By: Jane Hauser
Director of Marketing & Outreach, NESCA

NESCA is excited to announce that it is opening a Hingham location to serve clients on the South Shore of Massachusetts. NESCA is currently booking appointments now for Neuropsychological and Psychological Evaluation Services commencing on November 1, 2023. Learn more about what is being offered by our Hingham-based staff from my interview with Hingham Director; Pediatric Neuropsychologist Moira Creedon, Ph.D.

What prompted NESCA’s expansion to the South Shore or Massachusetts, and how can clients benefit from our Hingham location’s services?
NESCA is expanding our in-person services to Hingham on the South Shore to widen the breadth of neuropsychological and educational evaluation and consulting services offered within the state. We know that families have options as they partner with neuropsychologists, and we want to be in close proximity to communities we hope to serve. This is an exciting opportunity to support students in elementary, middle, and high school as well as young adults, as they navigate the complexities of their daily lives. It is our priority to continue providing detailed, client-centered, thorough evaluations that highlight a client’s areas of strength and vulnerability. I am also excited to strengthen relationships with local care providers and schools, and to build new relationships as a new clinician within the South Shore community.

What services do you offer?
At this time, NESCA’s South Shore-based practice will offer Neuropsychological Evaluations and Projective Assessments. The goal of these services is to build a complete picture of a client’s functioning, including their intellectual, academic, and social-emotional profile. Team members are also available to participate in team meetings at school (IEP meetings), conduct school observations, and offer consultation to parents and team members. Sometimes, a child has already participated in evaluations in other settings (schools, hospitals), and a family needs help to review these documents and make meaning of the findings.

What types of clients will NESCA serve in its South Shore location?
NESCA’s South Shore-based practice is similar to our other locations and will serve children, teens, and young adults with a range of presenting issues. The focus is in working with students in elementary, middle, and high school as well as young adults. I can see clients with diagnostic questions, including Autism Spectrum Disorder (ASD), Learning Disorders (e.g., dyslexia, dysgraphia), Attention-Deficit/Hyperactivity Disorder (ADHD), anxiety, depression, and complex psychiatric diagnoses.

A specialty we have at NESCA – including in Hingham – is working with clients who have multiple diagnoses or who don’t fit neatly into a singular diagnostic box. I also see clients who are high functioning and curious about their learning style, how to improve their study skills, and how to plan for their academic future based on their unique profile.

Where are you on the South Shore? Are services in-person or remote?
We are practicing in person in an office at 99 Derby Street, Suite 200, in Hingham, MA. Hingham is uniquely positioned to serve the South Shore/Southcoast, and the Cape and Islands. For those traveling for appointments, most clients schedule testing in two longer (2.5 hour) blocks of time so the commute is reduced for families. I am also available to participate in IEP team meetings and conduct student observations in person on the South Shore, which is an exciting way to collaborate and build strong relationships with families, schools, and organizations.

What is different about what NESCA offers on the South Shore compared to other organizations or services available locally?
NESCA is highly respected in the community for providing detailed, comprehensive evaluations of students that speak to their strengths as well as their needs. Compared to some practices, your child or teen will be assessed directly by a neuropsychologist rather than a technician. You can depend on your neuropsychologist to bring their own expertise as well as the “village” of NESCA, as I am always collaborating with NESCA’s team of innovative neuropsychologists, transition specialists, educational consultants, speech and language pathologists, occupational therapists, and therapists. We work routinely with special education attorneys, advocates, therapists, and school personnel in collaborative relationships to support children and teens. At NESCA, we live our core values everyday: being creative problem solvers, being collaborative and building lasting relationships, and caring deeply for students, their families, and the community.

Does insurance cover your services in Hingham?
Several NESCA providers take both Blue Cross Blue Shield and private pay for services. I am paneled with BCBS. Some families are able to obtain some coverage or reimbursement through other insurance agencies, and we can provide those families with brief billing information to submit to their insurance company. We can never guarantee insurance reimbursement, so it is important that families check with their insurance plan regarding covered services.

What if I am unsure if I should refer my child or client for an evaluation?
Give us a call! Our administrative team is happy to support you in navigating this process. We are also planning some community events to provide information to our community about a variety of topics, including who we are and how to recognize signs that a child or teen may need additional support. There is also a ton of information on our website.

How do people get more information about NESCA’s South Shore services?
You can fill out our online intake form, call 617-658-9800 to speak with an intake coordinator, or reach Hingham-based Pediatric Neuropsychologist Dr. Moira Creedon directly at mcreedon@nesca-newton.com.

About the Author

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

If you are interested in booking an evaluation with Dr. Creedon or another NESCA neuropsychologist, please fill out and submit our online intake form. 

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

By: Lyndsay Wood, OTD, OTR/L
NESCA Executive Function and Real-life Skills Program Manager

As the new school year unfolds, many of us struggle to transition from the carefree days of summer into the rigorous routines of being a productive and organized student. If you find yourself grappling with low energy, an overwhelming list of tasks, scattered notes, forgotten homework, and neglected chores, take comfort in the fact that you’re not alone. The beginning of a school year can be a challenging adjustment. Fortunately, modern technology offers a number of solutions to help ease the cognitive load that comes with academic responsibilities. Below are six technology tools that can help you reclaim control over your productivity and organization.

1. Goblin Tools: The first tool on the list, Goblin Tools, is a versatile platform designed to empower folks to independently manage their lives and it was specifically designed for the neurodiverse community. The tool can be used on a desktop or can be downloaded as an app. Goblin Tools has a number of features, including the “Magic To-Do List,” that breaks down simple to complex tasks into manageable steps, a time estimator for effective planning, and a writing formalizer to polish communication. It even includes a tone judge to assist with interpreting the tone of written messages, a brain dump compiler to organize your thoughts into a to-do list, and a “chef” which can recommend recipes based on the ingredients you have in your house.
2. Google Calendar: Google Calendar is an extremely popular tool when it comes to staying organized. It allows you to keep track of events, create tasks, set reminders, and collaborate with others on the platform. Google Calendar syncs across all devices, which allows individuals to ensure they are not missing important appointments or assignments. The integration with Gmail and other Google services further streamlines productivity by centralizing your tasks and appointments.
3. Reminders App (iPhone): If you’re an iPhone user, the built-in Reminders app is a hidden gem for boosting productivity. It offers a straightforward way to create to-do lists, set time-based and location-based reminders, and categorize tasks. The app integrates with Siri, allowing you to add tasks with voice commands.
4. Habitica: Habitica gamifies the process of staying organized and forming good habits. This unique tool transforms your daily tasks and goals into a role-playing game, where you earn rewards and level up by completing your to-do list and adhering to your habits. Habitica also allows you to join parties with friends, creating a supportive community of accountability. By turning productivity into an enjoyable game, Habitica makes the journey toward organization and productivity both fun and motivating!
5. Livescribe: Livescribe is a note-taking tool that bridges the gap between traditional pen-and-paper note-taking and digital organization. This smart pen not only records your handwritten notes but also synchronizes them with an app on your device. As you write, it captures audio recordings of lectures or discussions, making it an invaluable resource for reviewing class materials. You can even tap on your written notes to hear the corresponding audio, allowing you to revisit important moments and enhance your understanding of complex topics.
6. Rocketbook: Rocketbook is a digital notebook designed to bring together the ease of handwritten notes with the organization of a digital storage system. Using special erasable pens, you can take notes on Rocketbook’s pages and then use a companion app to scan and store your notes in the cloud. The pages are reusable and can be wiped clean with a damp cloth. This solution ensures your notes are organized, accessible, and eco-conscious. You will no longer be scrambling to find where you scribbled down the information about an upcoming test. All of your notes will be stored in the same place.

Transitioning into a new school year can be a daunting task, but with the right technology tools at your disposal, you can navigate the challenges of productivity and organization with confidence!

About Lyndsay Wood, OTD, OTR/L

Lyndsay Wood, OTD, OTR/L, Vermont-based Executive Function and Real-life Skills Program Manager, is an occupational therapist who focuses on helping students and young adults with disabilities to build meaningful skills in order to reach their goals. She has spent the majority of her career working in a private school for students with ASD. She has also spent some time working in an inpatient mental health setting. Lyndsay uses occupation-based interventions and strategies to develop life skills, executive functioning, and emotional regulation. While completely her doctoral degree at MGH Institute of Health Professions, Lyndsay worked with the Boston Center for Independent Living to evaluate transition age services. She uses the results from her research to deliver services in a way that is most beneficial for clients. Specifically, she focuses on hands-on, occupation-based learning that is tailored the client’s goals and interests.

Dr. Wood accepts Vermont- and Massachusetts-based transition and occupational therapy assessments. Her in-home and community-based coaching services are available in the greater Burlington, Vermont area. Dr. Wood can accept virtual coaching clients from both Massachusetts and Vermont.

To book coaching and transition services at NESCA, complete NESCA’s online intake form. 

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

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

Good transition planning is about building a “team” that can outlast special education and using resources wisely. There is often talk of “maximizing benefits” so that private funds can be reserved and made to last. In order to create an effective and individualized transition plan, you have to know what resources are available in your local community as well as on the state and federal levels. One resource that may be overlooked or underused is your local Center for Independent Living (CIL). In Massachusetts, and some other states, these are often named Independent Living Centers (ILC).

Across the United States, CILs are free community-based agencies that provide a range of services designed to help individuals with disabilities build skills for living more independently. The barrier to entry is typically very low as the intake process may sometimes just be a phone call and acknowledgement of having a disability.

