55 Chapel Street, Suite 202, Newton, Ma 02458

75 Gilcreast Road, Suite 305, Londonderry, NH 03053

Thank you for visiting. NESCA Notes has moved!

For articles after June 4, 2018 please visit nesca-newton.com/nesca-notes/.

Search This Blog

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.

Monday, February 12, 2018

Acupuncture and its Role in Treating Anxiety

By: Holly Pelletier, L.Ac.
Licensed Acupuncturist, NESCA

Whether or not you’re familiar with acupuncture, you may be wondering what role it could possibly play in the field of mental health. Most people associate acupuncture with the treatment of pain conditions, and although it has gained recent popularity and prevalence in our little corner of the world, it is often only given a portion of the credit it deserves when it comes to the scope of treatment possibilities. 

Acupuncture is a branch of Chinese medicine based upon a meridian system that runs throughout the entire body. On the meridians, there are acupuncture points that can be accessed through different means such as needling, acupressure, or by using a warming herb called mugwort. The purpose of using these points is to move blockages of energy, blood, or fluids (i.e. lymph) in the body. By using different needling techniques and various point combinations you can either add to a deficient area or move an excess one. 

How does acupuncture work with anxiety and other mental health concerns? To explain fully, we can look at it from two different perspectives: 

The first is a more traditional “western” approach where we look at things on a biochemical level. Acupuncture points are specific areas beneath the surface of the skin that have high concentrations of nerve endings, mast cells, lymphatic vessels and capillaries. When an acupuncture needle is inserted into a point, it stimulates the sensory receptor, which in turn stimulates the nerve and transmits impulses to the brain. In this sense, it can be viewed as a “feedback loop” that directly affects your brain, your hormones, and your glands. So, the relaxed feeling you get after an acupuncture session is real, it is not just a placebo or “in your head”. The needles directly adjust imbalances in the body and allow the person to begin the healing process with a “blank slate." This unique aspect, specific to acupuncture, is extremely powerful because it allows the body to access its own, innate power to heal itself. 

The second approach is the stance of Chinese medicine, which frames anxiety as a symptom of something out of balance. If everything was functioning as it should, there would be no symptoms, we would live pain and stress free every single day of our lives. When something is “off”, tiny sensations start surfacing that at first may seem like nothing at all - a foggy head, fatigue, or tight shoulders. But as time goes by, symptoms worsen and the imbalance becomes larger, making it harder to reverse. 

Zooming in even closer to examine just the anxiety is helpful as well. Anxiety comes in all forms. If you have only seen or felt it one way in yourself or your child, it may surprise you that there is a wide array of symptoms that can show up when someone experiences anxiety. Some may have digestive upset while others get headaches or a racing heart, and others may have trouble breathing or dissociate from the world around them. Often, a person is treated for anxiety and given the same medication as someone else, regardless of their symptoms. Rather than treating someone for anxiety and having one specific point protocol or herbal approach, acupuncture treats those symptoms associated with the anxiety instead. For instance, the headaches, or the palpitations that signal stress to the body. Therefore, each person is looked at individually and each case/course of treatment is completely unique. 

As mentioned above, acupuncture is only a part of a much larger system of medicine. Other branches of the system include nutrition, meditation, herbs, and Qi Gong to name a few. Incorporating these other aspects allows the patient to not only feel better temporarily, but to possibly relieve the anxiety fully. 

If you have any questions about acupuncture and want to see if you or your child would be a good candidate, please contact our acupuncturist, Holly at: hpelletier@nesca-newton.com

To read Holly’s Blog with simple ways to incorporate Chinese Medicine in daily life, visit: http://holisticallyinspiredblog.blogspot.com/

About the Author:

Holly Pelletier, L.Ac. is a licensed acupuncturist who practices part-time at NESCA. Holly Pelletier has been working with children of varying ages, in many different capacities since 2004. Prior to treating kids with acupuncture, she worked as a teacher, coach, and mentor. She exceptionally enjoys working with children and acupuncture because of their speedy response time and genuine excitement about this form of medicine. Holly has a very gentle technique and has specific training in non-insertive acupuncture styles, which does not require needling directly into the skin. In additions to working with children, Holly is also very passionate about working with issues involving women’s health, nutrition/herbs, neurological disease, and psychological challenges such as anxiety and depression.

