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Monday, March 19, 2018

Modern Parenting: A Heartfelt Series of Social Media Tips - Part 1

By: Jacki Reinert, Psy.D., LMHC
Pediatric Neuropsychology Post-Doctoral Fellow

Prior to entering doctoral studies, my family and I had the opportunity to live overseas for two years. After spending most of my childhood in New England, complete with family vacations to upstate New York, my limited world view left me ill-prepared for the splendor and, at times, sadness of raising our two-year-old without the loving support of our extended families in one of the most beautiful cities in the world. To bridge this gap of time and space, I often looked to social media as a window into the lives of family and friends.

First came Facebook, where old high school colleagues, current English-speaking expatriate comrades, and family could follow our adventures. Then, with the new sensational “Instagram”, I found myself snapping away, first of myself, my son, and of course the Eiffel Tower, quickly followed by Francophiles, family, and new friends. My follower stats quickly climbed and I enjoyed sharing well-cultivated images of perfect macaroons, baguettes, and yes, images of my son, who, thanks to a sweet face, curly hair, and blue eyes, certainly garnished a lot of “likes”. Hashtags embedded into my photos drew strangers in search of #paris, #perpetualtourist. Social media was my connection to family but in my eagerness to share, I never thought about the potential negative outcomes one might experience through sharing photos of their child.

For those of you who do not dabble in Instagram, users have the option of following people and liking their photos. For those with public accounts, users can look at another user’s feed (pictures) without following the person. If someone “double taps” your picture, they “like” it and you are notified. At the time, I saw no harm in having a public account with a small group of followers (375 people) until someone liked a photo I had posted of my son, someone whose name I did not recognize. After clicking on the person’s name, I was horrified to find multiple images of my son in this young girl’s account.

In 2014, a community of teenagers began “baby role playing” which consisted of taking (or stealing) other people’s images of their children shared on social media sites. After capturing the image on their own phones, the teens then rename the child, create fictional information about the child, and engage in reciprocal conversations with other role players. In the comment sections below the images, users have the opportunity to have conversations with one another, pretending to be the child and/or the parent. While some of these users used the images in seemingly innocent ways, others shared photos of children naked or breastfeeding.

After the images of my son were stolen and used for #adoptionrp, I made my Instagram account private. I also stopped posting photos of my son’s face on all social media platforms. I deleted any pictures on Facebook and asked family members to do the same. Over the past four years, we have collectively abstained from sharing images of our son and now our daughter.

Research suggests that by the age of 2, most children in the United States have an internet presence (BusinessWire, 2010). For some children, like Mila and Emma Stauffer, who have over 3.7 million followers on their mother’s Instagram account, social media has led to profitable income.

For our family, it has led to many awkward requests of, “Can you please take down that photo?” and has fostered an interest in learning about social media, digital footprints, digital citizenship, and media literacy. In this series of blog posts, we will delve into the world of social media and address how parents and professionals can talk to kids about social media.

About the Author:

Dr. Jacki Reinert is a Pediatric Neuropsychology Postdoctoral Fellow who joined NESCA in September 2017. Dr. Reinert assists with neuropsychological and psychological (projective) assessments in the Newton office and will join the Londonderry office in March 2018. In addition to assisting with neuropsychological evaluations, Dr. Reinert co-facilitates parent child groups and provides clinical consultation. Before joining NESCA Dr. Reinert worked in a variety of clinical settings, including therapeutic schools, residential treatment programs and in community mental health. She has comprehensive training in psychological assessment, conducting testing with children, adolescents, and transitional-aged adults with complex trauma.

