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617-658-9800

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Wednesday, December 13, 2017

NESCA Offers Professional Training for ADOS-2 with Dr. Rhiannon Luystor

Clinical Training Workshop for Professionals 
with Dr. Rhiannon Luystor:
Autism Diagnostic Observation Schedule, 2nd Ed. (ADOS-2)

Friday, January 5 and Saturday, January 6, 2018
9:00 a.m. – 5:00 p.m.

For: Master's and Doctoral Level Clinicians 
Location: NESCA, 55 Chapel Street, Suite 202, Newton, MA 02458
Cost: $500.00 – 13.5 continuing education credits
Register online: https://goo.gl/forms/4SVqBv5VNbWeTaQj1

Description:

Diagnosing Autism Spectrum Disorders (ASD) can be accomplished utilizing a variety of standardized diagnostic measures that typically integrate parent and teacher feedback, such as the Gilliam Autism Rating Scale. Other diagnostic measures such as the Childhood Autism Rating Scale (CARS) integrates parent feedback with clinical observations. 

While these measures are helpful, the Autism Diagnostic Observation Schedule (ADOS), considered to be the gold standard of ASD diagnostic assessment, is appropriate across ages, developmental levels, and language skills. Join NESCA for a two-day training workshop with Dr. Rhiannon Luyster, developmental psychologist to learn about the ADOS-2, the latest edition of the ADOS.

This workshop provides in-depth information in both lecture format and live demonstrations. Participants will acquire the principals of administering and scoring ADOS-2 Modules 1 through 4 in addition to learning about the revised algorithms, new comparison scores for Modules 1-3, the new Toddler Module for young children, and updated protocols with administration and coding instructions. This is an essential training is necessary for professionals who intend on utilizing the ADOS-2 in either clinical or school settings and is appropriate for beginner and intermediate learners as well as advanced learners who are interested in acquiring the latest administration and scoring utilizing the ADOS-2.

Learning objectives:

At the end of this two-day workshop, participants will be able to:
  1. Identify the key features of the ADOS-2 approach, including the rationale for the approach and how it enhances autism assessment
  2. Describe use of the ADOS-2 for operationalizing diagnostic criteria for autism spectrum disorders
  3. Explain how to select the most appropriate ADOS-2 module
  4. Identify administration procedures for the ADOS-2
  5. Demonstrate a basic understanding of how to apply ADOS-2 codes
  6. Demonstrate a basic understanding of how to score ADOS-2 algorithms
  7. Identify the psychometric support for the ADOS-2
  8. Explain issues in the clinical application of ADOS-2 results
Prior to the workshop, attendees must view the 90-minute DVD of Module 1 and 3, review the scored protocols corresponding to the video demos, and preview the ADOS-2 manual. 

About the Presenter:

Rhiannon Luyster, PhD, is a developmental psychologist who studies social communication and language in young children with autism spectrum disorder (ASD). She is interested in identifying early features of ASD using standardized behavioral measures as well as exploratory methods like infra-red eye tracking and electrophysiology. Her research, which has been supported by the National Institutes of Health, the Brain & Behavior Research Foundation and the Organization for Autism Research, focuses on diagnostic assessment, language and nonverbal communication in toddlers with ASD, and patterns of early development. Dr. Luyster has published her work in several peer-reviewed journals, including Developmental Psychology, Journal of Child Language, Journal of Speech, Language and Hearing Research, and Journal of Autism and Developmental Disorders.

Sponsored by: Neuropsychology & Education Services for Children & Adolescents (NESCA)


NESCA is approved by the American Psychological Association to sponsor continuing education for psychologists. NESCA maintains responsibility for the program and its content.

Monday, December 11, 2017

Emerging Psychosis: When to worry about your teen’s thinking


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

Emerging Psychosis: When to Worry about Your Teen’s Thinking
Teenagers are famous for incidents of bad judgment and poorly considered decisions; it is one of the rites of passage for parents and children to have had at least one “What were you thinking?” discussion before the teen leaves the family nest for college or employment. These events are often memorable, however, because they tend to be outliers, occurring simultaneously with instances of relatively accurate appraisals of situations and relatively adequate problem-solving as they navigate the expectations of school, family, friends, and community.

Some parents must confront a separate set of ongoing concerns about their child’s thinking that effect their assessment of the world and themselves. In this article, I will talk about the nature of psychosis, describe the changes leading up to an episode of psychosis and outline emerging models of treatment which aim to prevent the first acute episode or at least delay onset of the episode as much as possible. These findings emphasize the critical importance of early identification and treatment of symptoms to prevent or reduce future impairment.

