Processing Speed Deficits and College – Part 2 – Finding a Fit

By | NESCA Notes 2020

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

In my last blog, Processing Speed Deficits and College – Part 1 – The Dilemma, I discussed specialized instruction for students who have processing speed deficits in high school in comparison to the accommodations process in college. Below is a list of some of the accommodations and instructional modifications that are often afforded to students with processing speed deficits in high school, and if/how that support can be replicated in college as well as how hard a student may need to work to bridge gaps in support. One of the most important things to remember when reviewing this list is that modifications to the course of study or workload in a college course are typically not available in college. Students with processing difficulties must be able to keep up with the same instruction provided to every student in the class through a combination of accommodations, self-help strategies and use of supports (tutoring, academic coaching, office hours, study groups, etc.) outside of the classroom.

In the classroom

  • Reduced pace for instruction – High school educators may be used to heavily modifying their instruction (i.e., providing instruction at a slower pace, in manageable “chunks,” sometimes even with breaks between content) when they are teaching a class that includes students with reduced processing speeds. This is a typical methodology for many private special education schools and for special education classes in public schools. However, this is not the typical instructional style at a traditional college. With that said, there is great variety in the pacing of classes from one institution to another, and even from one teacher to another within the same institution. For students who have received specialized instruction in high school, it is important to consider the pace of available instruction and to sit in on college classes when considering this transition. Depending on the student’s learning profile, it may be necessary to seek out a college or support program that is specifically designed for students with learning disabilities or has had targeted programming for students with learning disabilities—especially those with processing speed deficits—for many years.
  • Copies of teacher notes or fill-in-the-blank notes – Note-taking is an important skill for life, and even students who receive accommodations to enhance their note-taking need to build skills for retaining instruction and oral direction. However, some students exit high school without note-taking skills. Upon request, colleges often have one or more ways that they can accommodate students who are unable to effectively take their own notes in class. Students may be able to get copies of teacher notes/slides, copies of notes taken by another designated student or professional note taker, recordings of class or opportunities to use other technologies in class, such as a Livescribe Smartpen. When note-taking is a challenge, it is important to understand what accommodations are typically available at a particular college, including what support might be provided for assistive technology training and usage.
  • Follow-up questions and review of learning – Students who have difficulty processing classroom learning in real-time are often provided lengthy opportunities to ask questions about materials outside of class and/or provided with copies of the teacher’s lecture materials and study guides for separate review. When thinking about college, easy access to course information and resources from outside of the classroom is an important consideration. While many universities and professors use learning management system (LMS) technologies like Blackboard, Canvas, Google Classroom, etc., there are still some professors who have not made the shift to using these systems for the majority of their coursework or student communication. Getting a sense of technology use is important if a student expects to preview and review course materials outside of the classroom (independently or with support). Understanding how easy it is to get ahold of professors outside of class (e.g., percentage of faculty who work full-time at the school, have offices, have office hours), and how to schedule brief times for individual communication with the instructor is also useful.

Managing assignments

  • Reduced writing – In high school, students who struggle with processing speed may be expected to complete fewer assignments or have longer deadlines than typical peers. In college, students are expected to complete the same number of assignments and to have all of their work for each course completed by the end of the semester. It is possible at some colleges to request extensions on assignments as an accommodation or on a case-by-case basis. However, extensions on assignments should be something that are needed as an exception rather than a rule or students may find themselves unable to keep up toward the end of a semester. Instead of extending deadlines, students who struggle with writing demands may benefit greatly by taking a reduced course load (i.e., fewer classes per semester) or by diversifying the types of classes they enroll in during one semester—for example, taking a kinesiology class at the same time as an English Composition class. If these types of accommodations are important, students will need to carefully understand a school’s policies on underloads as well as how much control/flexibility a student is able to have when managing their course of study.
  • Grading based on quality not quantity – Just as described above, it is important to remember that every student in a college course is expected to complete the same quantity of work and same course requirements. Both quality and quantity matter in college and for those reasons it is important to pick a school that is well suited for your pace and style of learning as well as a major that will enable you to fulfill course requirements using your learning strengths.
  • Support with reading fluency – Specialized instruction during K-12 education may have focused on helping a student to increase their reading pace. Reading intervention and readers are not typical in college. However, technology can be a lifesaver in supporting a student’s independent reading fluency. Students may benefit from audio books or from text-to-speech technology so that they can take in information in multiple modes and a faster pace. Practicing with technologies and understanding the related accommodations that will be available in college are important for continued reading success. Some high school students have additionally needed tutoring support because they learn best when discussing aloud content that they have read in a supportive setting—for those students, it has been important to seek out schools or learning disability programs that can provide this type of tutoring (a less common support) or to pay privately for tutoring in addition to college-based learning supports.