Monday, March 12, 2018

Intensive Cognitive-Behavioral Therapy (CBT) for Anxiety

By: Ryan Ruth Conway, Psy.D.
Clinical Psychologist, NESCA

Deciding to enroll your child in mental health treatment is a big step in and of itself. Before initiating the process, there is often a trial and error period of interventions to improve the situation, whether at home or in school, and then coming to terms with the fact that they might not be enough to sufficiently address your child’s needs. Finding the right therapy and therapist match for your child can also prove challenging. Not only are there numerous therapeutic approaches available, but there are also varying levels of care depending on the severity of your child’s symptoms and amount of support he or she requires. This ranges from once weekly outpatient therapy to day treatment programs to inpatient hospitalizations for more acute psychiatric issues that may require crisis stabilization (i.e., suicidality, self-harm, etc.)

One type of treatment that has garnered considerable empirical support for treating youth anxiety and depression (conditions we regularly treat at NESCA) is Cognitive-Behavioral Therapy (CBT). CBT focuses on the intersection between our thoughts, emotions, bodily sensations and behaviors. The goal of CBT is to better manage overall emotional distress and reduce physiological symptoms by changing negative thoughts or unhelpful thinking patterns, ineffective coping strategies, and maladaptive behaviors that might be reinforcing uncomfortable feelings. CBT aims to teach children and their parents new, adaptive coping skills while providing opportunities both in and between sessions to practice these skills. CBT is a short-term, targeted treatment that promotes “approach” behaviors (as opposed to “avoidance”) through “exposures,” or exercises designed to practice facing fears gradually, in a safe environment. CBT might also include learning mindfulness, emotion regulation, and distress tolerance; techniques that have been shown to enhance treatment outcomes.

While some youth make progress in meeting with a therapist once per week, others benefit from a condensed, “intensive” format where they receive CBT treatment daily and over a shorter period of time. The accelerated nature of these types of programs, offered in both outpatient and hospital-based settings, allows for quicker acquisition of strategies, substantial exposure practice, and generalization of newly learned skills to other settings in a child’s life. Think of it as a crash-course in CBT.

You may want to consider an intensive therapy program for your child if:
  • Your child’s symptoms are greatly interfering with his or her life, such as attending school or school performance, family life, and friendships.
  • Your child has tried different therapies in the past but there has been minimal carryover from session to session and/or you haven’t noticed much progress overall.
  • Your child is experiencing distress but other commitments during the school year have hindered attending therapy on a consistent basis, making school breaks or the summer an ideal time to work on it.
At NESCA, we are pleased to offer a highly specialized and immersive therapy experience through our 2-Week Summer Intensive CBT Program for anxiety. We work with children and adolescents who present with all types of anxiety, including generalized anxiety, separation anxiety, social anxiety, specific fears (e.g., dog phobia, vomit phobia, etc.) and obsessive-compulsive disorder (OCD).

What does NESCA’s 2-Week Summer Intensive Program consist of?
  • Intake evaluation – A meeting is held with the child and parents to gain a comprehensive understanding of the child, provide an assessment of symptoms and discuss goals for treatment, all of which will inform the treatment plan.
  • 1:1 therapy sessions – Individual CBT therapy sessions with the child or teen are conducted 5 days/week for 90 minutes. Homework will also be assigned between therapy sessions to reinforce skills learned.
  • Parent involvement – Parent participation is vital in treating childhood anxiety. Parent sessions are held 5 days/week for 30 minutes. During these meetings, parents will be educated about their child’s anxiety, receive progress updates and also acquire tools to better support their child. Parents might also be asked to help children practice the new skills they are learning.
  • Discharge planning – Families will be assisted in determining follow up support that will be helpful in order to maintain treatment gains.
  • Treatment summary – Following the conclusion of the program, families will receive a written summary that reviews the course of treatment, progress made and discharge recommendations.
There are circumstances in which the frequency, duration and/or structure of the program can be modified to best fit your child’s needs.

For more information about NESCA’s Summer Intensive CBT Program or to find out if the program is appropriate for your child, please contact Dr. Ryan Ruth Conway at (617) 658-9831 or rconway@nesca-newton.com.