At a minimum, each center is charged with providing the following core services:

• Information and referral: Learning about services, providers, benefits, and programs within your local community that can help you achieve your goals (e.g., advocacy, daily living, housing, recreation, etc.). Also, learning about resources offered through state and national organizations.
• Skills training: Explicit instruction of self-advocacy and/or life skills that can help you to live, learn, and work more independently. Examples areas for skill development include accommodations, personal care, housing and household management, managing finances, interview preparation, etc.
• Peer counseling/mentoring: Talking with a peer by phone, video conference, or in person for mutual support, confidence building, and ultimately to make more independent and informed choices.
• Advocacy: Learning to advocate on both individual and systems levels. Building skills to advocate for oneself, including filing complaints or taking legal action to remove barriers when needed.
• Transition services: Services to facilitate transition to postsecondary adult life, services to facilitate transition from institutions to the community, and services to assist individuals at risk of needing to be in institutions.

Additionally, ILCs/CILs may have developed services that are specifically useful for consumers in their local community or state. And there is generally no age requirement for accessing services. For example, many ILCs in Massachusetts have specific youth programming or Transition to Adulthood Programs (TAPs) which offer advocacy, skills training, and peer counseling specifically tailored to students.

ILCs/CILs are awesome agencies run by, and for, individuals with disabilities. However, in my experience, they are not talked about or accessed nearly enough as part of transition planning. If you are reading the blog and interested in building independence at home and in the community for yourself, your child, or a youth you work with—I strongly recommend you look up your local Center for Independent Living and call to find out more about accessing services today.

Resources:

Administration for Community Living – What is Independent Living?  https://acl.gov/programs/aging-and-disability-networks/centers-independent-living

ILRU Directory of Centers for Independent Living and Associations – https://www.ilru.org/projects/cil-net/cil-center-and-association-directory

Massachusetts Independent Living Centers – https://www.mass.gov/independent-living-centers

By: Tabitha Monahan, MA, CAGS, CRC
Transition Specialist/Counselor

It’s Labor Day, and the signs for local elections will increase significantly over the next two months. Non-presidential election years see a drastic drop in participation in the voting process. This drop extends even more for years where there are only local elections. However, it is our local elections that have the most significant impact on our day-to-day lives. Whether it is the town selectman, city council, zoning board, or school committee, voting for these candidates can make a big difference in the priorities and projects that become the focus of your community.

So how can we help our young people with disabilities exercise their right to vote? Even individuals with guardianship maintain their right to vote in Massachusetts unless the court documents specifically state otherwise. There are many ways to support individuals, but it starts with helping them register. Massachusetts residents can register to vote online when obtaining or renewing a driver’s license or state ID or at the local registrar of voters’ office. Notices from MassHealth and the DTA also include voter registration forms.

Our young people may need more guidance in understanding the importance of voting in local elections and the purpose of those positions. Below are some great resources to support our young people in voting. This article by Rock the Vote explains more about the importance of voting in local elections. Reach out to your local election official to determine what positions will be on the ballot and if there is a local primary election before the November election. Be prepared to explain the role of the positions to youth who may not have had experience dealing with the department.

Absentee/mail-in ballots have long been an excellent strategy for individuals with disabilities who would have difficulty voting in person. Absentee ballots are a great option for individuals who may have difficulty navigating the multiple steps in person or have a lower processing speed.

All citizens are also allowed to bring a person to help them while they are at the polls. Encourage your young person by educating them that many people require assistance at the polls, and it is completely normal to have the help available if they need it. Each polling location should also have at least one AutoMARK Voter Assist Terminal, which helps individuals with visual impairments vote independently.

No one wants their vote not to be counted due to errors filling out their ballot. People can request a sample ballot in advance from their local registrar of voters (the Secretary of State’s website can give you the address and phone number of your local registrar). Practicing filling out ballots in advance (even ballots from previous elections) can help a new voter become comfortable with the form and is great fine motor skill practice for those who may need it!

While typically not applicable to local elections, it is important to remember that the Massachusetts Secretary of State also creates a voter information booklet for each election regarding the ballot initiatives. These red booklets can be found at many community locations and frequently include the local library, post office, and city/town hall. These booklets offer information on what a yay or nay vote would mean and have information from each initiative’s proponents and opponents. Use that sample ballot as a starting point for the different types of elected positions.

Help your young adult find out what the different boards do and why there is an election for things such as town selectman or zoning board. Help your young adult find the websites for candidates running for office and review the candidates’ stances on issues. Ask what issues they want to learn more about and are important to them.

Most importantly, remind them that their voice counts. As many disability rights activists have said, “nothing about us without us.” Individuals with disabilities are greatly affected by the policy decisions that occur in government at all levels. Individuals with disabilities have frequently experienced disenfranchisement, and many groups are working tirelessly to lessen and remove these barriers. How have you helped your young adult exercise their right to vote?

About the Author

Tabitha Monahan, MA, CAGS, CRC, is an experienced transition evaluator and vocational counselor. While she is well-versed in supporting a wide range of transition-aged youth, she is especially passionate and knowledgeable in helping clients and their families navigate the complex systems of adult services and benefits as well as medical and mental health systems. She is further adept in working individually with students of all abilities to empower self-advocacy and goal achievement.

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

NESCA is a pediatric neuropsychology practice and integrative treatment center with offices in Newton and Plainville, Massachusetts, Londonderry, New Hampshire, and the greater Burlington, Vermont area, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

By: Jane Hauser
Director of Marketing & Outreach, NESCA

NESCA welcomes Ms. Carly Edelstein, MSW, LCSW, back to its coaching and psychotherapy services teams. She previously interned with NESCA, and we are thrilled to have her back on board as both a Psychotherapist and Executive Function Coach. Read more about Ms. Edelstein’s career journey and her return to NESCA in the following Q&A interview.

This is your second time working with NESCA. Tell us what you did with NESCA previously.
Yes, and I am elated to be back! During my graduate studies at Simmons University, I interned at NESCA as a psychotherapist. In addition to providing individual psychotherapy to children, adolescents, and young adults, I worked with a few high school and college students as an executive function (EF) coach. I also provided psychotherapy to clients from India and the Philippines, which was an incredible and unique experience. I have yet to find a practice as dynamic and integrative as NESCA and look forward to rejoining as a seasoned clinician!

You will be splitting your time and talents in two roles here at NESCA. Fill us in on your dual role and what your previous experiences bring to both.
At NESCA, I’ll be providing psychotherapy and executive function coaching. Both of these roles have been a consistent focus of mine simultaneously throughout my professional life. After obtaining a B.S. in education at the University of Vermont, I worked in special education as a paraprofessional, supporting students with special needs in the classroom. In this role, I helped students learn new strategies to maintain their focus, self-regulate, and improve their organization. Additionally, throughout graduate school, I worked part-time as an EF coach at Engaging Minds, helping elementary, middle, and high schoolers with their homework and school assignments by finding ways to improve their task initiation, organization, time management, and planning skills.

My interest in social work/mental health counseling was sparked by my experience as a student teacher at UVM. During the entirety of my practicum, I found myself  gravitating towards students who struggled academically, mentally, socially, and emotionally. I was determined to help these students navigate their challenges by building meaningful connections, providing additional academic support, and increasing their self-confidence by focusing on their strengths.

My counseling experience officially started in graduate school with two full-year-long internships. My first internship took place in the counseling department at Boston Green Academy, a public charter school for grades 6-12, and my second was at NESCA. After graduate school, I worked as a school adjustment counselor at Newton South High School and also took on clients part-time at a private practice. In these roles, I supported the social and emotional wellbeing of students with special needs, as well as their families. After working in corporate wellness for the last year and a half, I am excited to return to the clinical setting, working for a practice that was a major part of my social work journey.

Having worked as a high school adjustment counselor, you must have seen many of the challenges students have with executive function. What are your biggest takeaways from that experience? How do you think that prepared you to be an EF coach?
The majority of my students struggled with executive function, therefore providing support in this area was part of my day-to-day routine. My biggest takeaways are:

1. Identifying a “why” helps individuals become more motivated to be proactive in their EF journey. For example, I tend to ask people how improving these skills will affect their academic goals, mental health, social relationships, etc., so that there is significant meaning to the work being done.
2. There is a system that works for everyone! Whether it’s electronic or physical, once someone identifies an organization system that increases their independence, it’s important that they stick to it and are consistent with it. Having a set system will allow them to easily locate their assignments, know when they are due, and how they’ll go about completing them. It’s always helpful for parents and teachers to be made aware of this system as well so that everyone is on the same page.
3. Creating a regular homework routine is key to increasing productivity and limiting distractions. This includes having an identified start time, location, and plan. I always recommend structured breaks being part of this plan as well.
4. I always advise folks to not compare themselves to others when it comes to their EF skills! We all have natural strengths. A skill that comes easy to you may be the most challenging task for someone else.

There have been countless reports and studies related to the negative impact COVID had on kids. As a psychotherapist to teens and young adults, what challenges are you seeing most in youth post-pandemic?
There’s no doubt that the impact of COVID on our youth has presented serious and complex challenges. The loss of structure, social opportunities, and extracurriculars (to name a few) is a shock to the system and very traumatic. The biggest challenges I’ve seen post-pandemic have been an increase in digital dependence, cyberbullying, school-based anxiety/refusal, and regression in social skills. That being said, as important as it is to identify post-pandemic challenges, there is value in pointing out gained strengths as well. A lot of students who I worked with learned new coping skills, acquired a deeper understanding of their needs, and discovered exciting new hobbies that they now get to share with others.

About Carly Edelstein, MSW, LCSW
Carly Edelstein is a Licensed Clinical Social Worker practicing in Massachusetts and Rhode Island. Having worked both in private practice and schools, she has extensive experience supporting students, families and educational teams to make positive changes. Ms. Edelstein provides executive function coaching and psychotherapy to clients ranging from middle school through adulthood. She also offers consultation to schools and families in order to support her clients across home and community environments.

