Blog-IEP-Meetings-FeaturedImage

IEP Meetings From a Mom’s Perspective

I have worked for North Shore Pediatric Therapy for more than two years in the marketing department. I thought I was familiar with the many challenges families go through with their children, Blog-IEP-Meetings-Main-Landscapehowever, the idea of going through “the IEP process” never crossed my mind, until I had to.

When my son started kindergarten, we had some concerns about certain behaviors, but honestly really thought they were only phases. A few weeks into the school year as they began practicing drills, he had a severe panic attack requiring help from the school social worker. At that time, his teacher recommended he begin seeing the social worker more frequently and that led to our process of seeking a full evaluation to really understand him.

He was evaluated by Dr. Greg Stasi at NSPT and given a diagnosis of Anxiety Disorder and Sensory Processing Disorder. It was then that we were faced with the dreadful IEP meetings. I had heard so many stories of hardship parents faced when fighting for their child’s needs. As a result, I went into the process expecting a fight, and boy would they get one if necessary because in my mind, nothing was going to come between my child getting the help he needed.

Because of my job, I am fortunate enough to have access to excellent professionals and resources, who understand the IEP process, and who helped me prepare for the initial IEP meeting. I was ready for that day. And you know what happened? I didn’t have to fight. I was so fortunate to have a wonderful team wanting and willing to give my son everything he needed to succeed. Everything I was prepared to fight for was already part of their plan, too.

I know this isn’t typical, and so many families struggle to get their child’s needs met.

Here are some tips, from a mom’s perspective on how to approach IEP meetings to get what you, and your child, need:

  1. Be prepared. Those same resources I have access to because of my job…guess what? YOU have access to those same things! NSPT has so many blogs and infographics to help you begin your journey. Having a full neuropsych evaluation is a real plus as it lends a direction for goal development and is appreciated by the district staff.
  2. Be understanding. Understand that those on the other side of the table really do want to help. Often they are restricted by legal mandates. So you may find that there are questions you ask where they can’t fully answer.
  3. Ask questions. Don’t be afraid to ask any and all questions you have in order to understand each element being addressed. It goes fast. And they use a lot of terms you don’t recognize. Stop them and ask.
  4. Bring help. Don’t be afraid to bring outside support, such as a school advocate, to help speak on your behalf. They know the rules and can help you “fight.”
  5. Don’t sign the plan if you are not happy. You will be asked to sign the plan at the end. If you are not comfortable, don’t do it, unless it’s on the condition that you are requesting another meeting to go over the details again to re-write the goals.
  6. Hold Accountability. As the school year continues, don’t be afraid to check in on the team, the therapists, and the teacher to ensure all accommodations are being met.

Be the voice. Remember, you are your child’s voice. Don’t be afraid to speak up.

NSPT offers services in Bucktown, Evanston, Deerfield, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Mequon! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140!

New Call-to-Action

Blog-ADHD-Accommodations-FeaturedImage

Academic Accommodations for Children with ADHD

Children diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) may face many obstacles in the classroom. Structure and consistency are the two main keys to success for children withBlog-ADHD-Accommodations-Main-Landscape ADHD, but each case presents with its own challenges and accommodations should address the unique needs of the individual student.

The following are examples of what a child with ADHD may present in the classroom and associated accommodations:

For a student presenting with difficulties sustaining attention and following directions:

  • Instructions should be kept brief and specific and presented one step at a time.
  • Maintain eye contact with child while presenting instructions and have the child “teach” the instructions back to the teacher.
  • Reduce task length (i.e., focus on quality of work rather than quantity) or break complex tasks into smaller pieces.
  • Seat the child near the teacher and away from distractions such as doors, windows, or other students who may be disruptive.
  • Provide a “quiet zone” for the student to complete tests or in-class assignments.
  • Use verbal cues or signals as behavioral prompts when the child falls off task.
  • Set time limits or “challenges” for completing tasks.
  • Provide visual prompts for classroom routines.

For a child presenting with excessive activity and/or impulse control:

  • Allow the child to stand near his or her desk or kneel in his or her chair during seated work as long as no disruption is caused.
  • Use instructional approaches that encourage active responding such as talking, moving, or working at the board.
  • Provide breaks for directed movement such as passing out materials.
  • Reward short periods of waiting or on task behavior and gradually increase the period a child is successful.
  • Encourage non-disruptive activities such as reading or doodling during times of day that have proven problematic.
  • Clearly state rules and expectations, and clearly state positive and negative consequences for behaviors. Review these rules often and post visual reminders.