For more information on our acupuncturist, Holly visit: http://www.hpelletieracu.com/

Monday, February 5, 2018

Supporting the Twice-Exceptional Children in our Lives

Free to Be 2e!
Supporting the Twice-Exceptional Children in our Lives

Licensed Clinical Social Worker, NESCA

Richard Branson
Businessman and Investor

Whoopie Goldberg
Actress and talk show host

Tim Burton

Daryl Hannah

What do the above celebrities all have in common, aside from being wildly successful and having household names? They are all considered “2e”!

The term, “Twice Exceptional” or “2e” is gaining popularity in educational and therapeutic settings, but what does it mean? The term refers to children who possess both exceptional gifts and talents, and who also experience various learning difficulties such as Attention Deficit Hyperactivity Disorder (ADHD), Learning Disabilities, and Autism Spectrum Disorders. A recently published textbook, Twice Exceptional: Supporting and Educating Bright and Creative Students with Learning Difficulties (2017) explores this movement in detail and offers the latest evidence- and strengths-based approaches in supporting the extraordinary “2e” young people in our lives.

Scott Barry Kaufman writes frequently on this topic. He argues that education and intervention have often employed a silo approach, meaning that these systems have viewed children as either exclusively disabled or exclusively gifted, instead of appreciating the dynamic interaction of both. Kaufman describes this as an “artificial mutual exclusiveness” that is harmful to children whose unique profiles include both remarkable strengths and complex learning deficits. This often leads to difficulty “fitting in” in traditional educational settings as well as to children feeling misunderstood and unappreciated for the things they are good at doing. According to davincilearning.org, a website dedicated to “multiple exceptionality” or the intersection of giftedness, disability, and trauma, there are three ways we misunderstand the needs of twice-exceptional children:
  1. Disability masks giftedness, and the focus on correcting disability leads to giftedness being overlooked. 
  2. Giftedness masks the signs of disability.
  3. Both giftedness and disability mask each other, and the person appears to be ordinary.
So what is to be done? If you have a "2e" child in your life, consider the following recommendations set forth by Dr. Kaufman:
  1. Specialized methods of identification that consider the possible interaction of the exceptionalities.
  2. Enriched/advanced educational opportunities that focus on developing the child’s interests and highest strengths while also meeting the child’s learning needs.
  3. Simultaneous supports that ensure the child’s academic success and social-emotional well-being, such as accommodations, therapeutic interventions, and specialized instruction.
As parents, educators, and therapists, we must be sensitive to the intricacies of a child’s abilities and deficits, and take care to not focus too exclusively on such a false dichotomy. Instead, let’s “see beyond lables,” as Dr. Kaufman suggests, and focus on natural strengths, internal motivation, and opportunities for growth.

Many accomplished people with learning differences attribute thinking differently as a factor in their success. May all our "2e" friends find what works best for them and create their own self-defined success.

NESCA is proud to offer evaluation services that help to uncover underlying reasons for struggles as well as unique strengths and aptitudes and to integrate findings into a recognizable portrait of of the whole child, teen, or young adult. If you would like to learn more about Neuropsychological Assessment or Transition Assessment at NESCA provides, click here.

And for more information about twice-exceptionality, see below!

*Disclosure: Rebecca Girard, LICSW contributed to Twice Exceptional: Supporting and Educating Bright and Creative Students with Learning Difficulties in the chapter, “Appreciating and Promoting Social Creativity in Youth with Asperger’s Syndrome”

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.