The Nature of Psychosis
Psychosis refers to a condition in which a person has lost contact with reality and is unable to distinguish what is real and what is not. Psychotic symptoms include what are called “positive” (what is present) and “negative” (what is absent) symptoms.
  • Positive symptoms include: abnormalities of thinking in both content as well as form; the former refers to distortions of reality such as hallucinations or delusions, and the latter refers to disorganization of thinking and bizarre behavior. 
  • Negative symptoms refer to the reduction of emotional response (“blunted” or incongruous affect), apathy and loss of motivation, social withdrawal, impaired attention, reduced speech and movement, loss of enjoyment in life (“anhedonia”). 
Researchers have also identified subtle cognitive impairments that include:
  • Deficits in processing speed 
  • Executive function 
  • Sustained attention/vigilance 
  • Working memory 
  • Verbal learning and memory 
  • Reasoning and problem solving 
  • Verbal comprehension 
  • Social cognition 
The impact of these issues can result in severe functional deficits across a range of domains such as work, school, and relationships.

Psychosis is now thought to be a neurodevelopmental disorder, meaning that it is thought to be related to abnormalities in brain development that become apparent as the brain matures in adolescence. Psychosis is thus a condition that emerges gradually as the underlying dysfunction comes to the fore. It is also thought to be a neurodegenerative disorder, meaning that the disease causes physical changes to the brain that results in impaired functioning. These changes include, on average, slightly larger lateral ventricle and slightly less cerebral gray matter for people at the first psychotic break compared to controls. From a behavioral perspective, researchers have found that the longer people live with an untreated psychosis, the more likely they are to experience functional impairments, have a poor response to psychiatric medications, and experience a poor quality of life. These alarming findings have prompted researchers and clinicians to research the period of time before the first psychotic break, referred to as the prodromal period, where symptoms start to emerge, in an effort to discover a way to divert or slow this process.

The Prodromal Period
The prodromal period is a time when “subclinical”, or milder symptoms of psychosis begin to appear. This period can vary in length from a few weeks to a few years. During this period, the adolescent or young adult may experience mild disturbances in perception, cognition, language, motor function, willpower, initiative, level of energy, and stress tolerance. These are differentiated from frank psychosis by lower levels of intensity, frequency or duration. The teen may complain of nonspecific clinical symptoms such as depression, anxiety, social isolation, and/or difficulties with school. They then may start to occasionally experience positive symptoms that are brief in duration and moderate in intensity. These events may become more serious over time, although they don’t happen often, last for only a few minutes to hours, and the person still retains some insight as to the unusual nature of the phenomena. However, this situation changes as the person comes closer to the initial psychotic break, signaled by the emergence of unusual thoughts, perceptual abnormalities, and disordered speech.

Risk and Resource
Who is most likely to move from the prodromal period to frank psychosis? Factors most predictive of this transition include people with a family history of psychosis and a recent deterioration of functioning, a history of substance abuse, and higher levels of unusual thoughts and social impairments. Other mediating factors include poor functioning, lengthy time period of symptoms, elevated levels of depression or other comorbid conditions, and reduced attention.

What factors appear to ameliorate risk of descending into psychosis? Risk/protective factors include higher premorbid cognitive skills and social skills and lack of a history of substance abuse. 

How and When to Intervene
The information provided here about emerging psychosis underlines the critical importance of early intervention to address the serious and pervasive impact on functioning. Professionals who treat people at risk of psychosis are now beginning to use a clinical staging of treatment, meaning treatments should be tailored to the client’s needs, starting with safer and simpler interventions for the prodromal stages and increasingly intensive and aggressive treatment for people who are already contending with psychosis. This requires starting with what appears to be most problematic at the time for the person. For some people, this means treating the comorbid psychiatric conditions. For those who are experiencing difficulties with attention/executive function or reporting elevated levels of unusual symptoms, it may mean starting the person on an atypical antipsychotic. The use of targeted psychosocial interventions such as cognitive behavioral therapy, social skills training, and family therapy have all been found to be associated with reduced or delayed transition to first episode psychosis.

Where to Go for Help
Living in the Boston area, we are fortunate to have a wealth of resources in our hospitals and training sites that are engaged in cutting edge research and intervention to address the needs of young people who are contending with emerging psychosis. These include Beth Israel-Deaconess Hospital’s Center for Early Detection and Response to Risk (CEDAR) and the Prevention and Recovery in Early Psychosis (PREP) jointly run by the Beth Israel-Deaconess and Massachusetts Mental Health Center. Also, Cambridge Health Alliance offers the Recovery in Shared Experiences (RISE) program for the treatment of first episodes of psychosis.

Neuropsychological testing, augmented by psychological testing can be a useful tool to learn more about cognitive and emotional functioning. However, this is best undertaken as part of a comprehensive program of intervention. 