All children will benefit from positive feedback, reinforcement for small improvements, frequent opportunities for active participation, and assignments related to the child’s interests. Additionally, established routines and schedules, along with both verbal and visual reminders, will help any child to be successful in the classroom environment. Most importantly, remember not to assume that a failure to follow instructions is due to a lack of effort or an intentional failure to pay attention, nor is overactivity or impulsive behavior intended as an act of defiance.

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates!

Find-Out-More-About-ADHD

Blog-Teacher-Tips-Anxiety-FeaturedImage

Teacher Tips: Accommodating an Anxious Child

Sometimes anxiety can be easy to identify, such as when a child is feeling nervous before a test. Blog-Teacher-Tips-Anxiety-Main-LandscapeHowever, in some children anxiety may look like something else, such as ADHD or a learning disorder.

The following is a list of tips to use in the classroom to accommodate a child with anxiety:

  • Some children may participate in therapeutic services. Therefore, it is imperative to talk with parents/guardian about strategies that work (and do not work) at home. Teachers can use and modify those strategies to help in the classroom.
  • Also, checking in with parents regularly is important to ensure that accommodations are helping and determine necessary adjustments

Homework & Assignments

  • Check that assignments are written down correctly
  • Using daily schedules
  • Modifying assignments and reducing workloads when possible
  • Allowing the child to take unfinished assignments home to complete

In the Classroom

  • Preferential seating that is less distracting
  • With regard to class participation
    • Determine a child’s comfort level with closed ended questions
    • Use signals to let the child know his/her turn is coming
    • Provide opportunities to share knowledge on topics he/she is most confident
    • If possible, only call on the child when he/she raises his/her hand
  • Extended time on tests
  • Provide word banks, equation sheets, and cues when possible
  • Allow for movements breaks throughout the day & relaxation techniques
  • Determine a discreet way the child can indicate he/she needs a break, such as a colored card the child places on his/her desk to signal he/she needs a drink of water, to use the restroom, or any other strategy to lessen feelings of anxiety
  • Allow the use of a fidget for children who have difficulty paying attention

Please refer to the following websites for additional information about anxiety in children and accommodations that can be used, or modified for use, in the classroom.

Resources:

http://www.worrywisekids.org
http://www.childmind.org/en/posts/articles/2015-4-13-anxiety-classroom
http://kidshealth.org/parent/classroom/factsheet/anxiety-factsheet.html
http://www.adaa.org/living-with-anxiety/children/anxiety-disorders-school

NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview, Lake Bluff and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

New Call-to-Action

Blog-Neuropsychological-Evaluation-FeaturedImage

Reasons to Seek a Neuropsychological Evaluation for Your Child

Neuropsychology is a field of psychology that focuses on the relationship between learning, behavior, and brain functioning. A child may be referred for a Blog-Neuropsychological-Evaluation-Main-Landscapeneuropsychological evaluation when there are concerns about one or more areas of their development. This can include a child’s cognitive, academic, memory, language, social, self-regulatory, emotional, behavioral, motor, visual-spatial, and adaptive functioning.

This type of evaluation can help rule out diagnoses such as Attention Deficit/Hyperactivity Disorder, Autism Spectrum Disorder, Specific Learning Disorder, Language Disorder, as well as various emotional and behavioral disorders. A neuropsychological evaluation can also be helpful if your child has been diagnosed with a medical condition such as Down Syndrome or other genetic disorders, Traumatic Brain Injury, or Epilepsy. The purpose of the evaluation is to identify a child’s patterns of strengths and challenges in order to provide parents, schools, and other providers with strategies to help them succeed across contexts. It can also be used to track a child’s progress and response to targeted interventions.