About the Author:

Dr. Ryan Ruth Conway is a licensed clinical psychologist who specializes in Cognitive Behavioral Therapy (CBT), behavioral interventions, and other evidence-based treatments for children, adolescents and young adults who struggle with mood and anxiety disorders as well as behavioral challenges. She also has extensive experience conducting parent training with caregivers of children who present with disruptive behaviors and Attention-Deficit/Hyperactivity Disorder. Dr. Conway has been trained in a variety of evidence-based treatments, including Parent-Child Interaction Therapy (PCIT), Dialectical Behavior Therapy (DBT), and Exposure with Response Prevention (ERP). Dr. Conway conducts individual and group therapy at NESCA utilizing an individualized approach and tailoring treatments to meet each client’s unique needs and goals. Dr. Conway has a passion for working collaboratively with families and other professionals. She is available for school consultations and provides a collaborative approach for students who engage in school refusal. 

Tuesday, March 6, 2018

AANE, NESCA, and MGH Aspire Partnering for Conference on April 7th!

I Am Who I Am: Asperger Syndrome and Building Self-Esteem

According to Dr. Tony Attwood and Autism Hangout founder Craig Evans, poor self-esteem is one of the most common and debilitating problems experienced by people with Asperger/Autism profiles. This interactive conference, featuring keynote speaker Sarah Hendrickx, Nomi Kaim, and a diverse group of presenters on the autism spectrum, will be a chance for professionals, adults, and family members to examine this topic in depth. We invite you to participate in this important discussion which aims to uncover strategies and tools for those on the spectrum to improve their feelings of self-worth.

Date: Sat, April 7, 2018
Time: 9 AM - 3:30 PM
Location: Newton-Wellesley Hospital (NWH), 2014 Washington Street, Newton, MA

Learn More



Hosted by AANE in partnership with NESCA and MGH Aspire
Price for Attendee: $50 *
Additional Attendee: $50*

* Thanks to a generous grant from the Belmont Savings Bank Foundation, AANE is able to offer half-price tickets, for $50 each, to all attendees.

Monday, March 5, 2018

Mindfulness In Schools

By: Ann-Noelle McCowan, MS, RYT
Therapeutic Yoga Instructor, NESCA

Open Google and type in Mindfulness in Schools and you are presented with a buffet of resources. What was once seen as an alternative idea has become mainstreamed. But what is Mindfulness and why is it something that deserves a place in schools?

Mindfulness was originally developed as part of the 8 Fold Path of Buddhism. With mindfulness your attention would be turned inward and also impact your relationship with the world through mindful actions and behaviors.  Now it is scientifically studied and found in locations like professional locker rooms, jails and hospitals to fortune 500 companies like Nike, Google and Apple. Advancements in brain imaging show that a regular mindfulness practice creates increased activity in the areas of the brain associated with working memory, executive function, emotional regulation, perspective taking and empathy, with decreases in the areas of the brain associated with depression, PTSD and stress (correlated with a decrease in amygdala size).

Mindfulness’ increased popularity may be due to the fact that it is an adaptable, take with you anywhere antidote to a society that is increasingly fast paced and technology focused. In a global world it helps us feel both connected to ourselves and grounded where we are. More adults and kids are feeling stressed, anxious and depressed, and mindfulness can help soothe our worries without negative side affects.

Schools are responsible for teaching children skills and information across many content areas, yet how often are children taught the best way to pay attention, or how to use attention?  Attention is the lens through which all of our experiences are filtered through, yet it is rarely directly and specifically taught! Mindfulness is at its core simply focusing on a single thing at time, in a particular way, without evaluation. It is an invaluable life skill for helping children be successful students as well as happy well adjusted and connected children. An informal survey of my colleagues and friends found that yoga and mindfulness is being adapted to various school settings.  From class transitions that begin with listening bells, rounds of belly breathing before assessments, calming scented oils on cotton balls in the nurse's’ office,  books clubs with teachers, introductions to mindfulness apps in health class and  mindfulness or yoga activities and clubs.  mindfulness is staking its place in schools. 