Articles used for this blog:
  • Larson, M, Walker, E, and Compton, M (2010) Early Signs, diagnosis, and therapeutics of the prodromal phase of schizophrenia and related psychotic disorders, Expert Review of Neurotherapy. Aug. 10 (8), 1347-1359. https://www.nimh.nih.gov/health/topics/schizophrenia/raise/what-is-psychosis.shtml 
  • NPR Your Health Podcast (2014) Halting Schizophrenia Before It Starts 
  • Miller, Brian Negative Symptoms in Schizophrenia; The Importance of Identification and Treatment, Psychiatric Times, March 2017 
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.




Thursday, December 7, 2017

4 Sports, 5 Months, Lots of Fun! A Research Opportunity from UMass Boston


Exciting Research Opportunity for Children 6-12 to Begin Building Healthy Habits


Physical Activity Research: A Sport Sampling Program for Kids with an Intellectual Disability

UMass Boston is seeking children with intellectual and developmental disabilities (IDD) ages 6-12 years to participate in a new sport sampling program as part of a research study. Sport sampling involves engaging children with IDD in multiple sports and activities (e.g. soccer, basketball) to promote skill development, confidence, and a love of sport/physical activity.  

The program will take place at the Waltham YMCA starting in mid-January and will run for 5 months.  The study is being conducted by Dr. Heidi Stanish from University of Massachusetts Boston.  

WHAT IS THE PURPOSE?
To build physical literacy in kids with an intellectual disability. Physical literacy involves developing movement skills, confidence and motivation to help kids be successful at physical activity. Sport sampling gives kids the opportunity to try different sports to find what they like.

WHO CAN PARTICIPATE?
  • Kids with an intellectual disability ages 6-12 years
  • Speak and understand English
  • Able to walk
WHAT IS REQUIRED?
  • Participate in a fun, non-competitive sport sampling program with other kids
  • Trained instructors will lead games and activities
  • Motor skill assessment and short survey(s) two times
  • Brief phone screen and meeting to confirm child’s eligibility
WHERE AND WHEN?
  • Mondays 3:30-4:30 pm (ages 6-8), 4:30-5:30 pm (ages 9-12)
  • 5 months, mid-January thru June 2018
  • Waltham YMCA – 725 Lexington St., Waltham 
There is no cost to participate

WANT TO JOIN?
For more information, contact Caitlin at sportsampling@gmail.com or call 617-287-7465

This important research is being overseen by Dr. Heidi Stanish, an Associate Professor in UMass Boston's Department of Exercise and Health Sciences. Dr. Stanish’ s research interests include examining physical activity participation among children and adults with disabilities (specifically intellectual disabilities) and developing strategies to promote physical activity in this segment of the population. Dr. Stanish is particularly focused on testing sustainable, community-based physical activity interventions designed to meet the needs of individuals with physical, intellectual, and sensory impairments.  

Monday, December 4, 2017

Director's Update


By: Ann Helmus, Ph.D.
Founder and Director
Clinical Neuropsychologist

NESCA was founded on the idea that a thorough evaluation reflecting careful analysis of information gathered from history, observations, and testing data is crucial in formulating a comprehensive, individualized plan for supporting a child to realize their potential. Increasingly, NESCA is expanding its intervention services, which allows for a higher level of integration between the evaluator and treater. Clearly recognizing the benefit of psychopharmacological intervention for many children and adolescents, at NESCA, we focus on the powerful benefits of many non-medication approaches. 

Our experience, supported by research, is that significant improvements in functioning result from psychoeducation, direct teaching of strategies to parents and students, and intervention at the physical level. Psychoeducation refers to the process of educating clients and their parents about the nature of challenges such as anxiety or ADHD.  Beyond gaining a thorough understanding of the challenges faced by a client, parents, teachers, and students need strategies for managing problematic symptoms and behaviors. Teaching and helping parents and students practice these strategies often yields huge changes in functioning.  Finally, the mind and body are interconnected and intervening at the physical level is often more straight-forward for many of our clients, leading to impressive changes in cognitive and emotional functioning. 

NESCA offers the following therapeutic interventions:

CBT is an evidence-based therapy that focuses on identifying and changing thoughts patterns and behaviors that are interfering with functioning.  Of note, we have a therapist who is highly experienced in psychotherapeutic intervention with children and adolescents who are on the autism spectrum, including the use of the Sidekicks app developed by the Affinity Project. 

ACT uses approaches such as mindfulness and behavioral change strategies to help clients increase flexibility and reach goals. 

Many children require more frequent meetings in order to master the strategies that are being taught for behavioral/emotional regulation or social functioning. NESCA’s intensive out-patient therapy programs generally involve three weekly sessions of direct service for the child followed by brief parent guidance meetings. 