To schedule an appointment with Ms. Edelstein for psychotherapy or EF coaching, please complete our online intake form. 

NESCA is a pediatric neuropsychology practice and integrative treatment center with offices in Newton and Plainville, Massachusetts, Londonderry, New Hampshire, and the greater Burlington, Vermont area, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

By Dot Lucci, M.Ed., CAGS
Director of Consultation and Psychoeducational Counseling Services, NESCA

NESCA’s International Work
NESCA is well regarded as an expert in providing neuropsychological evaluations for children and teens from around the globe as part of its International Evaluation program. To date, NESCA has provided evaluations to clients from more than 20 countries across Europe, Asia, Africa, South America, and North America.

Many families bring their child/children to our offices in New England to be evaluated, and NESCA’s founder and director Ann Helmus, Ph.D., has traveled to many countries to provide evaluations overseas. She also has a long-standing history training neuropsychologists in the Philippines. Our Transition and Coaching Services teams also conduct transition assessments for international clients as well as virtual executive function coaching to many young adults overseas.

Based on a neuropsychological evaluation conducted by NESCA this past year, I began providing consultation with a 5^th grade boy from Honduras who is a student at a non-profit, bilingual, independent, private PK-12 college preparatory school there. Because of my work with this student, his family recommended NESCA’s services to another Honduran family and their child’s school. As a provider, knowing that a family trusts us and finds what we do so beneficial that they recommend us to another family is extremely rewarding.

Setting the Stage: The Special Education Landscape in Honduras
The special education system in Honduras is very different than in the U.S. in that they do not have the variety of resources we are accustomed to in the U.S., and there are not many evaluators in Honduras in any discipline (i.e., neuropsychologists, speech/language, OT, etc.). For instance, there are only six neuropsychologists in the entire country. Another major difference is that it is the parents’ responsibility – not the school’s – to hire a 1:1 paraprofessional or aide if needed for their child. Paraprofessionals function similarly to their U.S. counterparts, but since they are not employed by the school, they are separate from the school.

The special education teachers and counselors also function similarly to those in the U.S.; however, there are unfortunately not enough of them, limiting treatment services. They work from documents similar to IEPs but that are qualitatively are very different from our IEPs.

There are only a couple of special education models used for students: 3 times a week for general special education support or 5 times a week for pull-out reading or math instruction. The 5 times a week options ends at 6^th grade. Some of the teachers we worked with reportedly had training in Wilson and Orton-Gillingham, but there are no SLPs or OTs at the schools, and families pay for these services to be provided at the school or after school. Since there are so few professional service providers in the country, these interventions are extremely limited.

Parent & School Consultation in Honduras
As these consulting engagements progressed, both families asked for NESCA to consult to staff at each of the student’s schools in-person in Honduras, and the schools welcomed this support. The families were hoping that my expertise as an educational consultant focusing on inclusion, program design, and autism could greatly benefit the educators and service providers at the schools – ultimately having a positive influence on the students and their classmates.

Both schools are international, bilingual, non-profit, tuition-based college preparatory schools, and are accredited by the Honduran National Ministry of Education, AdvancED, and the International Baccalaureate Organization. One is a Christian faith-based school. Both serve students from nursery through high school and use N-12 American standards of Core Curriculum. They are similar to American schools in that they have a wide choice of classes/electives as students move up in the grades, as well as sports and after school clubs and activities. Upon completion of their high school careers, students at these schools have the opportunity to earn three diplomas: each school’s typical high school diploma, the Honduran Bachillerato, and the International Baccalaureate diploma. A high percentage of graduates go on to higher education in the United States and abroad. They accept students with a variety of “moderate” special needs and have special education teachers and mental health counselors to support them.

For these in-person school consults, I teamed up with another professional who was also already consulting at these schools. She is a Board Certified Behavior Analyst (BCBA) and speaks Spanish – a welcomed addition, as I do not. She is very skilled at providing behavioral support and is not overly rigid in her approach with students. Together, we presented Professional Development trainings for the two schools on the ground in Honduras. We brought a combined, well-rounded knowledge base to our work with the families and schools, offering lessons in a variety of topics, such as Universal Design in Learning (UDL), Differentiated Instruction (DI), Social Skills training/approaches, Mindset and Mindfulness, Sensory Integration, and Positive Behavioral Intervention and Supports (PBIS), along with the ABCs (antecedent-behavior-consequence) and functions of behavior (EATS: escape-attention-tangible-sensory). In this first engagement, we provided a broad overview of these topics, giving the staff much to think about regarding their instructional practices, behavior management, classroom design, and teaching styles. We will continue to provide both virtual and in-person consults this coming school year so their learning can continue to grow and deepen.

This is an ongoing training/learning process for the staff at these schools. As mentioned, we will continue providing ongoing training to help the staff implement Universal Design principles in developing their lessons. We will continue our discussion about viewing student aberrant behavior through multiple lenses – not just as “breaking the rules and needing consequences” (i.e., neurology-sensory, cognitive disconnect, attention, etc.), instead thinking about what the student is trying to communicate through their behavior. This education helps them to think differently about prevention and antecedents, thus impacting behavior management and discipline practices.

The Experience
Staff at both schools were willing to learn and collaborate, and welcomed our input, with one school attending the training the week before their school year started, because we were scheduled to be in-person! The Honduran teachers we worked with throughout the year, prior to our in-person visit, were so open to instruction, feedback, and learning more, often reaching out to us between our scheduled virtual meetings preceding our visit. They were eager to figure out how to support their neurodiverse (a new word for them) learners and allowed me to join their classes remotely so I could model different techniques and practices. They were willing to share their successes, questions, and challenges, making consultation both productive and powerful. They were open to the many “homework assignments” (i.e., articles/books to read, videos to watch, visuals to make, etc.) given to them and the recommendations provided. They implemented new class-wide and individual behavior plans (self-awareness plans) and benefited from the modeling of strategies I demonastrated.

It was a wonderful experience for them and us, and I am happy that our relationship is continuing and will deepen well into this new school year. I am looking forward to watching their continued growth – directly impacting the two students who started it all, as well as their classmates and those to come in future years.

If you are interested in learning more about NESCA’s international evaluation, transition, consultation, and coaching services, complete our online Intake Form.

About the Author

NESCA’s Director of Consultation and Psychoeducational Services Dot Lucci has been active in the fields of education, psychology, research and academia for over 30 years. She is a national consultant and speaker on program design and the inclusion of children and adolescents with special needs, especially those diagnosed with Autism Spectrum Disorder (ASD). Prior to joining NESCA, Ms. Lucci was the Principal of the Partners Program/EDCO Collaborative and previously the Program Director and Director of Consultation at MGH/Aspire for 13 years, where she built child, teen and young adult programs and established the 3-Ss (self-awareness, social competency and stress management) as the programming backbone. She also served as director of the Autism Support Center. Ms. Lucci was previously an elementary classroom teacher, special educator, researcher, school psychologist, college professor and director of public schools, a private special education school and an education collaborative.

Ms. Lucci directs NESCA’s consultation services to public and private schools, colleges and universities, businesses and community agencies. She also provides psychoeducational counseling directly to students and parents. Ms. Lucci’s clinical interests include mind-body practices, positive psychology, and the use of technology and biofeedback devices in the instruction of social and emotional learning, especially as they apply to neurodiverse individuals.

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

By: Jane Hauser
Director of Marketing & Outreach, NESCA

NESCA recently announced that it is now offering transition services and coaching services in the Greater Burlington, Vermont region. Learn more about what is being offered by our Vermont-based staff from my interview with Vermont-based Program Manager Dr. Lyndsay Wood, OTD, OTR/L.

Why did NESCA expand to Vermont and how can clients benefit from your services?

NESCA is expanding our in-person services to Vermont to widen the breadth of transition services offered within the state. Through research and conversations with local professionals and parents, we recognized that there is an opportunity to bolster local transition services for students to meet their personal postsecondary goals and to live fulfilling lives post-high school. Through our variety of services, our goal is to empower teens and young adults to create their own vision for the future and build the skills necessary to achieve it. This is important for students currently in public middle and high schools as well as local college students and young adults new to the world of work. At NESCA, we take a relational approach with to build a strong foundational relationship between ourselves and the clients we support. Our priority to is create a safe, inclusive, and welcoming environment within our sessions.

What services do you offer?

At this time, NESCA’s Vermont-based practice will offer transition assessment, real-life skills coaching, executive function coaching, transition consultation, and functional community-based occupational therapy evaluations. All Vermont-based services are delivered by experienced occupational therapists and transition specialists with expertise in developing functional and relevant goals. For more information on each of these services, please visit our website and view our Post-Secondary Transition Services and Coaching Services links: https://nesca-newton.com/our-services/. Many folks are unfamiliar with transition assessments, so to learn more, see the following blog written by our Director of Transition Services Kelley Challen, Ed.M., CAS: https://nesca-newton.com/transition-assessment-what-is-it-anyway-how-is-it-different-from-neuropsychological-evaluation/.

What type of client does NESCA serve in Vermont?

NESCA’s Vermont-based practice primarily works with teens and young adults with autism spectrum disorders (ASD), attention-deficit/hyperactivity disorder (ADHD), mental health diagnoses, specific learning disabilities, executive function (EF) challenges, and other complex cases based on the expertise of our providers. A specialty at NESCA is working with clients who have multiple diagnoses or who don’t fit neatly into a singular diagnostic box.

Where are you in Vermont? Are services in-person or remote?

Coaching services will be offered in the home, school, or community within the greater Burlington area. Services can also be delivered remotely if deemed appropriate for the client. Transition assessment is typically conducted within the client’s school setting.