When introducing mindfulness in classrooms and schools the following steps help outline ways to weave mindfulness into classrooms and schools.

1. Learn More. 

Starting with this blog post the internet is full of articles and videos to explore.
     How Meditation Can Reshape Our Brains: Sara Lazar at TEDxCambridge 2011
     Kids getting lessons in mindfulness in school - Today's Parent

2. Model Mindfulness and Practice Yourself. 

You can’t teach what you don’t know. Practicing mindfulness will help you be aware of your own reactions if at first your students are squirmy or resistant. Keep in mind that students may not use the words you expect to describe their experience, listen for what is behind their words.

3. In an age appropriate way, explain how mindfulness is beneficial for them. 

My teens love learning about how their brain works and that mindfulness is a form of training for their brain. 

Some videos for younger  kids:

4. Teach about the monkey or animal mind. 

Children of all ages enjoy the practice of noticing how many places their thoughts go and how quickly thoughts connect to others. There are fantastic books for younger kids such as Moody Cow Meditates and  Mindful Monkey, Happy Panda.  Teens understand how if walk into class and see their friend laugh with a peer after a glance towards them their thoughts immediately race.... “ “what did I do” ...“ they are mad”...“I’m not going to have a partner for this project”... “ there goes my secrets, begin the rumors”... “I’ll be left out of the weekend plans” … “I’ll be alone forever”.  Teach them to acknowledge the chatter but not get caught in it.

5. Start small. 

Begin with 1-3 minutes at the start of class directing kids to feel their seat in their seat, their feet on the floor, their hands on their lap and intentionally take 5-10 long inhales and exhales. Other ideas:

  • Practice silent snack one day a week, take a mindful walk as a class and have them focus on their senses and record it in their own journal ( words or visuals) when back in the classroom. Create a mindful space in a corner of your room with coloring books, pencils, cushions as a safe break place.
  • For kids it may be hard to focus on a single item at a time, so use manipulatives. A Hoberman Sphere, Pinwheels or feathers to demonstrate breath.  Build Worry Jars, adapt Chutes and Ladders or other familiar games with mindful exercises. Use one of the many Yoga Card Decks. 

6. There’s an App for this!

Ironic perhaps to use technology but most kids love technology and it offers choice and control. Try  “Calm.com”, “Stop, Breathe and Think”, “Smiling Mind” or the “Insight Meditation Timer” (after medications my kids love to check out the world map and see all the locations where people are meditating!).  Try a classroom program such as http://www.innerexplorer.org/

7. Be consistent.

Greater benefits and habits are created when mindfulness is done repeatedly. Colleagues who practice mindfulness daily, even for a few minutes notice the impact is greater than if  done sporadically. 

Mindfulness is good for us and our children and has a natural place in our schools. Benefits abound like enhanced attention, self-regulation, social competence, as well as greater kindness and compassion. After I have practiced mindfulness with my students or clients they look different, calmer and relaxed and ask for it again. I too notice the rest of my day feels more manageable and my smile is broader. Enjoy adding mindfulness to your classroom or express your hope to your child’s teacher or school leaders that mindfulness be a part of your child’s school experience. 

Thursday, March 1, 2018

Continuing Education Opportunity: Late, Lost, and Anxious! – Technology to Support Executive Function

An exciting continuing education opportunity for psychologists, occupational therapists, speech-language pathologists, educators and related professionals!!!


Angela M. Currie, Ph.D., Pediatric Neuropsychologist at NESCA
Heather Gray, M.S., CCC-SLP, ATP, Gray Consulting and Therapy
Jennifer Stylianos, M.S., OTR/L, Gray Consulting and Therapy

About the Workshop:

Students nowadays are confronting significantly greater levels of stress and anxiety than ever before. Often times, this stress occurs alongside executive function and attentional difficulties that make it difficult for the student to manage increasing academic demands. In this workshop, we will discuss how executive function, attention, and stress intersect and ultimately impact a student’s academic motivation. We will then discuss assistive technology as a tool to support these challenges, addressing how to identify appropriate supports and how to develop an effective plan for their implementation. 