In order to assess whether a neuropsychological evaluation may be helpful for a child, a family may identify concerns in the following areas:

  • Cognitive
    • Difficulties with verbal and nonverbal reasoning and problem solving
    • Requiring a significant amount of repetition and/or additional time when learning
    • Delays in adaptive functioning
  • Academic
    • Grades below peers
    • Concerns with reading (phonetic development, fluency, comprehension), mathematics (calculation, word problems), or writing (spelling, content, organization)
    • Needing additional time to complete schoolwork, homework, or tests
    • Frustration with academic work
  • Language
    • Expressive (output of language) or receptive (understanding of language) difficulties
    • Challenges initiating or maintaining a conversation
    • Difficulties with sarcasm or non-literal language (e.g, “It’s raining cats and dogs”)
    • Repetitive or odd language usage (e.g., repeating lengthy scripts heard from television or news programs)
    • Pronoun reversals or odd use of language
  • Self-Regulation
    • Difficulty paying attention or sitting still
    • Needing frequent prompts or reminders to complete tasks
    • Difficulty with multiple-step commands
    • Losing or misplacing items
    • Forgetting to turn in completed assignments
  • Social
    • Poor peer relations
    • Inappropriate response when approached by peers
    • Difficulty with imaginative, functional, or reciprocal play
    • Limited interest in peers or preference for solitary play
  • Repetitive Behaviors
    • Repetitive vocalizations
    • Repetitive motor mannerisms (e.g., hand flapping, finger flicking, body rocking)
    • Lining up toys, spinning wheels of cars, sorting objects for prolonged periods of time
  • Behavioral Dysregulation
    • Physical or verbal aggression
    • Defiance or non-compliance
    • Difficulties with transitions or changes in routine
    • Self-injury (e.g., head banging)
  • Emotional
    • Poor frustration tolerance
    • Irritability or easily upset
    • Eating or sleeping difficulties
    • Somatic complaints
    • Negative self-statements
    • Lack of interest in things he/she used to enjoy
  • Visual-Spatial, Visual-Motor, and Motor
    • Poor handwriting
    • Trouble with fine motor tasks (e.g., unwrapping small items, buttoning or zipping clothing, tying shoe laces)
    • Difficulty transferring information from the classroom board to a notepad, or transferring information from a test booklet to a scantron/bubble sheet
    • Difficulty with overwhelming visual displays (e.g., computer screen with several icons; homework with several problems on one sheet; a book with several colors and pictures)

Should a child demonstrate difficulties in some of the areas listed above, he/she may benefit from further consultation or a subsequent neuropsychological evaluation. Through this process, areas of difficulty can be identified, and targeted interventions will be suggested to enhance a child’s development.

NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview, Lake Bluff and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

Meet-With-A-Neuropsychologist

BlogLearningDisabilityDiagnosis-FeaturedImage

10 Steps to Diagnosing A Learning Disability

If your child has difficulty with reading, writing, math or other school learning-related BlogLearningDisabilityDiagnosis-Main-Landscapetasks, this does not necessarily mean that they have a learning disability. Lots of children struggle at times with school.

Common signs of a learning disability:

  • Difficulty with reading, writing or math skills
  • Short attention span or difficulty staying on task (easily distracted)
  • Difficulty with memory
  • Trouble following directions
  • Poor hand-eye coordination
  • Difficulty with time management
  • Problems staying organized
  • Inability to discriminate between or among letters, numerals, or sounds
  • Difficulty with paying attention
  • Inconsistent school performance

Each learning disability has its own signs and not every person with a particular disability will have all of the signs. These signs alone are not enough to diagnose a learning disability, so a professional assessment is necessary to diagnose a learning disability.

If some of these symptoms sound familiar, below are 10 steps to take:

  1. Talk to your child about the areas they are struggling in order to understand the symptoms.
  2. Provide empathy and emotional support for your child. Let them know that lots of people struggle at times with school related tasks.
  3. Get specific feedback from teachers regarding problem areas or grades.
  4. Set up an initial intake session with a Psychologist/Neuropsychologist to discuss symptoms and background information.
  5. Have the child tested in specific areas:
    1. Intellectual/IQ
    2. Achievement/Academic
    3. Language/Communication
    4. Memory
    5. Attention
    6. Visual/Motor
    7. Problem Solving
    8. Social, Emotional, Behavioral
  6. Get feedback from teachers with specific forms regarding behaviors
  7. Discuss with Psychologist/Neuropsychologist the results of the testing and recommendations.
  8. Talk to the child’s school about accommodations and services.
  9. Follow up with teachers about effectiveness and gains of accommodations.
  10. Follow up Neuropsychological testing in 6 months to 1 years’ time.