What is different about what NESCA offers in Vermont compared to other organizations or services already available?

NESCA will be a premier independent transition assessment provider in Vermont. We are happy to collaborate with school districts or work with families directly. Additionally, we are unique in providing one-on-one occupational therapy services that specifically address life skills within a client’s home and community setting. Working within the home and community, and not only within the school setting, is incredibly important for the generalization of life skills as well as social skills, functional academic skills, and executive functioning skills.

Does insurance cover your services in Vermont?

NESCA is primarily a private pay service provider. Some families are able to obtain some coverage or reimbursement for our real-life skills coaching service with their health insurance, but it is vital that folks first check with their insurance provider to ensure our services would be covered.

How do people get more information about NESCA’s Vermont services?

To learn more about NESCA, please visit our website at: https://nesca-newton.com/.

If you would like to fill out an intake form, follow this link: https://nesca-newton.com/intake.

If you have more specific questions, do not hesitate to call: 617-658-9818

Additionally, you can contact our Vermont-based Program Manager Dr. Lyndsay Wood, OTD, OTR/L, directly at: lwood@nesca-newton.com

About Lyndsay Wood, OTD, OTR/L

Lyndsay Wood, OTD, OTR/L, is an occupational therapist who focuses on helping students and young adults with disabilities to build meaningful skills in order to reach their goals. She has spent the majority of her career working in a private school for students with ASD. She has also spent some time working in an inpatient mental health setting. Lyndsay uses occupation-based interventions and strategies to develop life skills, executive functioning, and emotional regulation. While completely her doctoral degree at MGH Institute of Health Professions, Lyndsay worked with the Boston Center for Independent Living to evaluate transition age services. She uses the results from her research to deliver services in a way that is most beneficial for clients. Specifically, she focuses on hands-on, occupation-based learning that is tailored the client’s goals and interests.

To book coaching and transition services at NESCA, complete NESCA’s online intake form. 

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

By: Ferne Pinard, Ph.D.
NESCA Pediatric Neuropsychologist

Although typically thought of as an “adult illness,” children and adolescents can get diagnosed with multiple sclerosis (MS). Pediatric-onset multiple sclerosis (POMS) occurs when MS is diagnosed before age 18.

Approximately 30% of POMS patients show evidence of cognitive impairment. Problems with attention, working memory, processing speed, and language (including word retrieval) are commonly reported. Poorer verbal expression/vocabulary acquisition have also been reported among patients who were diagnosed at younger ages. Overall IQ, memory, complex attention (i.e., shifting attention between competing stimuli) and visual-motor integration skills may also be impacted. These cognitive deficits as well as absences due to illness and fatigue can undermine the student’s academic performance (i.e., grades), leading to feelings of inadequacy and a sense of not being able to “keep up with” their peers academically.

However, POMS can also affect the child’s/adolescent’s social and emotional functioning. Fatigue, depression, bowel/bladder problems and physical limitations can decrease a child’s/adolescent’s interest in socializing. Heat sensitivity can limit participation in physical activities while in a warm environment, which can make them feel even more isolated. They may also feel embarrassed and have lowered self-esteem because they feel different from peers. Children/adolescents with chronic illnesses are also at an increased risk for teasing and bullying from peers. It is no surprise then that children/adolescents with MS are vulnerable to psychiatric disorders. Depression, anxiety, and bipolar disorder occur more often in the MS population than the general population.

Multiple sclerosis is an unpredictable disease. Symptoms can come and go without apparent reason or warning, and no two people experience MS symptoms in exactly the same way. Some symptoms are clearly visible (like weakness, causing walking problems) or less visible (like fatigue or cognitive concerns). It is not possible to predict when symptoms will occur or what parts of the body will be affected. MS symptoms can change from week to week.

It is important that school officials understand that because symptoms come and go without warning, accommodations need to be in place, even when symptoms seem to diminish for a time. Accommodations can include:

• • Home tutoring when students are not able to attend school
  • Excused absences and a reasonable plan to make up missed work
  • Extended time for tests/exams/projects
  • Second set of books at home
  • Preferential seating for visual, attention, or bladder/bowel issues
  • Bathroom pass/extended bathroom time
  • Portable air conditioner/fan
  • Elevator access
  • Psychotherapeutic support
  • Plan to manage fatigue:
    • Frequent/scheduled breaks
    • Modification of class schedule
    • Workload modifications

A detailed neuropsychological evaluation is essential for objectively measuring any neurocognitive deficits, tracking them over time, and informing treatment recommendations. Speech/language, audiology, occupational therapy, and physical therapy evaluations may also be warranted depending on the severity of symptoms to determine whether these services are needed. Psychologists, psychiatrists, school guidance counselors, teachers, and school administrators as well as support groups with other patients and families facing this disease should also be part of the child’s/adolescent’s care team.

About Pediatric Neuropsychologist Ferne Pinard, Ph.D.

Dr. Pinard provides comprehensive evaluation services for children, adolescents, and young adults with learning disabilities, attention deficit/hyperactivity disorders (ADHD), and psychiatric disorders as well as complex medical histories and neurological conditions. She has expertise in assessing children and adolescents with childhood cancer as well as neuro-immunological disorders, including opsoclonus-myoclonus-ataxia syndrome (“dancing eyes syndrome”), central nervous system vasculitis, Hashimoto’s encephalopathy, lupus, auto-immune encephalitis, multiple sclerosis (MS), acute disseminated encephalomyelitis (ADEM), and acute transverse myelitis (ATM), and optic neuritis.

To book a neuropsychological evaluation with Dr. Pinard or another expert neuropsychologist at NESCA, complete NESCA’s online intake form. 

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

By: Maggie Rodriguez, Psy.D.
Pediatric Neuropsychologist, NESCA

Before I had children, I knew parenting would bring with it new demands. If you’d asked me what tasks I imagined would take a lot of my time and energy as a parent, I would have listed things like feeding hungry little mouths, washing adorable clothes, driving kids to and from school and activities, dealing with bath time, and reading stories at bedtime. What I would never have guessed is how much time and mental effort I would spend filling out paperwork. From the moment a child enters a parent’s life—regardless of what process brings them together as a family—it seems like there are unending forms to complete. As a parent of three children, I cannot begin to calculate how many hours I’ve spent filling out forms for doctors, daycares, schools, camps, babysitters, and extracurriculars. It’s a lot.

Perhaps that’s why I sometimes notice a very relatable subtle sigh when I hand parents forms to complete as part of their children’s neuropsychological evaluation. I get it, and I never want to add to a parent’s already overwhelming list of tasks to complete. Nevertheless, carefully selected questionnaires are an important part of a thorough neuropsychological assessment. Here are a few of the reasons why.

1. Simply put, parents are the experts on their children. No doubt about it, a parent (or primary caregiver) knows a child better than just about anyone else could. Parents are uniquely qualified to provide invaluable information about their children and are a tremendous resource.
2. Parents have more data points. During an evaluation, I typically spend about five hours with a child over the course of two testing sessions. It’s a limited glimpse into mere hours out of years of a child’s life. Parents are typically positioned to observe their children much more frequently and on many more occasions. I may see a child at their best or on a particularly bad day, and I don’t want to rely on my observations alone. Having information from many points in time, and from different settings, is incredibly useful and helps capture a more complete picture of a child.
3. I want and need to know what happens outside the testing office. By design, the testing environment is deliberately developed to be a quiet space as free of distractions as possible to maximize a child’s ability to focus and participate in formal testing. It’s a highly structured situation and a one-on-one interaction. Life outside the office is…well, quite different. I want to get a sense of what happens during the hectic morning rush to get out the door, on the playground and the soccer field, and at the family dinner table.
4. On a related note, people present differently in different settings, and having data helps us make sense of this. Many parents can relate to the concept of “restraint collapse.” Essentially, kids often work hard to keep it together in the academic setting throughout the day and “fall apart” when they come home after a long day of school. Similarly, children are often on the “best behavior” in public settings and with adults other than their parents. For this reason, I often don’t get to see this important aspect of things, so I rely on parent reports.
5. Some things simply cannot be readily assessed using standardized testing measures in an office environment. Two skill sets that fall into this category are executive functions and social skills. Executive functions, which include skills like working memory, are not easily captured through tests in the somewhat artificial environment of an office. To assess working memory, we rely on tasks such as asking a child to recall strings of numbers. In the real world, working memory applies to more complex tasks, such as following multi-step instructions in a busy classroom or home setting. A child may do well remembering single digit numbers, but this doesn’t always translate to being able to remember and complete a series of directions in the “real world.” Similarly, interacting with one adult in a highly structured environment doesn’t allow a glimpse into a child’s social skills within the more complex, unstructured situations they face day to day.

In short, neuropsychologists rely on information from parents to gain a clear and complete picture of a child and to provide answers to the questions that bring a family to us. One of the ways we obtain this information is through questionnaires, symptom rating scales, and checklists. So, parents, thank you, for taking the time to give us your unique and invaluable perspective. We couldn’t do our jobs without it or without you.

About the Author

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

By Jasmine Badamo, MA
Educational Counselor; Executive Function Tutor

The ability to say “no” and honor your limits is a beautifully powerful skill that we can all benefit from. In a productivity-focused culture where today’s 40-hour work week is roughly equivalent to a 160-hour work week in 1950’s time (read more in Devon Price’s Laziness Does Not Exist), it’s easy to ignore our limits and put pressure on ourselves to perform at an otherworldly capacity.

While life requires all of us to push ourselves at times, it is impossible to work at 100% capacity 100% of the time. And by saying no, or deciding where to strategically place your energy, you leave yourself with the bandwidth and energy needed to be more effective and consistent in the activities that are priorities to you.