NESCA offers a group for school age children with ADHD and their parents. Children meet in one group while their parents meet concurrently in another group, both led by experienced psychologists.  Starting in 2018, NESCA will be offering drama-based therapy groups based on the Spotlight model developed at the Northeast Arc and researched by the Social Competence and Treatment Lab at Stony Brook University. 

This intensive program was developed to address school refusal through both home-based and center-based psychotherapy, parent guidance and school consultation.    

Many clients struggle to generalize strategies that they have learned in therapy to daily living. NESCA has highly skilled coaches that work with adolescents and young adults in the community to practice skills and strategies.

Adolescents with developmental challenges, learning disabilities, and psychiatric issues often need support in planning for “life after high school”. Our veteran transition specialists work with adolescents and their parents to identify strengths, formulate realistic goals and a plan for reaching goals over their high school years. 

Individual or small group interventions in our yoga studio to build self-awareness and the ability to use breath and movement to address symptoms of anxiety and enhance attention. 

These ancient treatments can be highly effective for treating anxiety, ADHD, and other childhood conditions. 

Further information about all of these interventions are available on our website. If you are wondering whether one of these approaches may be helpful for your child, please contact me at:  ahelmus@nesca-newton.com

About the Author:
NESCA Founder/Director Ann Helmus, Ph.D. is a licensed clinical neuropsychologist who has been practicing for almost 20 years. In 1996, she jointly founded the Children's Evaluation Center (CEC) in Newton, Massachusetts, serving as co-director there for almost ten years. During that time, CEC emerged as a leading regional center for the diagnosis and remediation of both learning disabilities and Autism Spectrum Disorders. Dr. Helmus specializes in the evaluation of children with learning disabilities, attention and executive function deficits and primary neurological disorders. In addition to assessing children, she also provides consultation and training to both public and private school systems. She frequently makes presentations to groups of parents, particularly on the topics of non-verbal learning disability and executive functioning.

Monday, November 27, 2017

A Tale of Two Social Styles: Classical and Jazz Socializers

Senior Neuropsychologist

Classical and Jazz Socializers

I work with a number of parents concerned about the quality of their child’s social life.  Lamenting that their child has no true friends, many parents I see note that that their child doesn’t “hang out” with peers.  However, when asked about how their child does spend time with peers, many parents report that their child is involved in several different structured after-school activities, such as a church youth group, scouting, or a gaming club.  In other words, while not getting together with peers in less structured settings, these students often do, despite parent misgivings, have satisfying social lives.

I find it useful to think about socializers as lying in one of two camps: Jazz and Classical.  Jazz socializers are all about improv.  They’ll head downtown with a friend and see where the afternoon takes them, invite a friend over with no particular plan or agenda, or wander the mall in a herd.  They care little about predictability and in fact relish spontaneity and surprise.  Classical socializers, by contrast, are most comfortable with structure.  They crave predictability, wanting to know the specific parameters of a social activity, including the start and end times, the purpose, and the rules of engagement.  Classical socializers, then, tend to do best with organized social activities.

It’s important to note that one type of socializing is not better than the other; it’s about match.  I say that as many parents of Classical socializing children worry that their children will grow up to be friendless and alone.  To those concerns, I observe that there are plenty of socially-satisfied Classical socializing adults: they have their book club the first Monday of every month, poker night every other Thursday, weekly chorus practice, and bar trivia on Wednesdays.

Thus, rather than trying cram to their Classical socializing child into a Jazz paradigm – which in fact runs the risk of leading to more social isolation due to anxiety stemming from the mismatch – I encourage parents to embrace the kind of socializer that their child is.  For parents of Classical socializers, that means supporting their child’s social satisfaction and growth through encouragement of their participation in a variety of structured after school activities (of course without over-scheduling).  In addition to giving their children a chance for a rich and rewarding social life now, participation in such activities serves as important practice and preparation for adult life, as in college and as adults in the working world, that is how Classical socializers will be most socially satisfied.

About the Author:



Dr. Jason McCormick, a senior clinician at NESCA, sees children, adolescents and young adults with a variety of presenting issues, including Attention Deficit Hyperactivity Disorder (AD/HD), dyslexia and non-verbal learning disability. He has expertise in Asperger’s Disorder and has volunteered at the Asperger’s Association of New England (AANE). Dr. McCormick mainly sees individuals ranging from age 10 through the college years, and he has a particular interest in the often difficult transition between high school and college. As part of his work with older students, Dr. McCormick is very familiar with the documentation requirements of standardized testing boards. He also holds an advisory and consultative role with a prestigious local university, assisting in the provision of appropriate academic accommodations to their students with learning disabilities and other issues complicating their education.