  • Extra time – This is one accommodation that is fairly common in both high school and college settings. One major change is that many high schools provided unlimited extra time to students, even those with no identified learning disabilities. In college, students will typically receive 50% or 100% extended time based on their needs as demonstrated in diagnostic testing. Good executive functioning can be helpful if you are a student who uses extra time on exams, because you may need to schedule your exams in a separate testing setting each time they occur.
  • Shorter length/Reduced writing requirements – As a college student, you are required to meet the same testing requirements as every student in your class. If you are accustomed to reduced writing requirements on tests, you will need to consider some of the other available accommodations (e.g., extra time, assistive technology, etc.) to successfully manage. You may also need support building your test taking strategies so that you can use your time most efficiently on tests.
  • Separate testing space – Taking a test in a reduced distraction environment, or possibly a private room, is another accommodation that is common in both high school and college. Similar to students who receive extra time on tests, there can be a high degree of planning and organization involved in scheduling one’s exams in a separate setting according to school guidelines. Students may want to inquire about the level of support that college personnel will provide to a student when they are first learning to organize and implement their testing accommodations.

Social and daily life

  • Two additional factors that may have been important in high school include Smaller school/class size and Similar peer cohort. Matriculating from a small homogenous class or school environment, where all of your peers have similar learning styles and accommodation needs, can be a shock. When researching and visiting schools, it will be extremely important to get a sense of who the other students on campus are, how common processing speed deficits are among students with learning disabilities on campus, how diverse the school is and how tolerant students generally are, etc. Sitting in on classes and taking part in accepted student days can be critical activities for students who are looking for a college that will meet them where they are at.

When students enroll with disability support services, they are often asked how their disability impacts their learning, what accommodations they were provided in high school, and what accommodations they think they will need. For students with processing speed deficits, it is critical to be able to answer these questions before beginning a college search and to find colleges that truly match their learning needs as well as their more general wishlist!



About the Author:

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

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

Why does my neuropsychologist need that? What do the tests measure and why is previous testing important?

By | NESCA Notes 2019


By:  Stephanie Monaghan-Blout, Psy.D.
Pediatric Neuropsychologist

When a family books an intake for neuropsychological evaluation, they are typically asked to complete a few pieces of paperwork and to bring previous testing and other educational documents such as an Individualized Education Program (IEP) for their intake appointment. Despite this request, many parents will come to the intake session with empty hands. Understanding that parents have an enormous number of tasks on their plate, one could expect that paperwork was left at home due to timing or organization difficulties. However, when I ask parents about the missing paperwork decision, the reasons for leaving it behind generally fall into two groups: (1) lack of knowledge about the purpose of testing; and (2) concerns about creating some form of bias in the examiner’s mind. Some parents don’t share prior testing with me because they don’t have a clear idea of what the testing is and how it is going to be used for my evaluation. This is very common with families who are new to the special education or mental health process. Some parents are reluctant to share past testing because they want a “fresh view” and are concerned that looking at someone else’s work may create a bias. This often comes up when there is disagreement between parents and their school or past provider as to the nature of the child’s difficulties. Sometimes the parents and child have had a bad previous experience with testing and/or with the examiner, and they do not feel that the test results accurately (or at least empathetically) describe their child. In any of these situations, I find that parents feel more comfortable if they know more about how the tests we use are developed and why we find it helpful to view previous testing.