This is definitely not the first time you’ve heard these ideas. However, today I’d like to focus on why saying no and honoring your limits can be especially important for neurodivergent individuals.

Neurodiversity is the natural brain diversity that exists within the human population, similar to other forms of human diversity. The terms “neurodivergent,” “neurominority,” or “neurovariant” typically refer to individuals with a brain makeup that falls outside of the statistical majority of human neurotypes. Being a neurominority is not a problem, nor is it something to overcome. However, being a minority often means having to function within a world that is generally not designed by or for you.

Because of this, neurodivergent individuals are often implicitly or explicitly taught to modify their thoughts and actions to better fit their environment. Instead of being able to honor their individual needs and boundaries, they are frequently asked to push themselves beyond their limits. While every person—neurodivergent or not—must operate outside their comfort zone at times, for neurodivergent individuals it can become a default way of life. This is exhausting and can result in burnout.

During intake sessions with new clients, I make it a point to clarify that I’m not here to “cure” ADHD, autism, or a learning disability. I’m here to help reduce, and also cope with, the disconnect between the client, their environment, and the activities they are being asked to regularly manage. Together we find ways to make the environment better fit the individual and their needs, and then (and only then) we will implement strategies for navigating the remaining barriers to reaching their goals.

And in order to make the environment better fit the individual, each client needs to figure out what works for them and, most importantly, what does NOT work for them. For some neurodivergent folk, it can be truly ground-breaking to ask themselves, “What about my environment or current activities is not working for me? What can I start to say ‘no’ to?” It’s an important step in learning more about yourself and how your brain works, and what is sustainable for you (not someone else).

This can be hard, especially if your productivity or ability to “keep up” with others has become a pattern—or even a part of your identity. Learning to say no and to let go of not only what others regularly ask of you, but also what you have become accustomed to asking of yourself, takes time, patience, and practice.

Remember, you wouldn’t begrudge a cactus for wilting if it were asked to constantly absorb more water than its capacity, or if it didn’t get the amount of sun it required. And once you provide that cactus with the specific and appropriate external conditions, it will be able to flourish and show the world all the unique beauty it has to offer.

All of this is much easier said than done, but one of the most rewarding aspects of my job is being able to join clients as they learn how to work with their brains, accept their specific way of being in the world, and start to say no to the rest.

To read more on this topic:
https://www.simonandschuster.com/books/Laziness-Does-Not-Exist/Devon-Price/9781797120591

If your child, teen, or young adult needs support in this realm, complete our online Intake Form to learn more about NESCA’s Executive Function and Real-life Skills Coaching.

About the Author

Jasmine Badamo, MA, is an educational counselor and executive function coach who works full-time at NESCA supporting students ranging from elementary school through young adulthood. In addition to direct client work, Ms. Badamo provides consultation and support to parents and families in order to help change dynamics within the household and/or support the special education processes for students struggling with executive dysfunction. She also provides expert consultation to educators, special educators and related professionals.

Ms. Badamo is a New York State Certified ENL and Special Education teacher. She has more than 10 years of teaching experience across three countries and has worked with students and clients ranging in age from 7 to adulthood. She earned her bachelor’s degree in Biological Sciences from Cornell University and her master’s degree in TESOL from CUNY Hunter College. She has also participated in graduate coursework focusing on academic strategies and executive function supports for students with LD, ADHD, and autism as part of the Learning Differences and Neurodiversity (LDN) certification at Landmark College’s Institute for Research and Training. In addition to being a native English speaker, Ms. Badamo is also conversationally fluent in verbal and written Spanish.

Having worked in three different New York City public schools, Ms. Badamo has seen firsthand the importance of executive function skills in facilitating student confidence and success. Her coaching and consultation work focuses on creating individualized supports based on the specific needs and strengths of each client and supporting the development of metacognition (thinking about one’s own thought processes and patterns), executive function skills, and independence. She will guide clients to generate their own goals, identify the barriers to their goals, brainstorm potential strategies, advocate for support when needed, and reflect on the effectiveness of their applied strategies.

Ms. Badamo is a highly relational coach. Building an authentic connection with each client is a top priority and allows her to provide the best support possible. Additionally, as a teacher and coach, Ms. Badamo believes in fostering strong collaborations with anyone who supports her clients including service providers, classroom teachers, parents, administrators, and community providers.

To book executive function coaching with Jasmine Badamo or another EF or Real-life Skills Coach at NESCA, complete NESCA’s online intake form. 

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

Redshirting is a phrase that has traditionally been associated with college athletics, such as when coaches “redshirt” first-year athletes, providing younger athletes an additional year to develop skills and extend their playing eligibility. Academically, redshirting your child means choosing to delay kindergarten for a year even though your child is technically old enough to attend kindergarten.

Current research suggests there are pros and cons to redshirting kindergarten depending upon your child’s development and needs. One advantage of redshirting is the opportunity for the child to develop emotional maturity. While some students are ready academically, they may not be ready emotionally. This difference becomes particularly notable in the middle school and high school years, as a year difference in age (or almost two years if some students have been redshirted and your child is young for their grade), can lead to exposure to topics and behaviors your child is not emotionally ready for.

However, if your child has an identified or suspected disability, or you feel they may need extra help in school, you may not want to redshirt, as doing so would result in delay of necessary services provided free through the public schools (e.g., occupational or speech therapy, specialized academic instruction), which research finds to have a meaningful impact on improving a student’s long-term outcome. Additionally, if redshirted, a child loses a year of special education eligibility at the other end of their school experience if a student has significant disabilities covered under the IDEA, as those services end at the age of 22.

To help you make an informed decision, it is also recommended that you speak with your child’s preschool teacher in addition to any professionals (e.g., speech therapist or psychologist) working with your child. You may also want to consider meeting with an educational consultant who specializes in this area. Finally, you may consider a neuropsychological evaluation to gain a better understanding of your child’s strengths and challenges as well as to obtain educational recommendations.

Clearly, there is no right or wrong answer to redshirting in kindergarten. It is highly dependent on a child’s level of development and needs. Parents are encouraged to watch for signs of readiness, such as the ability of their child to communicate and listen well, follow instructions, and be able to sit and focus for 10-15 minutes at a time. Also, having a good understanding of your child’s developmental profile (language skills, self-regulation skills, social skills, etc.) can help a parent make an educated decision.

Sources

https://www.psychologytoday.com/us/

https://www.sciencedirect.com/

https://cepa.stanfod.edu

About the Author

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

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

By: Kristen Simon, M.Ed, Ed.S
NESCA Transition Specialist; Psychoeducational Counselor

Volunteering has many benefits for school aged students beginning to participate in transition planning. Many charities and organizations rely on volunteers to continue their services and reach more people. In general, volunteering is a great way to form community connections, achieve a sense of purpose, and boost confidence and self-esteem, all while helping those in need. In thinking about a child’s eventual transition to adulthood, there are many additional hidden benefits to volunteering.

• Build social connections: Volunteering allows individuals to engage and connect with others in a structured environment. Working with others through task completion towards a common goal is a great way for individuals to form friendships and positive connections in a low-pressure setting.
• Mental health benefits: Volunteering has been shown to decrease symptoms of depression and loneliness. Many studies have shown that helping others and carrying out altruistic acts makes you happier. In fact, some therapists believe volunteering should be built into a treatment plan in the management of depression.
• Employment/Transition Skills: Volunteering can help individuals build various skills that will help them in future jobs. Volunteering can help develop leadership skills, one’s ability to work in a team, customer service, following instructions, and punctuality to name a few important pre-employment skills. Volunteering helps individuals learn what type of work they enjoy through exposure to various work activities and work sites. Consistent volunteer work can also help build a young person’s resume.

It may be decided that a good match leads to long-term volunteering; however, it does not have to be a long-term commitment. Consistent volunteering can be a helpful tool in the stressful seasons of the year. Helping others can help to clear your head, reduce stress, and bring a perspective that allows you to engage more fully in your other commitments.

If your child and or family unit is looking for volunteer opportunities, you can start by contacting local animal shelters, senior centers, public libraries, community centers, or food pantries. Other websites to locate family volunteer opportunities in the greater Boston area include:

https://www.doinggoodtogether.org/family-volunteering-boston

https://community-harvest.org/

https://www.cradlestocrayons.org/boston/take-action/volunteer/

About the Author

Kristen Simon, M.Ed, Ed.S, has worked with transition-aged youth as a licensed School Psychologist for more than a decade. She has extensive experience working with children and adolescents with a range of learning and social/emotional abilities. Kristen’s strengths lie in her communication and advocacy skills as well as her strengths-based approach. She is passionate about developing students’ self-awareness, goal-setting abilities, and vision through student-centered counseling, psychoeducation, social skills instruction, and executive functioning coaching. Mrs. Simon has particular interests working with children and adolescents on the Autism spectrum as well as individuals working to manage stress or anxiety-related challenges.

Mrs. Simon is an expert evaluator and observer who has extensive working knowledge of the special education process and school-based special education services, particularly in Massachusetts. She has been an integral part of hundreds of IEP teams and has helped to coordinate care, develop goals, and guide students and their families through the transition planning process. Mrs. Simon further has special expertise helping students to learn about their diagnoses and testing and the IEP process in general. She enjoys assisting students, families, and educators in understanding a student’s disability-related needs as well as the strategies that can help the student to be successful in both academic and nonacademic settings. Mrs. Simon has often been a part of teams in the years when students are initially participating in transition services, and she has helped countless students to build the skills necessary to be part of their first team meetings. She is committed to teaching students—as well as parents and educators—how to participate in student-centered team meetings and the IEP processes.