Wednesday, November 22, 2017

Lynn Lyons, LICSW, Anxious Kids, Anxious Parents: Strategies to Interrupt the Worry Cycle

If you have not previously attended the Dr. Charles P. Conroy Speaker Series at Dr. Franklin Perkins School, next Thursday's presentation provides an excellent reason to attend their first session:

Anxious Kids, Anxious Parents: 
Strategies to Interrupt the Worry Cycle
Speaker: 
Lynn Lyons, LICSW

Date: 
Thursday, November 30, 2017

Time: 
6 pm to 8 pm

Where: 
Charles P. Conroy Auditorium
Perkins Janeway Education Center
975 Main Street, Lancaster, MA

Lynn will provide an overview of managing anxiety and will then delve deeper into how to manage anxiety in both adults and children. She will explain why it is much more important to answer "how" questions than "why" questions in managing the fears that lead to anxiety. She will offer productive solutions and strategies. Lynn Lyons is a licensed clinical social worker and psychotherapist in Concord, New Hampshire, specializing in the treatment of anxiety disorders in adults and children. Lynn has traveled globally as a speaker and trainer on the subject of anxiety and its roles in families and the need for a preventative approach in the home and in schools.

Learn more about Lynn Lyons and her work:



While the sessions are FREE, please register by e-mail to dbuono@perkinschool.org or call 978-365-7376 during regular business hours (8:30am-4:30pm, Monday through Friday). Parking is plentiful but seating is limited, so please be sure to register!

Monday, November 20, 2017

Community-Based Skills Coaching: What is it? Is it the right intervention for my son or daughter?


Transition Specialist

What is Community-Based Skills Coaching?

Community-Based Skills Coaching is an individualized service delivered by seasoned professionals to support the needs of transition-aged youth and young adults. It is an intensive 1:1 coaching model provided in the young person’s community. It can include any area of need and is tailored to the young person’s age and stage of development. 

Community-Based Skills Coaching is empowering to the young person because the coach meets them where they are at emotionally, socially and developmentally. It allows the individual to learn practical living skills across multiple real-life environments. The first step in Community-Based Skills Coaching is an evaluation period where the young person works with the coach to identify strengths and areas for improvement. Through a collaborative process, the coach and young person tailor each session to allow for direct in-vivo teaching. This can include, but is not limited to, independent living skills, career planning and work readiness skills, financial literacy skills, travel skills, social pragmatic skills and self-advocacy skills. 

Coaches meet with individuals in their home communities in order to determine how to best problem solve around any barriers or obstacles that the young person may encounter. It allows for the individual to develop and generalize learned and new skills across settings and in real-time. With frequent opportunities to practice skills in authentic environments, the individual begins to develop a level of confidence and automaticity that can only be learned outside of a classroom or office. 

Many transition-aged young adults are at a developmental stage of individuating away from parental support. Community-Based Skills Coaching provides an experienced and trained adult to serve as a coach and mentor in order to guide the young person. This coach becomes an important "expert" and a qualified and trusted team member who can support the individual through the lengthy process of transitioning from high school to post-secondary adult life including learning, working, daily living, and community-based leisure activities.

How do I know if this is the right support for my son, my daughter, or myself?

Coaches work with young people aged 12-26 with varying skill levels. Coaches most often work with transition-aged youth who have a diagnosed learning, emotional, and/or developmental disability and transition related skill development needs. However, our coaches are also experienced in working with young people who are struggling with forward progress unrelated to a specific learning or medical diagnosis. Coaching utilizes a strength-based approach and supports youth and young adults to learn about themselves while experiencing life outside of school and home. 

The student or young adult drives the process by choosing an area of interest and need. The coach provides guidance and immediate feedback and support to practice and improve upon skill areas. The coach builds rapport with the individual and is able to re-frame and teach in the moment. An inquiry based approach is used to allow the young person autonomy over the mastery of the skill. The coaching can occur weekly or more often, if necessary. Feedback to parents and designated team members typically occurs on a weekly or monthly basis, often beginning with student input.

To learn more about our Community Coaching at NESCA, please feel free to contact Kathleen Pignone, M.Ed., CRC at (617) 658-9800 or email at kpignone@nesca-newton.com

Who provides coaching at NESCA?

Kathleen Pigone, M.Ed., CRC, brings a wealth of knowledge and experience to her role as a Transition Specialist at NESCA. She received her undergraduate degree in Sociology from Boston College and her master of education in Rehabilitation Counseling from the University of Massachusetts Boston.

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 supervised the Career Development Program, developed individualized transition plans for students, created innovative programming for tracking and assessing long-term employability and career success for students. She also trained staff in the areas of career development and transition services.

Ms. Pignone joined NESCA in March 2016, bringing her unique expertise supporting vocational assessment and employment planning for adolescents and young adults as well as local school programs. In addition to supporting 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 skills coaching.