Purpose of Testing: The purpose of neuropsychological testing is to find out if a child (or adolescent or adult) is developing skills at a rate and capacity commensurate with their age and ability level. In order to do this in an efficient, equitable, and consistent manner, test developers identify skills they think are important in learning, devise a task that appears to quantifiably measure that skill, give that task to children in different age groups and then transform the raw scores attained by the children into a common scale. This allows them to compare different children within an age group, and this also allows them to compare the same child at different ages. Some common measurement scales are standard scores, scaled scores, Z scores, T-scores and percentiles. All of these formats are based on a normal distribution (remember the bell curve?) in which the majority of scores fall within a certain area with increasingly fewer scores falling at either end. The “bump” where most scores fall is described as average (between 25th and 75th%ile) with the tails receiving an above or below average description. While these descriptions do not begin to capture the whole child, they do convey information about how a child is performing relative to developmental expectations based on what we know about children of the same age. They can also tell us if the child is making age expected progress according to their unique learning curve. Furthermore, most people are good at some things and not so good at others, and the pattern of their scores can often give us valuable information about their learning profile.

Question of Bias: The concern about bias is important, given that neuropsychological tests are often used to classify people and make decisions about providing or denying services. There are a number of ways in which we try to control for bias, starting with trying to make sure that the group of people that are used as test subjects when developing norms are representative of the population at large. Test makers are getting better at this, but we have a long way to go, which means that it is important that evaluators know how each test has been developed and normed. Test selection is also extremely important; some tests are not appropriate for some groups. Think about giving a Calculus test to someone who has not completed Algebra 1; this kind of mismatch is going to result in a spuriously low score on math ability.

The main way that neuropsychologists and psychologists try to control for bias is through what is referred to as standardized administration—giving the test in the same way to each child. A good deal of the training of graduate students, interns, and post-doctoral fellows involves learning and practicing these skills so that the test is given to every child in the same way, regardless of who gives it. At the same time, children are children, and sometimes they need something different. It is up to the evaluator to decide when to engage in “non-standardized administrative procedures.” One example of non-standard administration could be starting a child who has trouble catching on to novel tasks at a lower age starting point in order to help them master the task demands. Another example would be stopping a task before a ceiling of errors is reached because the child is very anxious and is having a hard time staying with the activity. It is important to make note of that break in protocol in the report; while it may somewhat reduce the validity of the scores, it also tells us something very valuable about the child’s learning style and tolerance.

Value of Having Previous Testing: Having the opportunity to review all previous testing is extremely valuable to neuropsychologists because it gives up some insight as to a child’s developmental trajectory. Scores that are higher than in previous testing may suggest improvement in a skill set. Scores that are consistent with previous testing indicate that a child is making age-expected progress along their unique learning curve. However, they may be falling farther and farther behind their same-age peers or progressing more quickly. Scores that are significantly weaker than in previous testing need to be closely examined. This could be a result of an imbalance between the environmental demands and the child’s internal resources. For instance, smart kids with executive function deficits are often not prepared for the organizational challenges of middle and high school. Significantly lower scores could also indicate stalled development due to ineffective educational interventions. It could also be a sign of emotional distress that is interfering with a child’s functioning. Rarely, it could be a sign of a medical or neurological problem. There are also some times when a change in average scores reflects a change in the exact tests or subtests used for the child. For example, when a teenager turns 16, it is common to begin administering adult intelligence scales and these tests may place higher value on slightly different skills (e.g., mental math). Without reviewing previous testing, a current evaluator may be able to provide a snapshot of a child’s current functioning, but might miss a critical developmental pattern important for understanding if/how the child is learning, what is needed to enhance their performance, and what can reasonably be expected over time for the child.


About the Author:

Formerly an adolescent and family therapist, Dr. Stephanie Monaghan-Blout is a senior clinician who joined NESCA at its inception in 2007. Dr. Monaghan-Blout specializes in the assessment of clients with complex learning and emotional issues. She is proficient in the administration of psychological (projective) tests, as well as in neuropsychological testing. Her responsibilities at NESCA also include acting as Clinical Coordinator, overseeing psycho-educational and therapeutic services. She has a particular interest in working with adopted children and their families, as well as those impacted by traumatic experiences. he is a member of the Trauma and Learning Policy Initiative (TLPI) associated with Massachusetts Advocates for Children and the Harvard Law Clinic, and is working with that group on an interdisciplinary guide to trauma sensitive evaluations.



To book an evaluation with Dr. Monaghan-Blout or one of our many other expert neuropsychologists and transition specialists, 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.