At the conclusion of this workshop, participants will be able to:
  • Define and understand executive function as a complex set of self-regulation skills 
  • Understand how attention and anxiety intersect with executive function, resulting in motivation 
  • Identify 3 factors necessary to effectively implement an assistive technology plan 
  • Describe key features of assistive technology needed for executive functioning 
4.5 continuing education credits or professional development units will be offered for this workshop.

When and Where: 

May 17th, 2018 9:00am – 2:30pm
Brookstone Park, Derry, NH


Registration is $119 and includes continental breakfast and lunch. Registration deadline in May 11th. Please register by calling or emailing Stephanie MacInnis at 603-818-8526 or smacinnis@nesca-newton.com.

Cancellation Policy: 

Cancellations received prior to May 10th will receive full refund. Cancellations received after that date will not be refunded.

This event is Co-Sponsored by Neuropsychology & Education Services for Children & Adolescents (NESCA). NESCA is approved by the American Psychological Association to sponsor continuing education for psychologists. These credits are also accepted by the State Board of Mental Health Practice for all NH licensees. NESCA maintains responsibility for the program and its content.

Monday, February 26, 2018

Neurodevelopmental Evaluations - Where and When to Start

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

Parenthood is a daunting task to say the least. Not only must we worry about keeping our children healthy and safe, but we are constantly bombarded with information about potentially harmful foods, chemicals, toys, etc. Many parents also have concerns about whether their children are meeting developmental milestones on time and/or whether they should worry about certain behaviors their children are displaying.

When concerns arise about older children, parents are often advised to seek a neuropsychological evaluation to rule out possible attention, learning, or developmental challenges. However, parents of children under 5 are often urged to “wait and see” or might be told it is “too early” to seek an evaluation. The truth of the matter is that it is never too early to have your child evaluated when you are worried about his or her development.

Where do I start?

If you have concerns about your child’s development, it is always a good idea to start with your pediatrician. Describe what you are seeing at home and any difficulties you have noticed. Your pediatrician might recommend that you seek a comprehensive neurodevelopmental evaluation to assess for any developmental delays.

What is a neurodevelopmental evaluation?

This is a comprehensive set of tests designed to assess all aspects of your child’s development, including cognition, language, motor, and social skills. This type of evaluation is conducted by a pediatric neuropsychologist. First, you will be asked to provide information about your child’s developmental and medical histories. Your child will then be asked to participate in a series of activities over the course of 2 or 3 hours. For example, he/she will have to solve simple puzzles, label pictures, or play with different types of toys.

Why is a neurodevelopmental evaluation useful?
After completing the evaluation, the neuropsychologist will analyze all of the information and develop a comprehensive picture of your child’s developmental profile. In addition to helping you understand your child’s strengths and weaknesses, the neuropsychologist will also identify any developmental delays that require intervention.

What happens next?

An evaluation will identify developmental delays that need to be treated in order to help your child catch up with peers. Some examples include speech/language therapy, occupational therapy, physical therapy or applied behavior analysis (ABA).

For children under 3, this means they can start receiving Early Intervention services right away. Early Intervention is a system of services for babies and toddlers who have developmental delays or disabilities and is available in every state in the US.

For children over 3, parents can seek services privately, or can work with their local school district to develop an Individualized Education Program (IEP) for their child. Having an independent evaluation completed prior to your child’s transition to public education is extremely useful as it provides the district with the child’s type of disability and informs the process of developing necessary services.

Where can I go?