Sophie Bellenis, OTD, OTR/L, is Licensed Occupational Therapist in Massachusetts, specializing in pediatrics and occupational therapy in the developing world. For the past five years her work has primarily been split between children and adolescents with ASD and related profiles in the United States, and marginalized youth in Tanzania, East Africa.

Dr. Bellenis graduated from the MGH Institute of Health Professions with a Doctorate in Occupational Therapy, with a focus on pediatrics and international program evaluation. She is a member of the American Occupational Therapy Association, as well as the World Federation of Occupational Therapists. 

Dr. Bellenis works as a school-based occupational therapist for the city of Salem Public Schools and believes that individual sensory needs, and visual motor skills must be taken into account to create comprehensive educational programming. She is joining NESCA in order to offer community-based skills coaching services as well as social skills coaching to students and young adults.

Kelley Challen, Ed.M., CAS, is Director of Transition Services at NESCA and oversees Community-Based Skills Coaching as well as transition assessment, planning, consultation, case management, program development, college supports, trainings, and professional development offerings. 

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. Initially trained as a school guidance counselor, she completed her practicum work at Boston Latin School focusing on competitive college counseling. She began facilitating social, life, and career skill development programs for transition-aged youth in 2004.

Prior to joining NESCA, Ms. Challen founded an array of programs for teens and young adults at MGH Aspire, and spent time as Program Director of the Northeast Arc's Spotlight Program, where she often collaborated with schools to develop in-district social skill and transition programming. She is also co-author of the chapter "Technologies to Support Interventions for Social-Emotional Intelligence, Self-Awareness, Personal Style, and Self-Regulation" for the book Technology Tools for Students with Autism.

While Ms. Challen has special expertise in working with students with Asperger's Syndrome and related profiles, she provides transition assessment, consultation, planning, and programming support for individuals with a wide range of learning and developmental needs.

Thursday, November 16, 2017

Sophie Bellenis, OTD, OTR/L joins NESCA


Dr. Sophie Bellenis is a Licensed Occupational Therapist specializing in pediatric treatment as well as occupational therapy in the developing world. She is joining NESCA in order to offer community-based skills coaching services as well as social skills coaching as part of NESCA’s transition team.

We are pleased to announce the newest member of the NESCA transition team, Dr. Sophie Bellenis!

Meet Dr. Bellenis:

Dr. Sophie Bellenis is Licensed Occupational Therapist in Massachusetts, specializing in pediatrics and occupational therapy in the developing world. For the past five years her work has primarily been split between children and adolescents on the Autism Spectrum in the United States, and marginalized children in Tanzania, East Africa.

Dr. Bellenis graduated from the MGH Institute of Health Professions with a Doctorate in Occupational Therapy, with a focus on pediatrics and international program evaluation. She is a member of the American Occupational Therapy Association, as well as the World Federation of Occupational Therapists.

Dr. Bellenis has worked for the Northshore Education Consortium at the Kevin O’Grady School providing occupational therapy services and also at the Spaulding Cambridge Outpatient Center. She also has extensive experience working at the Northeast ARC Spotlight Program using a drama-based method to teach social skills to children, adolescents, and young adults with autism, Asperger’s Syndrome, and related social cognitive challenges.

Internationally, Dr. Bellenis has done extensive work with the Tanzanian Children’s Fund providing educational enrichment and support. She has also spent time working with The Plaster House, a post-surgical, pediatric rehabilitation center in Ngaramtoni, Tanzania.

Dr. Bellenis currently works as a school-based occupational therapist for the city of Salem Public Schools and believes that individual sensory needs, and visual motor skills must be taken into account to create comprehensive educational programming. 

Dr. Bellenis will be working with a small caseload of clients aged 12-26 who have recently participated in neuropsychological evaluation and/or transition assessment at NESCA. If you have questions about working with Dr. Bellenis, please email Kelley Challen, Director of Transition Services, at kchallen@nesca-newton.com.



Monday, October 23, 2017

The Great Masquerader

Anxiety and School Refusal


By: Ryan Ruth Conway, PsyD

Everyone experiences anxiety at some point in life. It is a normal, adaptive human emotion that helps us prepare for important events and optimizes performance – think upcoming tests, ballet recitals, sports playoff games – and alerts us to danger in situations that threaten our safety. However, some individuals experience anxiety so intensely and so frequently that it becomes impairing, hindering their daily functioning. In fact, according to the National Institute of Mental Health (NIMH), it is the most common mental health disorder in the United States among adults and children. In my work with children and teens, I have seen anxiety become such a powerful force that it gets in the way of having sleepovers at friend’s houses, limits social engagement, results in marked physical discomfort, impairs concentration in class, and even contributes to flat out refusal of school.