References:

https://www.nichd.nih.gov/health/topics/learning/conditioninfo/Pages/symptoms.aspx

http://ldaamerica.org/symptoms-of-learning-disabilities

NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview, Lake Bluff and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

Meet-With-A-Neuropsychologist

BlogGraphics-LearningDisabilityFeatured

Specific Learning Disorders in Children

Learning disorders are some of the most common neurodevelopmental LearningDisorders-Main-Landscapeconditions that children face. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which is the guidebook on classification of diagnoses published by the American Psychiatric Association indicated that the prevalence of specific learning disorders across academic domains of reading, mathematics, and written expression is between 5%-15% in school aged children.

There is significant discussion both in the literature, and among clinicians and researchers, regarding how to appropriately classify and subsequently diagnose a specific learning disorder. Traditionally, it was assumed that a specific learning disorder existed when there was a significant discrepancy between a child’s cognitive ability and achievement in reading, mathematics, or written expression. However, within the US, changes have occurred over the past decade regarding the criteria used for determining a specific learning disorder which is now based on a multi-tier process involving early identification and intervention and the child’s response to the intervention.

Where children might exhibit learning disorders:

According to the DSM-5, there are three specifications of learning disorders that children might exhibit: Specific Learning Disorder With Impairment in Reading, Specific Learning Disorder With Impairment in Written Expression, and Specific Learning Disorder with Impairment in Mathematics. It is quite common for children to exhibit multiple learning disorders.

Potential related deficits:

There are definite concerns with a child’s social, emotional, and behavioral regulation if they have a documented learning disorder. Prior studies have indicated that up to 75% of children with a diagnosed learning disorder demonstrate significant social skill deficits expressed by peer rejection and social isolation.

What can be done:

It is our strong recommendation that in order to most effectively address a child’s specific learning disorder, it is important that the child undergo a comprehensive evaluation in order to effectively classify and make sense of the patterns of difficulty that the child presents with as well as to rule out additional existing factors of concern, and to best determine what specific interventions are warranted. Recommended interventions are specifically based on the area of weakness a child exhibits both across the testing as well as within the child’s academic environment.

NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview, Lake Bluff and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

Meet-With-A-Neuropsychologist

Finding the Right Treatment for Your Child

Choosing the Right Treatment for Your Child: Evidence-Based Practices

Trying to decide which treatments would provide the best outcomes for your child can be a difficult and overwhelming process. You want your child to receive the most effective treatment option but what determines whether or not a treatment is effective? If it worked for other children with similar problems, will it work for your child? Is there research or evidence to support the effectiveness of this treatment?Choosing The Best Treatment For Your Child: Evidence-Based Treatments All of these questions are important and relevant questions to ask yourself when it comes to finding the right treatment for your child. Although it is strongly recommended to address these questions and concerns with your child’s clinician, one way to learn more about effective treatments is by familiarizing yourself with Evidence-Based Practices (EBP).

What are Evidence-Based Practices?

Evidence-Based Practices (EBP) are well-established treatments because they are strongly supported by evidence from research studies that are designed to evaluate their effectiveness.  Specifically, when a treatment is identified as an EBP it means that the treatment has been studied in a community or academic setting and has been proven to show positive treatment outcomes in multiple studies conducted by multiple research teams. Additionally, EBPs are client-centered because they are treatments that are designed to integrate research evidence, clinical expertise, and client/patient/family values, preferences, culture, and environment.

What Are Current Evidence-Based Practices?

The table below provides a brief list of EBPs for specific child and adolescent disorders:

 

Diagnosis Evidence-Based Practice
Anxiety Ages 9-18 Cognitive Behavior Therapy (CBT)

Ages 3-17 Exposure Therapy

Ages 3-13 Modeling Therapy

ADHD Ages 3-12 Behavior Therapy (in home and in school)

Ages 3-16 Parent Management Training

*The combination of behavior therapy and medication is often most effective in treating ADHD

Autism Spectrum Disorder Ages 3-13 Behavior Therapy

Ages 3-13 Individual and family therapies that target   communication skills, interaction skills, and behavior modification

Bipolar Disorder No controlled studies of psychosocial interventions for youth with bipolar disorder have been done. However, behavior therapy, family education, and support benefit youth and families and improve relationships, communication, and coping skills.
Conduct Disorder Ages 3-15 Parent Training

