a restaurant – teach about tipping habits and budgeting; similarly schedule a haircut and pay adding tip calculation – learn multiplication and practice phone skills
  • Provide a menu of chores and determine prices for duration and frequency – help teens be seen as resources to parents by providing a menu of desired activities and a money value associated with each task
  • Help plan for a vacation – pick an activity in the destination and price it out or cost-compare flight options
  • Cost out weekly snacks – make decisions about healthy spending and healthy eating habits
  • Volunteer at school bake sale with your teen – practice making change for cash purchases while helping fundraise and give back to your school community
  • Purchase birthday card and/or birthday present – model how to budget and cost out how much for a DIY card and birthday present versus buying both from a store
  • Figure out how much it will cost to fill a gas tank – determine how far can you get on one tank of gas versus an hourly salary for entry level competitive job
  • Bus fare or uber fare comparison – great conversation about wants versus needs!
  • Play an online financial game with your teenager, such as Financial Soccer by Visa or Plan It Prom App – learn together how much it costs to attend a prom (and subsequently plan for the expenses) or play a fun game where both parents and teen can learn together

All of these activities teach saving, budgeting, financial goals, wise use of credit, cost comparison and other key executive functioning skills. Hopefully this will make spending time with your teen enjoyable and educational.

About the Author:

Kathleen Pignone, M.Ed. CRC is a deeply knowledgeable and experienced transition specialist. Prior to her tenure at NESCA, Ms. Pignone was the Career Development Director at Bay Cove Academy for 15 years, providing students with classroom and real-world employment skills training, community job placement and on the job employment-training. She has also worked at Massachusetts Department of Secondary and Elementary Education and privately as a vocational rehabilitation consultant. As a certified rehabilitation counselor, Ms. Pignone brings unique expertise carrying out vocational assessment and employment planning for adolescents and young adults as well as supporting local school programs. In addition to fortifying NESCA’s premier transition assessment services, Ms. Pignone engages in person-centered planning with teens and young adults, consultation and training for parents, providers and schools, and community-based coaching services.

 

To book a transition assessment or consultation with Kathleen or one of NESCA’s expert neuropsychologists and consultants, please 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, 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.