Anxiety is an inward focused feeling, meaning that we experience it internally. As a result, it is often unrecognizable to parents and teachers and can go easily undetected for a long time until it becomes a problem. Children might be ashamed to talk about it, try to push it away to avoid distress or be limited in their ability to fully articulate what is happening. Behaviorally, anxiety causes a fight-flight-freeze reaction. It leads to acting out and aggressive behaviors (i.e., “fight”) as well as running away and escaping (i.e., “flight”). Anxiety can also be an underlying source of noncompliance, disguised as unwillingness to engage and shutting down in overwhelming situations (i.e., “freeze”).

In a recent New York Times Magazine article (see link below), writer Benoit Denizet-Lewis takes a closer look at the increasing prevalence of adolescent anxiety as well as a residential program, Mountain Valley Treatment Center, that provides services for more severe cases. In an information age, many teens, parents, educators and mental health professionals are citing social media as partly to blame for the uptick in anxiety. The constant comparing to peers through social media is problematic in that it makes teens feel like they aren’t good enough, which can greatly impact their self-esteem. In my clinical work I see an overreliance on smartphones due to the reinforcing function they serve – whether it be a text back to hang out or a “like” on an Instagram post – and I will often work with youth on self-reinforcement and finding alternatives that are intrinsically rewarding to them.

Many of the students interviewed for the New York Times Magazine article who attended Mountain Valley had histories of significant difficulty attending their regular school due severe anxiety and/or depression, a presentation known as school refusal. School refusing behaviors exist on a spectrum, from the mild (e.g., missing gym class every now and then due to fears of changing in front of classmates) to the more severe (e.g., missing entire weeks of school due to persistent worries about having panic attacks). Early intervention is key. The longer the child or adolescent is out of school, the more pressure they feel about “catching up” academically. The more they feel like they are falling behind, the more depressed and anxious they become. The more upset and stressed they are, the more difficult it is to get back to school. And the cycle continues.

Understanding this cycle, NESCA offers a special program for youth who refuse school because of emotional distress, called Back to School (BTS). In this program, clinicians use a comprehensive evidence-based treatment approach and work closely with parents and school faculty to figure out the most effective plan that will help the student reenter school.

  • Given the importance of catching school refusal early, here are some warning signs to look out for:
  • Test-taking anxiety
  • Peer bullying
  • Ongoing visits to the nurse despite no apparent signs of illness
  • Frequent requests to phone or go home during the school day
  • Somatic complaints without a medical explanation (e.g., stomachaches, headaches, etc.)
  • Absences on significant days (e.g., tests, speeches)
  • Sleep problems or resistance to leave bed in the morning
  • Changes in mood – anxiety, irritability, sadness 
If you have any questions about the BTS Program or NESCA’s therapy program in general, please contact Dr. Ryan Ruth Conway at rconway@nesca-newton.com or 617-658-9831. Dr. Conway will additionally be speaking at several workshops this fall on the subject of School Anxiety, School Phobia, and School Refusal. Information regarding upcoming NESCA events can be found on our web site at http://www.nesca-newton.com/events.html.

Article: 
Denizet-Lewis, B. (2017). Why Are More American Teenagers Than Ever Suffering From Severe Anxiety? The New York Times Magazine. Retrieved from https://www.nytimes.com/2017/10/11/magazine/why-are-more-american-teenagers-than-ever-suffering-from-severe-anxiety.html.


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. 

Thursday, October 5, 2017

Catch Them When They're Good!

A Positive Parenting Tool


By: Ryan Ruth Conway, PsyD

If your child’s go-to response to your requests is typically “no,” then keep reading…

Children who tend to disobey rules, become easily agitated, experience temper outbursts and argue with authority figures are known to display a pattern of behaviors called disruptive behaviors. These behaviors can cause significant family turmoil and become quite challenging for schools to manage. Children who have trouble regulating their emotions and behaviors may be pinned as “the bad kids.” This is unhelpful, because it does not explain what exactly is underlying the acting out. This type of reputation can also impact a child’s self-esteem, resulting in feelings of inadequacy and self-doubt. Disruptive behaviors could be masking other issues that are not obvious to teachers and parents. Consider the possibility that the kindergarten student who shuts down and refuses to engage in class is not oppositional, but instead experiencing anxiety about being away from his mother or father. Maybe the second grader obtains his parents’ attention most often at home when she lashes out. In trying to control disruptive behaviors, children get a lot of attention from adults for what they are doing wrong, often times unintentionally.  

One of the hallmarks in teaching caregivers how to effectively manage these kinds of behaviors is positive parenting, which comes from a behavior therapy approach. Among positive parenting techniques is “catching them when they’re good,” which shifts the focus away from what is problematic and towards the appropriate behaviors parents want to see continue. With this technique, parents become more mindful about the behaviors they attend to, and seek out opportunities to let their child know when he or she is on the mark. It feels good for both the giver and the receiver, and can bring you closer to your child!