At NESCA, Mrs. Simon works as a transition specialist and psychoeducational counselor. She works with adolescents, their families, and their school communities to identify and build the skills necessary to achieve their postsecondary goals. Mrs. Simon provides transition assessment (including testing, functional evaluations, and observations), program observations and evaluations, case management and consultation, and individualized counseling and skills coaching.

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

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

By: Cynthia Hess, PsyD
Pediatric Neuropsychologist

School is out for many, and it is no surprise to many that it was a challenging year for teachers, parents, and children. One word that captures the experience of the 2022-2023 school year is stress. Teachers were stressed as their students continued to contend with the academic and social deficits that resulted from the pandemic. Many students have struggled to adapt to post-pandemic learning, and incidents of acting out behavior have increased precipitously. How do we make sense of children’s behavior while helping them develop and effectively manage the academic, social, and behavioral expectations of an ever-changing world?

Ross Greene, Ph.D., states, “Children want to do well and would if they could.” Behavior is not just random or meaningless. It serves as a way for children to express their needs, feelings, and experiences, especially when they have not yet developed strong verbal or communication skills. When the demands of the environment exceed a child’s capacity to manage them, they are apt to become stressed, increasing the likelihood that they will act out. Stress is a complex concept that is a response to perceived or anticipated demands or pressures that exceed an individual’s coping abilities.

When stressed, the adrenal glands release cortisol, a stress hormone that helps mobilize energy reserves for the fight-or-flight response. Fear and anxiety also increase individuals’ vulnerability to responding with fight or flight. So, while fear is focused on a specific threat, physiologically, it feels much the same as stress. Behavior is, therefore, a way of communicating that something is amiss. For instance, a child who acts aggressively may express frustration, which is stressful. And a child who becomes withdrawn might feel overwhelmed or anxious, triggering a stress response. Behavior is a natural way for children to communicate their needs, emotions, or reactions to the environment.

Our job as adults is first to check our own emotional status, because if we are tired or stressed, it will likely influence how we respond when children behave badly. Observing and interpreting behaviors with a curious and open mindset is important. By paying attention to patterns, triggers, and context, adults can gain insights into what a child might be trying to communicate through their behavior. Our job is not to manage the behavior but to understand, per Dr. Greene, what skills are lagging or what problems need to be solved, build relationships, and work collaboratively with children to solve problems and change behavior.

Resources:

The Explosive Child, Ross Greene, Ph.D., 2021

Beyond Behaviors; Mona Delahooke, Ph.D., 2019

Podcast: Two Sides of the Spectrum; episode dated April 5, 2023; “Safety as the Foundation for Everything

About the Author

Dr. Cynthia Hess (Cindy), a licensed psychologist, worked as an elementary counselor and school psychologist for 15 years before starting her doctorate. In this role, she developed extensive expertise and aptitude for working with individuals and groups struggling with a wide range of emotional and learning challenges.

She completed her pre-doctoral internship with Rochester Institute of Technology in Rochester, N.Y., where she trained at Hillside Family of Agencies in a therapeutic residential school. At Hillside, she worked with youth ages 5-17 who had experienced complex developmental trauma.

She earned her Psy.D. in Counseling and School Psychology from Rivier University in 2018. Having a strong interest in the impact of social media on children and our culture, her doctoral dissertation studied the impact social media has on social skills development in fourth- and fifth-grade children.

Dr. Hess’s first post-doctoral fellowship was with The Counseling Center of New England, where she provided psychotherapy and family therapy to children ages 5-18 and young adults.

Dr. Hess joined NESCA’s Londonderry, N.H. office in 2019, where she completed a second two-year fellowship in pediatric neuropsychological assessment. Dr. Hess now conducts neuropsychological evaluations as a pediatric neuropsychologist and has a particular interest in working with children and young adults with complex emotional and behavioral profiles. Her experience allows her to guide families in navigating the complicated options for school and other support services.

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

NESCA is a pediatric neuropsychology practice and integrative treatment center with offices in Newton and Plainville, Massachusetts, Londonderry, New Hampshire, and the greater Burlington, Vermont area, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

By: Jessica Hanna MS, OTR/L
Occupational Therapist, NESCA

Jessica Hanna has over 10 years of pediatric OT experience in conducting assessments and providing treatment of children and adolescents with a broad range of challenges and disabilities, including autism spectrum disorders, sensory processing disorders, visual impairments, cerebral palsy, executive function deficits and developmental disorders of motor function. Prior to joining NESCA, Jessica trained and worked in a variety of settings, including inpatient and outpatient hospital settings, private practice, schools and homes. She has served on interdisciplinary treatment teams and worked closely with schools, medical staff and other service providers in coordinating care. In addition, Jessica provided occupational therapy services at Perkins School for the Blind and Spaulding Rehabilitation Hospital pediatric inpatient unit, where she conducted comprehensive evaluations and interventions for children with a broad range of presentations.

By: Jane Hauser
Director of Marketing & Outreach, NESCA

NESCA recently welcomed Pediatric Neuropsychologist Renee Cutiongco Folsom, Ph.D. to its clinical staff. Dr. Cutiongco Folsom brings a wealth of experiences and vast knowledge in assessing and diagnosing autism spectrum disorders (ASD) as well as conducting international evaluations. Take a moment to learn more about Dr. Cutiongco Folsom from my interview with her. 

Tell us about your background and how you got to NESCA.

I grew up in the Philippines. I started my career as a preschool teacher there for two years. At that point, I knew I wanted to work with children. I eventually got my master’s degree in psychology and took a neuropsychology class with a professor who was trained at Boston Children’s Hospital. I immediately fell in love with neuropsychology. I then came to the U.S. to pursue my Ph.D. and did my fellowship in neuropsychology at UCLA. I planned to go back to the Philippines but met my husband here in the U.S. and decided to stay here.

Since I did not go back to the Philippines, I was interested in practicing neuropsychology internationally, which I was able to do in Baltimore at Johns Hopkins. I was interested in the work NESCA has been doing internationally. The opportunity to work with a talented team at NESCA and the ability to do international evaluations was the right move for me.

What do you mean by looking beyond the data when conducting neuropsychological evaluations?

I refer to employing the “Boston Process Approach” in my evaluations and assessments because my mentor in the Philippines was trained in this approach when she did her postdoctoral work at Boston Children’s Hospital. She tried to ingrain this methodology in her trainees. What it means is that when we look at the data, we do not just look at a score. There is so much more to a child’s story than a number. As neuropsychologists, we are always looking at how the child comes up with an answer to a test. It is possible for a child to get a low score on a test of reproducing designs using blocks, for example, because the child threw or even ate the blocks! We must decipher what is behind the process by which the child produced the answer. This critical information falls outside of the data or what a score is. It tells us how the child learns, and what will help them at school, at home, and in their day-to-day life. This is the approach I take when I work with a child. I take a LOT of notes! I look to see what the child says and does, whether he or she is paying attention, and note other behaviors throughout the evaluation process. Then, I analyze all the data and look for patterns and discrepancies across various tests and measures.

When we see the data associated with the performance on a test, we must ask why, for instance, they achieved a low score. What other factors are at play? Is it anxiety or a visual-motor issue? What we observe throughout the evaluation can guide us to administer some tests that may not have been initially scheduled. Our knowledge, experiences, and careful observations help us to tease apart where a score came from and what it is telling us. We end up with a fuller picture of both the strengths and vulnerabilities of a child or adolescent.

What kind of international work were you doing previously?

After I completed my fellowship in neuropsychology at UCLA, my first job was with the Kennedy Krieger Institute at Johns Hopkins. Because so many families go there from other countries seeking answers, the organization assembled interdisciplinary teams to serve international patients. We conducted week-long intensive and comprehensive evaluations involving a neurologist, neuropsychologist, occupational therapist, speech-language pathologist, and social worker who could help them access resources in their home country. At the end of the week of intense evaluation, we came together as a team to make a diagnosis, if warranted, and provide recommendations for interventions. It was a challenging and intense program because we needed to develop our impressions immediately. And we often saw some of the most difficult and complex cases because the families had already exhausted all the resources available to them in their home countries before traveling overseas.

What do you find most rewarding about being a pediatric neuropsychologist?

I have been practicing neuropsychology for a long time. I chose to work in pediatric neuropsychology vs. adult because we can do so much more with children. We have a particularly good chance of making a bigger impact on their lives at such an early age.

What I find most rewarding is to have patients come back for a follow-up evaluation, and I can see how the child has progressed. Their parents often thank me for providing them with a diagnosis and helping them to access resources and attest how far their child has come. Working alongside families to change the trajectory of a child’s life is very powerful.

 You specialize in autism spectrum disorders (ASD). How do you make a diagnosis and differentiate ASD from its related challenges?

You rely on years of training, your knowledge and expertise, trust your clinical judgment, and factor in the wisdom of colleagues when needed. This is how you make meaningful conclusions and diagnoses that impact a child’s life.

What do you feel makes NESCA a unique environment and practice?

The beauty of a practice like NESCA is that we get a broad spectrum of clients who present with different challenges or diagnoses. We get to see a range of ages and draw clients from all over the New England region as well as internationally. That variety enriches your perspective and gives more insight into your clinical work.

I have been at NESCA for about a month, and they take collaboration to heart. My colleagues at NESCA are a giving group of professionals when it comes to sharing experiences and knowledge. The clinicians are humble, candid, open, and eager to help children, adolescents, and young adults. As a pediatric neuropsychologist, I also get to collaborate with transition specialists, educational consultants, OTs, SLPs, and more. The multidisciplinary approach, learning from other perspectives, is a refreshing addition to my work experience.