Ages 9-15 Anger Coping Therapy

Ages 6-17 Brief Strategic Family Therapy (BSFT)

Ages 13-16 Functional Family Therapy (FFT)

Ages 9-18 Treatment Foster Care (TFC)

Ages 12-17 Multisystemic Therapy (MST)

Ages 12-17 Mentoring

Ages 9-18 CBT

Depression Ages 9-18 CBT

Ages 11-18 Relaxation Therapy

Ages 12-18 Interpersonal Therapy (IPT)

Ages 12-18 Family Education and Support

Schizophrenia No controlled studies of psychosocial interventions for youth with schizophrenia have been done. However, behavior therapy, family education, and support benefit youth and families and improve relationships, communication, and coping skills.
Substance Use Ages 9-18 CBT

Community Reinforcement

Family Therapy

 

Online Resources on Evidence Based Practices

The Society of Clinical Child and Adolescent Psychology (Division 53 of the American Psychological Association) offers clinicians and parents access to a variety of online video resources on EBPs, which also includes a more recently developed YouTube channel titled: Effective Child Therapy Resource Library. Along with providing par

ents and clinicians with a variety of free videos, these online resources cover a wide range of topics pertaining to EBPs for children and adolescents including:

These video resources provide parents with interviews conducted with experts in child and adolescent psychology. Experts provide brief discussions on specific issues such as, treating specific disorders, identifying certain behaviors (to determine whether or not your child might have a problem), as well as evidence-based treatment options. The videos also provide additional links to related videos and PDFs that offer parents more information regarding the specific topic.

NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview, Lake Bluff and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

Help Your Child Thrive

5 Ways To Help Your Child Thrive

The brain is divided into two hemispheres with each side having its own unique functions.  The left side is logical, literal, linguistic, and linear (the four L’s).   The right side is holistic, non-verbal, and focuses on the emotions and experiences of relationships.  When it comes to development, very young children tend to be right brain dominant!  This is especially true during the first three years of life when they live completely in the moment and have not mastered the ability to use words and logic to express their feelings.

When can you determine a change to using both side of the brain?  Once your toddler begins askingHelp Your Child Thrive “why?” all the time! This is because the left brain strives to know linear cause-effect relationships and uses language to express logic.

The following are some strategies that parents can use to help their children survive and thrive through the challenges of childhood.  However, these strategies are not just for parents.  Anyone who plays a significant role in a child’s life, whether you’re a grandparent, relative, teacher, or babysitter/nanny, can use these strategies in nurturing whole-brain development.

Strategies to Help Your Children Thrive!

  1. Connect & Redirect: Surfing Emotional Waves: First, connecting with the right brain means acknowledging your child’s feelings.  Regardless of how illogical and frustrating your child’s feelings may seem to you at the moment, they are real and important to your child.  Using nonverbal signals, such as physical touch, empathetic facial expressions, a nurturing tone of voice, and nonjudgmental listening are great ways to connect and communicate with your child’s right brain.  Once your child’s brain is back in balance, you can move to step 2 to integrate the left and right brain.  Next, after responding to your child’s right brain, you can now redirect with the left brain through logical explanation, planning, and discussing misbehavior and consequences.
  1. Name It to Tame It: Telling Stories to Calm Big Emotions: Help your child retell the story of a frightening or painful experience.  Allow your child to retell the story as much as he can and help fill in any details, including lingering feelings since the experience.  You and your child can retell the story several times, with the aim to lessen his fears or pain.  Also, this technique will help your child bring the left and right brain together and make sense of their experience.
  1. Engage, Don’t Enrage: Instead of presenting ultimatums, direct your child to use more precise and specific words for how he/she is feeling.  Then, give your child the opportunity to practice problem solving and decision making.  Also, this will help your child consider appropriate behaviors and consequences, and assist them in thinking about the wants and feelings of others.
  1. Move It or Lose It: Moving the Body to Avoid Losing the Mind: Research has shown that movement directly affects brain chemistry.  Therefore, physical activity is a powerful way to help your child regain balance and change his emotional state.  This could be in the form of yoga, going to the park, blowing/popping bubbles (who doesn’t love that), or a bike ride.
  1. Increase the Family Fun Factor: Making a Point to Enjoy Each Other: Sometimes, with all the hustle and bustle of life, it’s easy to forget to have fun with your family.  As such, “playful parenting” gives your children positive experiences to prepare them for relationships and encourage them to connect with others.  Some great ways to have fun as a family include, playing improv games, telling jokes, being silly, playing board games, family bike rides, and making cookies.  Lastly, don’t forget to take interest in things they care about.