Positive feedback is a powerful tool at any age. For children, it comes in many forms – a sticker for helping to set the dinner table, a praise statement (“I’m so pleased that you are using gentle hands with your brother”), even a hug! As your child starts to recognize that you are giving more attention to appropriate behaviors, they will similarly shift from negative actions (e.g., sassing off, whining, crying, etc.) to positive ones.

Behavioral parent training empowers caregivers by teaching them specific skills to not only manage their children’s behavior at home, but also to improve communication, build warmth within the parent-child relationship and create a calmer household. The Society of Clinical Child and Adolescent Psychology (SCCAP), a group dedicated to disseminating information about evidence-based therapies for youth mental health problems, sites behavior therapy (individual parent and groups of parents with or without child participation) as the most efficacious treatment for disruptive behaviors in children. The SCCAP website, www.effectivechildtherapy.org, was recently updated and is a helpful resource for parents seeking information and guidance about treatment for children and teens.

NESCA is excited to be offering a new group for parents and children ages 7-10 who exhibit disruptive behaviors and/or ADHD symptoms. This group will have separate parent and child sections – with opportunities for combined parent-child sessions – and utilize both behavioral and cognitive-behavioral techniques. For additional information, visit http://www.nesca-newton.com/events.html.

Or visit our previous article about behavioral parent training and the research backing this approach: http://www.nesca-news.com/2017/04/parent-training-programs-101.html. 

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. 

Monday, September 25, 2017

Transition Workshop October 17: Forget Failure to Launch! How to Support Your Teen or Young Adult in Getting Off the Couch and Involved in Life Outside the House

That's the topic of a presentation taking place at NESCA's offices in Newton at 7:00pm on Tuesday, October 17th, featuring Veteran Transition Specialist  Kathleen Pignone as speaker.




Participants in this work shop will learn how to:

·        Contingency plan when Transition Plan A (and even Plan B) is not working out as hoped 
·        Create and balance a long-term plan with short-term attainable goals
·        Foster social motivation and engagement and prevent isolation
·        Develop motivation, perseverance and resiliency using a strengths-based and person-centered approach
·        Help teens and young adults learn skills necessary for engaging in decision making and daily activities independent of parents
·        Access key community resources

Light refreshments will be served. Admission is free, although seating is limited!

To register, email info@nesca-newton.com, with "Failure to Launch" in the subject line.

Tuesday, September 19, 2017

Ron Suskind and The Affinity Project



is excited to announce a new partnership with Ron Suskind and


A strengths-based approach to building social, emotional, practical, and executive functioning skills for people with an Autism Spectrum Diagnosis

The Affinity Method is an exciting new approach that uses your child’s unique interests – or affinities – as tools to expand social-emotional awareness and intelligence. By using their passions as pathways, we meet them where they are, learn more about how they use their interests to navigate the world, and draw out the connections between what they know and what we want to help them learn. 

Meet Ron Suskind, founder of the Affinity Project,
and hear about how this exciting new partnership could benefit you!

Day: Monday, October 2nd, 2017
Time: 7:00p-8:30p
Location: NESCA office
55 Chapel St.
Newton, MA 02458

The method uses ground-breaking technology – an app called Sidekicks - to engage our clients.  The client is called the Hero, Sidekicks are avatars; animated characters that live in the Hero’s smartphone or tablet app who act as the Hero’s friend. Behind the scenes, these avatars are controlled by various coaches - therapists, parents, and other individuals who wish to engage with Heroes through the app. When either a Hero or a Coach searches for video content, it will mirror simultaneously on the other paired device.

They can play, pause, discuss, enjoy, play again!
The Coach controls what the Sidekick says out loud to the Hero.


The Hero responds by speaking out loud to the Sidekick.
This is heard by the Coach through their mobile device or computer console.
The Hero can also choose to text (instead of speaking aloud), and the text will appear on the Coach’s screen.
Ron Suskind, Pulitzer Prize winning journalist and best-selling author of Life, Animated, now an Academy-award nominated movie, used Disney movies to reach his nonverbal autistic son and bring him back to language and relationships. He and leading technologists created The Affinity Project and the Sidekicks app so parents everywhere could do the same, no matter what their child loves.



Click the video link to learn more about Ron, his son Owen and how the Affinity Project came to life! 


NESCA is proud to be one of the very first providers to offer use of the Sidekicks app in therapy sessions!

To learn more about this exciting opportunity, contact
Rebecca Girard at NESCA
617-658-9800
or
rgirard@nesca-newton.com
or
Join us on Monday, October 2nd. 

We look forward to seeing you!