About the Author

Dr. Renee Cutiongco Folsom, Ph.D. has been working with families in the greater Boston area since 2015. Prior to this, she was on staff at Johns Hopkins University and trained at the University of California, Los Angeles (UCLA). She provides comprehensive neuropsychological evaluations of children, adolescents, and young adults who have learning, behavioral, and socio-emotional challenges. Her areas of expertise include Autism Spectrum Disorder and other conditions that usually co-occur with this diagnosis; Attention-Deficit/Hyperactivity Disorder; Dyslexia and other Specific Learning Disabilities; and Anxiety/Depression. She thinks that the best part of being a pediatric neuropsychologist is helping change the trajectory of children’s lives.

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

NESCA is a pediatric neuropsychology practice and integrative treatment center with offices in Newton and Plainville, Massachusetts, Londonderry, New Hampshire, and the greater Burlington, Vermont area, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

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

By: Tabitha Monahan, M.A., CAGS, CRC
NESCA Transition Specialist/Counselor

Summer will be here before we know it! Do you have your child’s summer plans and services scheduled? NESCA offers various coaching and counseling services, from executive function and real-life skills coaching to transition counseling and career counseling for high school students and young adults who are looking for support in determining their next steps. NESCA will also be offering its transition seminars again this summer from July 10^th to August 9^th. Each program will meet for two hours twice a week.

It can be challenging for many of our teens and young adults to fit transition skills into their school day schedule. Additionally, most students benefit and require repeated opportunities to build skill mastery and generalize the learned skills across settings. NESCA’s summer transition programs are designed to fulfill that need. Program participants will be guided through interactive and engaging lessons with 3-6 peers to develop a detailed postsecondary vision plan that incorporates all aspects of adult life (i.e., education/training; employment; independent living; social, recreation, and leisure; and community engagement).

• The Transition Skill Building & College Exploration seminar focuses on connecting strengths and interests to college majors and potential post-college careers. This program is an excellent fit for high school students who plan to attend a 2-year or 4-year program immediately after finishing 12^th grade.
• The Transition Skill Building & Postsecondary Options/Career Exploration seminar focuses on exploring various postsecondary options and is an ideal fit for students who plan to attend non-traditional college programing, post-12^th grade transition programs, or are still exploring/undecided about their next steps.

For questions or more information about either of the Summer Transition Planning Seminars, please contact:

Crystal Jean
cjean@nesca-newton.com
617-658-9818

About NESCA’s Summer Transition Planning Seminars

NESCA’s Postsecondary Transition Specialist and Counselor Tabitha Monahan, MA, CAGS, CRC, will be leading both summer transition courses.

Transition Skill Building & College Exploration

Who: Students who are considering going directly to a 2-year or 4-year college after leaving public education

When: Mondays and Wednesdays from 3:30 to 5:30 PM ET between July 10 and August 9, 2023

Where: NESCA’s offices @ 55 Chapel Street, Newton, MA

Participants Will:

• Learn how to connect skills to college majors and potential post-college careers
• Understand the differences between high school and college accommodations
• Understand their current accommodations, explore those they use most and identify the most beneficial ones for success in college
• Create a list of priorities when researching colleges; create a document to help conduct college research and when attending college tours
• Develop a short-term goal to accomplish over the course of the program with scaffolding support to develop action steps and monitor progress

Transition Skill Building & Postsecondary Options/Career Exploration

Who: Students who plan to attend non-traditional college programming, training programs, or receive employment/day service supports after leaving public education or are still exploring/undecided about their next steps after completing 12th grade

When: Mondays and Wednesdays from 6:00 PM to 8:00 PM ET between July 10 and August 9, 2023

Where: NESCA’s offices @ 55 Chapel Street, Newton, MA

Participants Will:

• Explore postsecondary options other than college (i.e., MAICEI, Americorps, Job Corps, certificate programs, MRC and DDS programs, other resources, etc.)
• Work through strengths and challenges with more emphasis on general job skills and independent living skills
• Learn about transferable skills and how skill-building at school, home, and in the community connects with success
• Discuss resume development and learn about different resume formats
• Understand why contacts are important
• Learn about reasonable accommodations in the workplace and rights to request accommodations
• Talk through how and when to disclose a diagnosis(es)
• Develop a short-term goal to accomplish over the course of the program with scaffolding support to develop action steps and monitor progress

About the Author
Tabitha Monahan, M.A., CAGS, CRC, is an experienced transition evaluator and vocational counselor. While she is well-versed in supporting a wide range of transition-aged youth, she is especially passionate and knowledgeable in helping clients and their families navigate the complex systems of adult services and benefits as well as medical and mental health systems. She is further adept in working individually with students of all abilities to empower self-advocacy and goal achievement.

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

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

By: Lyndsay Wood, OTD, OTR/L
NESCA Transition Specialist & Occupational Therapist

Recently there has been a lot of talk in the media about artificial intelligence (AI) technology and the impact it will have on the world. With the recent development of ChatGPT and other AI technologies, the way we work, learn, and live may see some significant changes. While change can be difficult – and there are often many considerations to make before adopting a new technology system – ChatGPT is a useful tool that can support different aspects of life when used properly. Specifically, it may be a very helpful tool to support life- and transition-related skills for teens and young adults. Here are four ways that ChatGPT can support independence with real-life skills.

1.Meal Planning and Grocery Lists: Often meal planning can be daunting, and it heavily relies on strong executive functioning skills. To make this process easier, AI technology can be utilized. Simply tell ChatGPT that you would like a meal plan for the week (or any amount of time you desire), and it will create a specific meal plan and provide the grocery list if requested. It will also break down the nutritional value if requested. You can input dietary restrictions or any special considerations, and ChatGPT will create a plan in seconds. Below is an example of the prompt I provided and the response I received.

Prompt I input: Create a one-day vegan meal plan with a grocery list. Make sure it is high in protein.

Response from ChatGPT:

Breakfast:

• Tofu Scramble with Spinach and Mushrooms
  1. 1 block of firm tofu
  2. 1 cup of spinach
  3. 1 cup of sliced mushrooms
  4. 1 tbsp of olive oil
  5. 1/4 tsp of turmeric
  6. Salt and pepper to taste
  7. 2 slices of whole grain toast

 Snack:

• Apple and Almond Butter
  1. 1 apple
  2. 2 tbsp of almond butter

Lunch:

• Quinoa and Black Bean Salad
  1. 1 cup of cooked quinoa
  2. 1/2 cup of black beans
  3. 1/2 cup of diced bell peppers
  4. 1/2 cup of diced tomatoes
  5. 1/4 cup of chopped cilantro
  6. 1/4 cup of diced red onion
  7. 1 tbsp of olive oil
  8. 1 tbsp of lime juice
  9. Salt and pepper to taste

 Snack:

• Roasted Chickpeas
  1. 1 can of chickpeas
  2. 1 tbsp of olive oil
  3. 1 tsp of paprika
  4. 1/2 tsp of cumin
  5. Salt and pepper to taste

 Dinner:

• Lentil and Vegetable Stir Fry
  1. 1 cup of cooked lentils
  2. 1 cup of mixed vegetables (broccoli, carrots, bell peppers, etc.)
  3. 1 tbsp of olive oil
  4. 1 tbsp of soy sauce
  5. 1/2 tsp of garlic powder
  6. Salt and pepper to taste
  7. 1 cup of brown rice

 Grocery List:

• Tofu
• Spinach
• Mushrooms
• Whole grain bread
• Apple
• Almond Butter
• Quinoa
• Black beans
• Bell peppers
• Tomatoes
• Cilantro
• Red onion
• Olive oil
• Lime juice
• Chickpeas
• Paprika
• Cumin
• Lentils
• Mixed vegetables
• Soy sauce
• Garlic powder
• Brown rice

This meal plan provides approximately 90 grams of protein, which is well above the recommended daily intake for most people.

2. Role Playing Social Scenarios: ChatGPT can create role playing scenarios to help teens and young adults navigate challenging or new social situations. This can help teens figure out what wording they may want to use and what someone may say in response to prepare for an interaction. Below is an example of a role play created by ChatGPT to practice social introductions.

Prompt I input: I am trying to make friends. What is a good way to introduce myself to a classmate? What might she say back? Can you create a role play?

Response from ChatGPT:

Role Play:

You: Hi there! My name is Jane. What’s your name?

Classmate: Hi, Jane! I’m Sarah.

You: Nice to meet you, Sarah! How’s your day going so far?

Classmate: It’s going pretty well, thanks for asking. How about you?

You: It’s going pretty good too. I’m excited to be in this class. What do you think about it so far?

Classmate: Yeah, me too! I’m really interested in the subject matter. What about you?

You: Same here! I think it’s going to be really interesting. Hey, do you want to grab lunch together sometime this week and chat more about the class?

Classmate: That sounds great! I would love to. How about Thursday?

You: Thursday works for me. Let’s plan on meeting in the cafeteria at noon?

Classmate: Perfect. I’ll see you then!

You: Great! Looking forward to it. See you on Thursday, Sarah.

Classmate: See you then, Jane!

3. Writing Professional Emails: Many teens and young adults struggle with composing professional emails. Determining what to say and making it professional can be very difficult for folks who struggle with social pragmatics, written language, anxiety, and executive functioning. When provided with a prompt, ChatGPT can help support this skill. Below is a sample email composed by ChatGPT to ask a professor for an extension on an assignment because the student has been sick.

Prompt I input: Write a professional email to my professor asking for extended time on a project because I am sick.

Response from ChatGPT:

Subject: Request for an Extension on Project Submission

Dear Professor [Name],

I am writing to request an extension on the project submission deadline, which is due on [date]. Unfortunately, I have been unwell for the past few days, and I have been unable to work on the project as planned. I am currently under medication and resting to recover fully.