Neurodevelopmental evaluations are available at many local area hospitals as well as private neuropsychology clinics. Parents can also contact their insurance company for a list of providers or search through the Massachusetts Neuropsychological Society: https://www.massneuropsych.org/i4a/pages/index.cfm?pageID=3309

At NESCA, we are proud to offer neurodevelopmental evaluations for children ages 1-5 and will provide parents with a comprehensive report, extensive recommendations for services, and ongoing consultation through the years. Our clinicians are able to do observations of children in their natural environments (e.g., day care, preschool) to gain a full picture of the child and provide environmental recommendations that would be most supportive. Moreover, we are available to attend meetings with early intervention specialists and special educators to help a child's team fully understand their individual learning and service needs.

If you are interested in scheduling a consultation or evaluation at NESCA, please complete our on-line intake form: https://nesca-newton.com/intake-form/.

About the Author:

Erin Gibbons, Ph.D. is a pediatric neuropsychologist with expertise in neurodevelopmental and neuropsychological assessment of infants, children, and adolescents presenting with developmental disabilities including autism spectrum disorders, Down syndrome, intellectual disabilities, learning disabilities, and attention deficit disorders. She has a particular interest in assessing students with complex medical histories and/or neurological impairments, including those who are cognitively delayed, nonverbal, or physically disabled. Dr. Gibbons joined NESCA in 2011 after completing a two-year post-doctoral fellowship in the Developmental Medicine Center at Boston Children’s Hospital. She particularly enjoys working with young children, especially those who are transitioning from Early Intervention into preschool. Having been trained in administration of the Autism Diagnostic Observation Schedule (ADOS), Dr. Gibbons has experience diagnosing autism spectrum disorders in children aged 12 months and above.

Monday, February 19, 2018

Sleep Hygiene and Sleep Debt

By: Rebecca Girard, LICSW, CAS
Licensed Clinical Social Worker, NESCA

For many students, teachers, and families in Massachusetts (and several other states throughout the country), this week marks a vacation and a time for rest. In that spirit, this week on NESCA News & Notes, we are highlighting the importance of good sleep hygiene for children, a vital element of wellness, mental health, and learning. Check out this short TEDx talk by Roxanne Prichard of the University of St Thomas about the importance of sleep for children. Highlights of the talk include:
  • Sleep is an essential for a healthy brain
  • United States school children are ranked 1st among nations with academic problems directly attributable to sleepiness
  • A 2014 Sleep in America poll found that fewer than 1 in 5 teens is getting the minimum amount of recommended sleep

Benefits of a good night’s sleep include:
  • Better regulated vital systems including growth and immune responses
  • Better memory and ability to retain new information
  • Boosts mood

Tips for good sleep health (according to the CDC):
  • Be consistent. Make sure your child goes to bed at the same time each night and gets up at the same time each morning, including on the weekends (as much as possible)
  • Make sure the bedroom is quiet, dark, relaxing, and at a comfortable temperature
  • Remove electronic devices, such as TVs, computers, and smart phones, from the bedroom
  • Avoid screens 30 minutes before bedtime. Promote reading, drawing or another quiet, non-screen activity to wind down
  • Avoid large meals, caffeine, and sugar right before bedtime
  • Make sure your child is getting some exercise. Being physically active during the day can help a child fall asleep more easily at night.

So how much sleep does a child need?

For more information on Dr. Roxanne Prichard as well as sleep hygiene, visit the following web sites:
About the Author:

Rebecca Girard, LICSW, CAS is a
licensed clinical social worker specializing in neurodivergent issues, sexual trauma, and international social work. She has worked primarily with children, adolescents, adults with Autism Spectrum Disorders and their families for over a decade. Ms. Girard is highly experienced in using Cognitive Behavior Therapy (CBT) as well as Socio-dramatic Affective Relational Intervention (SDARI), in additional to a number of other modalities. She is excited to provide enhanced psychotherapy to children with ASD at NESCA as well as to provide therapeutic support to youth with a range of mood, anxiety, social and behavioral challenges. Her approach is child-centered, strengths-based, creative and compassionate.