Thursday, February 1, 2018

Transition Webinars By Asperger/Autism Network (AANE)

Moving into Your Own Place: Making a Plan

Webinar with Nataliya Poto

Monday, February 5, 2018
7:00-8:30 pm (EST)

Are you thinking about moving out of your parents’ house and into your own place? You may feel both excited and anxious. You may wonder how to find the right living situation, and whether you’re ready to live on your own.
This workshop offers practical strategies and tips on how to prepare for this big milestone in your life. We’ll help you develop a step-by-step plan by:

  • Clarifying your specific situation, resources, and preferences.
  • Assessing external factors that could affect your choices.
  • Identifying sources of helpful information and support.
  • Setting realistic, achievable goals.

Moving into your own place: Nataliya S. Poto, M.A. is the Director of LifeMAP Coaching Programs at the Asperger/Autism Network (AANE). Mrs. Poto conceptualized LifeMAP unique coaching approaches into the AsperCoach curriculum which is offered annually to independently practicing Asperger coaches from all over U.S. and South America. In addition to leading the LifeMAP team, Mrs. Poto continues to serve as an active LifeMAP coach herself, successfully assisting clients with their goals in the areas of higher education, career development, employment, personal growth, relationship-building, independent living and more.

Find a Career That is Right for You

Webinar with
Tom Bergeron

Tuesday February 13, 2018
6:30-8:00 pm

There are many factors in deciding on a career path. What are my interests? What is my working style? Are there jobs in the industry I’m interested in? How well do they pay? How does being on the spectrum affect my decision? The path to most careers is through a college education, but with education costs skyrocketing it makes sense to evaluate careers options before entering college, not after graduation. There is even the possibility of exploring careers that require training, but not a degree.
This webinar explores ways to identify careers that are a good match. It highlights strategies for landing the right job beyond “getting the degree.” The webinar will also highlight a few organizations that are making a concerted effort to hire individuals on the spectrum.
Finding a career that is right for you: Tom Bergeron is the co-founder of InventiveLabs, a career (and business) incubator focused on college-aged adults with dyslexia, ADHD, and/or ASD. The Lab runs a hands-on program helping individuals find their path forward by exploring career and school options, or maybe even starting their own business. Tom has worked at various start-up companies helping to bring new products to market. He uses the skills he learnt in business to help individuals find their “market fit”. Tom experienced many challenges in school, but by charting his own path he found success in business. He noticed the traits that hold some individuals back in school can actually be their advantage in the workplace. He is now committed to helping the next generation find their path forward and launch their careers.

Forget Failure to Launch:
How to Support Teens and Young Adults in Creating a Balanced Life Outside of the House

Webinar with
Kathleen Pignone

Wednesday February 28, 2018
1:00 - 2:30 pm

In this workshop you will learn how to:
  • Create a 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
  • Learn skills necessary for engaging in decision making and daily activities independent of parents
  • Access key community resources

Forget failure to launch: Kathleen Pignone, M.Ed. is a Transition Specialist at NESCA. She currently works closely with young adults and their families to plan life after high school. Ms. Pignone performs transition assessments, supports students directly through community coaching and consults with schools, parents and outside agencies around transition related issues. Prior to working at NESCA, Kathleen worked at Bay Cove Academy (BCA), where she developed individualized transition plans for students, provided assessment and created innovative programming related to long-term employability and career success for students, and trained professionals in the areas of career development and transition services. In addition to her 15-year tenure at BCA, Kathleen has worked as an Education Specialist at the MA DESE and a Vocational Rehabilitation Consultant.

More Information
  • Not available on these dates? Webinars will be recorded. Registrants will receive the video link and a copy of the presentation two business days after the session ends.

  • Upon registration, a confirmation email will be sent with instructions on how to access the online event

  • Registration closes 24 hours before the webinar start time

To cancel your registration prior to the start of the webinar, please contact Joanne.Jensen@aane.org