More strategies and information can be found in the book The Whole-Brain Child by Daniel J. Siegel, M.D. and Tina Payne Bryson, Ph.D.

Neuropsychology testing IL

NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview, Lake Bluff and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

Executive Functioning Skills for School Success

Executive Functioning Skills for School Success

Executive functioning skills are behaviors that guide and complete actions.  They are the skills we use, independently, to help us to complete tasks and achieve goals.

Think of them as not the individual skills of a task, but the behaviors needed to complete the task.

Executive functioning skills are crucial for academic success. These skills are not directly taught in school, through are expected to be utilized in the classroom setting. The independent use of skills, including initiation, problem-solving, working memory, inhibition and organization, is difficult for both adults and children.

Executive functioning concerns are seen in a variety of conditions and diagnoses including ADHD, Learning Disabilities, Anxiety, Depression, Autism Spectrum Disorder, and a variety of medical conditions. However, there are no specifics of what is necessary for a diagnosis of Executive Functioning Disorder in the Diagnostic and Statistical Manual 5th Edition (DSM-V).

Executive Functioning By Age:

During the preschool years, prefrontal brain systems undergo rapid changes such as making newExecutive Functioning Skills for School Success neurological connections and speeding up how fast messages are transmitted in the brain. It is the time in which executive functioning skills, specifically inhibitory control, rule use, working memory, and motor persistence, play a critical role in the development of socialization and readiness for academic learning. The early years of schooling are learning how to be a student.  There are many inherent structures and routines in place to help ensure the child completes work.  As children get older the natural scaffolds of teacher interference and organization are removed, stressing the need for independence.

As children reach school age, executive functioning skills are central to successful acquisition and efficient use of academic skills, particularly in efforts to overcome learning problems of all kinds. At this age, children are expected to integrate multiple executive functioning skills as a means to complete longer tasks.

As these children age into adolescence, the demands of executive functioning skills increase tenfold. At this age, executive functioning difficulties are seen with spontaneous use of skills, strategic initiation of tasks, and mental flexibility. Meaning concerns are no longer with regard to impulse regulation but rather with initiating action on work/time management as well as developing organizational strategies to complete work.

Interventions for Executive Functioning:

A major component of intervention for executive functioning is that the techniques have to be in real-life contexts. Teaching skills during tasks that mimic academic and life demands results in better carryover of skill. This systematic approach to teaching problem solving with everyday activities is best.  Familiar tasks should be used to learn skills initially. The use of novel tasks in the learning process will prove difficult due to perceived difficulty, stress or anxiety around possible failure.

Specifically, as the child learns to complete a multi-step task following a set sequence of steps (with multiple opportunities to practice the routine), the task becomes less novel. The child is then able to improve functional activities with less reliance on external cues.

Interventions must be rehearsed, coached, and practiced to support overlearning or automaticity in the environment in which they will be needed. This will explicitly support the “how and when” skills associated with the child’s unique areas of problem behavior.

There is also an emphasis on developing a child’s metacognitive skills.  Metacognition is essentially thinking about thinking.  You are teaching the child to think and plan ahead before diving into an activity or task.

A fourth principle involves structuring the child’s environment by establishing simplified, consistent routines for daily tasks.  Teaching and carryover is most effective with accommodations and interventions across each environment. These accommodations could include verbal cues, nonverbal gestures, schedules, check-lists, alarm clocks, timers (auditory or visual), and/or environmental modifications.

Additionally, a motivational reward/consequence system, and/or self-talk methods can also be used to ensure success.

Executive Functioning

NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

the WISC-V

Understanding the Wechsler Intelligence Scale for Children, Fifth Edition (WISC-V)

In the world of psychological assessment, the Wechsler Intelligence Scales are considered to be the gold standard measures of intellectual functioning.  The assessments represent over 70 years of research and subsequent revisions that reflect advancements in neurodevelopmental and neurocognitive research, psychology, technology, and changes in population. (Wechsler, 2014).