I am aware that the project is a crucial part of our coursework, and I understand the importance of meeting the deadline. However, given my current health condition, I am finding it challenging to complete the project on time. I am hoping that you can grant me an extension of [number of days] days to submit the project.

I assure you that I will utilize the extended time to work diligently on the project and submit it as soon as possible. I am willing to accept any penalty that comes with the late submission, and I am committed to ensuring that the quality of my work is not compromised.

Thank you for considering my request. I appreciate your understanding and support during this challenging time. Please let me know if you require any further information or clarification.

Sincerely,

4. Job Applications: ChatGPT can provide a significant amount of support around job applications. ChatGPT can create a resume template, provide cover letter examples, outline a cover letter, and create sample interview questions. Below is a sample outline created by ChatGPT for a cover letter to Starbucks.

Prompt I input: Create an outline for a cover letter to Starbucks

Response from ChatGPT:

Introduction

• Briefly introduce yourself and express your interest in working for Starbucks

Relevant experience and skills

• Highlight any previous experience or skills that would make you a good fit for the company
• Mention any experience working in customer service or the food and beverage industry
• Emphasize your ability to work in a fast-paced environment and handle multiple tasks at once

Passion for coffee and the Starbucks brand

• Discuss your love for coffee and how it has influenced your desire to work for Starbucks
• Mention any knowledge you have about the company’s values and mission

Availability and willingness to learn

• State your availability to work and any flexibility in your schedule
• Express your eagerness to learn and grow within the company

Closing

• Thank the reader for considering your application and express your excitement for the opportunity to join the Starbucks team.

These four examples are just a few of the many ways that AI can help support our teens and young adults with real-life skills. As with anything that is computer-generated, it is important to teach our teens and young adults to review the output and modify information for their needs or to match their own voice. It is exciting to see how these methods will evolve and be utilized in the classroom to supplement and support learning and independence in the future.

Note: it is important to make sure to check school/company policies around AI prior to using the technology and to remember that AI is not human and therefore may not afford the “human touch” that helps with some activities.

About Lyndsay Wood, OTD, OTR/L

Lyndsay Wood, OTD, OTR/L, is an occupational therapist who focuses on helping students and young adults with disabilities to build meaningful skills in order to reach their goals. She has spent the majority of her career working in a private school for students with ASD. She has also spent some time working in an inpatient mental health setting. Lyndsay uses occupation-based interventions and strategies to develop life skills, executive functioning, and emotional regulation. While completely her doctoral degree at MGH Institute of Health Professions, Lyndsay worked with the Boston Center for Independent Living to evaluate transition age services. She uses the results from her research to deliver services in a way that is most beneficial for clients. Specifically, she focuses on hands-on, occupation-based learning that is tailored the client’s goals and interests.

To book coaching and transition services at NESCA, complete NESCA’s online intake form. 

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

By Dot Lucci, M.Ed., CAGS
Director of Consultation and Psychoeducational Counseling Services, NESCA

We often talk a lot about wanting our children to have good self-esteem. There’s nothing wrong with good self-esteem; it means that a child has a positive view of themselves and their worth. However, self-esteem is not enough. Life has its challenges, failure being one of them. How are we helping children to pick themselves up and try again? If our children are lagging in this ability, we need to help them develop realistic self-efficacy.

Self-efficacy and self-esteem are related but are also qualitatively different. Self-efficacy is related to how you feel about your ability to succeed in different contexts. It is more specific and context-driven versus self-esteem. Is your child capable of preserving at performing a difficult task? Do they stay engaged and try again, or do they give up? Self-esteem is considered a global belief about oneself, whereas, according to psychologist Albert Bandura, self-efficacy is “the belief in one’s capabilities to organize and execute the courses of action required to manage prospective situations.”

A child with high self-efficacy believes their challenges are obstacles to overcome. Failures don’t immobilize them. Their inner voice says, “I’ve got this!” They may demonstrate good self-awareness by knowing their strengths and challenges, thus setting manageable goals and achieving success because the goals are indeed attainable. Their motivation to try difficult tasks is buoyed by a positive thinking style and an inner belief system that recognizes failure as a part of life. So, when they fail at something, their self-esteem remains intact. They don’t “beat themselves up” when they make a mistake. They recognize it as a part of learning. As they say, “they get back in the saddle.” Children with good self-efficacy have better self-regulation, utilize a growth mindset, and have a stronger sense of agency and mastery. As Henry Ford said, “Whether you think you can, or you think you can’t–you’re right.”

Children with poor self-efficacy often shy away from work that they failed at or with tasks that they perceive as difficult. They tend to believe that these tasks are beyond their capabilities, so they shy away from even trying to do them. Children with low self-efficacy often berate themselves when they make a mistake, lose confidence in themselves, and their self-esteem suffers.

Helping children develop self-efficacy is important to their overall social-emotional functioning and well-being. The earlier we start helping to develop self-efficacy in our children, the better off they will be at improving their self-efficacy independently throughout their lives. Bandura identified four influencers or sources that impact self-efficacy: performance experience, vicarious experience, social persuasion, and physical and emotional states. Using these as our guideposts when teaching our children enhances their development of self-efficacy.

Performance Experience refers to when we perform a task successfully, it strengthens our sense of self-efficacy. This can also be called Mastery Experiences. We feel good about ourselves, our skills, and our knowledge; however, the converse is true as well. Failing to perform a task well will further weaken self-efficacy, particularly if it was not strong to begin with. Thus, it is important to emphasize and normalize the concept that failure is a part of the learning process.

When we watch others who are like us succeed by persevering at and completing a difficult task, it can raise the observers’ beliefs that they, too, can achieve it. This is Vicarious Experience or Social Modeling. By watching another person succeed through dedication, a person can be inspired to achieve the goals they set for themselves.

Another way to improve self-efficacy is through Social Persuasion. It is just as it sounds – someone you trust as a credible source giving verbal encouragement about your ability to perform a task can have a positive impact on one’s self-efficacy, becoming a self-fulfilling prophecy.

The last influencer, Our Own Personal Physical Sensations, Moods, Emotional Reactions, and Stress Level, etc., can dramatically…and positively or negatively impact how a person feels about their skills and abilities to complete a task. Bandura, highlighted, “it is not the sheer intensity of the emotional and physical reactions that is important but how they are perceived and interpreted by the person.” If we can acknowledge the stress and minimize it when we are confronted with a challenging task, we can improve self-efficacy. These are all important ways to help facilitate a child’s development of self-efficacy.

Facilitating the development of self-efficacy in our children can be done through a variety of means, keeping Bandura’s four influencers in mind. Here are some approaches to consider:

• Keep in mind Bandura’s four self-efficacy influencer types as your guideposts.
• Model self-efficacy and point it out to your children. Share your struggles/set-backs and how you managed to persevere. Talk about how you are willing to work towards a goal even though you failed multiple times along the way. Typically, parents do it without even knowing it.
• Help children develop realistic self-efficacy by praising them honestly and concretely. Praise their effort, not their ability. Help them recognize failure is a part of life and learning.
• Preview new learning by saying something like, “Remember you’re learning ___. You might make some mistakes. It’s okay. Mistakes are a part of learning.”
• Use failures to help build realistic expectations and self-confidence by pointing out growth from previous attempts. Help children learn from their set-backs.
• Empathize with their emotions related to their failures, struggles, etc.
• Name their strengths and challenges, and use them as jumping off points related to their effort, not ability.
• Help children set “realistic” short-term goals and help them stay on track. Help children recognize that their achievements are related to internal strengths, skills, and thoughts – not on external factors (i.e., I learned that hook shot because I practiced, watched and analyzed videos, and listened to my coach, etc.).
• Create opportunities that are within “their zone of proximal development” (i.e., just right learning level – not too hard or too easy). To help build self-efficacy, a child needs a difficulty level to hold their interest, feel challenged, and experience some amount of struggle while ultimately achieving success.

Self-efficacy is worth paying attention to as it is truly one of the best gifts we can instill in our children. As Mahatma Gandhi said, “If I have the belief that I can do it, I shall surely acquire the capacity to do it even if I may not have it at the beginning.”

References

Bandura, A. 1999. Self-efficacy in Changing Societies. Cambridge Univ. Press, UK.

Self-Efficacy: Helping Children Believe They Can Succeed https://www.forsyth.k12.ga.us/cms/lib3/ga01000373/centricity/domain/31/self-efficacy_helping_children_believe_they_can_suceed.pdf

If You Think You Can’t… Think Again: The Sway of Self-Efficacy https://www.psychologytoday.com/intl/blog/flourish/201002/if-you-think-you-can-t-think-again-the-sway-self-efficacy

About the Author

NESCA’s Director of Consultation and Psychoeducational Services Dot Lucci has been active in the fields of education, psychology, research and academia for over 30 years. She is a national consultant and speaker on program design and the inclusion of children and adolescents with special needs, especially those diagnosed with Autism Spectrum Disorder (ASD). Prior to joining NESCA, Ms. Lucci was the Principal of the Partners Program/EDCO Collaborative and previously the Program Director and Director of Consultation at MGH/Aspire for 13 years, where she built child, teen and young adult programs and established the 3-Ss (self-awareness, social competency and stress management) as the programming backbone. She also served as director of the Autism Support Center. Ms. Lucci was previously an elementary classroom teacher, special educator, researcher, school psychologist, college professor and director of public schools, a private special education school and an education collaborative.

Ms. Lucci directs NESCA’s consultation services to public and private schools, colleges and universities, businesses and community agencies. She also provides psychoeducational counseling directly to students and parents. Ms. Lucci’s clinical interests include mind-body practices, positive psychology, and the use of technology and biofeedback devices in the instruction of social and emotional learning, especially as they apply to neurodiverse individuals.

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