The Wechsler Intelligence Scale for Children, Fifth Edition (WISC-V):

One of the most commonly used assessments for school-aged children is the Wechslerchilds-brain-Portrait Intelligence Scale for Children, Fifth Edition (WISC-V). The assessment generates five composite score indices:

  • Verbal Comprehension (VCI)
  • Visual Spatial Index (VSI)
  • Fluid Reasoning Index (FRI)
  • Working Memory Index (WMI)
  • Processing Speed Index (PSI)

Together, a Full Scale Intelligent Quotient (FSIQ) is developed.  When large discrepancies are identified between the indices which comprise a child’s FSIQ, alternative scores can be calculated to best capture a child’s cognitive profile.  Alternative scores may be considered when deficits in language, attention, or motivation appear to have negatively impacted a child’s overall performance. Through the analysis of the general and specific domains of cognitive functioning, clinicians are better able to make informed decisions regarding diagnostic conceptualization and treatment recommendations.

WISC-V Composite Score Indices:

  • VCI: The VCI measures verbal reasoning, understanding, concept formation, in addition to a child’s fund of knowledge and crystallized intelligence.  Crystallized intelligence is the knowledge a child has acquired over his or her lifespan through experiences and learning.  The core subtests which comprise the VCI require youth to define pictures or vocabulary words, and describe how words are conceptually related.  Children with expressive and/or receptive language deficits often exhibit poorer performance on the VCI.  Studies have also indicated that a child’s vocabulary knowledge is related to the development of reading abilities, and as such, weaker performance on tasks involving vocabulary may signal an academic area of difficulty.
  • VSI:  The VSI measures a child’s nonverbal reasoning and concept formation, visual perception and organization, visual-motor coordination, ability to analyze and synthesize abstract information, and distinguish figure-ground in visual stimuli.  Specifically, the core subtests of the VSI require that a child use mental rotation and visualization in order to build a geometric design to match a model with and without the presence of blocks.  Children with visual-spatial deficits may exhibit difficulty on tasks involving mathematics, building a model from an instruction sheet, or differentiating visual stimuli and figure ground on a computer screen.
  • FRI: The FRI assesses a child’s quantitative reasoning, classification and spatial ability, knowledge of part to whole relationships.  It also evaluates a child’s fluid reasoning abilities, which is the ability to solve novel problems independent of previous knowledge.    The core tasks which make up the FRI require that a child choose an option to complete an incomplete matrix or series, and view a scale with missing weight(s) in order to select an option that would keep the scale balanced.  A child with fluid reasoning deficits may have difficulty understanding relationships between concepts, and as such, may generalize concepts learned.  They may also struggle when asked to solve a problem after the content has changed, or when question is expressed differently from how a child was taught (e.g., setting up a math problem by using information in a word problem).  Difficulties with inductive reasoning can also manifest as challenges identifying an underlying rule or procedure.
  • WMI: The WMI evaluates a child’s ability to sustain auditory attention, concentrate, and exert mental control.  Children are asked to repeat numbers read aloud by the evaluator in a particular order, and have memory for pictures previously presented.  Deficits in working memory often suggest that children will require repetition when learning new information, as they exhibit difficulties taking information in short-term memory, manipulating it, and producing a response at a level comparable to their same age peers.  It is also not uncommon for youth with self-regulatory challenges, as observed in Attention-Deficit/Hyperactivity Disorder (ADHD) to present with difficulties in working memory and processing speed (noted below).
  • PSI: The PSI estimates how quickly and accurately a child is able to process information. Youth are asked to engage in tasks involving motor coordination, visual processing, and search skills under time constraints.  Assuming processing speed difficulties are not related to delays in visual-motor functioning, weaker performance on the tasks which comprise the core subtests of the PSI indicate that a child will require additional time to process information and complete their work.  In the academic context, school-based accommodations may include allowing a child to take unfinished assignments home, focusing on the quality of work over quantity, shortening tasks, and allowing extended time.

In summary, IQ is more than one aspect of functioning and encapsulates several factors described above.  As a result, it is often more helpful to assess the indices which comprise a child’s FSIQ separately in order to best inform treatment and intervention.

Neuropsychology testing IL
NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!