brain-health-neuro

The 18+ Cliff: Navigating the Neuropsychological Transition to College

Fri, 20 Mar 2026 17:57:21 GMT

For many families in New Jersey , high school graduation is a milestone of celebration. But for students with ADHD, learning disabilities, or executive functioning challenges , it can also feel like standing at the edge of a cliff.

In K-12, the Individuals with Disabilities Education Act (IDEA) ensures the school is responsible for identifying, testing, and supporting your child. However, the moment a student steps onto a college campus, the legal landscape shifts. Access to support is no longer guaranteed—it must be sought out.

At Brain Health Neuropsychology , Dr. Ghilain serves as the bridge for this critical transition, providing the specialized documentation and cognitive strategies young adults need to succeed in higher education.

The Legal Shift: Moving from IEP/504 to the ADA

The most significant "shocks" for transition-age students (ages 17–22) are the changes in legal protections. In college, the Americans with Disabilities Act (ADA) and Section 504 take over.

In college, professors are not required to follow an IEP. To receive accommodations—such as extended time, distraction-reduced testing environments, or note-taking assistance —the student must "self-identify" to the Office of Disability Services with a current, comprehensive neuropsychological evaluation.

Why High School "Child Study Team" Testing Often Fails in College

Many New Jersey colleges reject evaluations that are more than three years old or conducted solely by a high school's Child Study Team (CST) .

Why? School-based testing is designed to determine eligibility for special education services. College disability offices, however, require proof of Functional Limitation . They need to see how a diagnosis specifically impacts a student’s ability to function in a rigorous, self-directed academic environment.

The "College Readiness Evaluation" Difference

A comprehensive evaluation at Brain Health Neuropsychology goes beyond a simple diagnosis. We provide:

Current Cognitive Profiles: Data-driven proof of how ADHD or processing speed impacts performance at the university level.
Executive Functioning Insights: Assessment of "management" skills—time management, task initiation, and organization—which are the primary barriers to college retention.
Clinical Justification for Accommodations: Clear evidence for the specific supports required to navigate 300-person lectures or cumulative three-hour final exams.

Expert Transition Support in Randolph, NJ

There is a notable shortfall of neuropsychologists in New Jersey specializing in the 17–22 age range. As a Double Board-Certified lifespan expert , Dr. Ghilain understands the "emerging adult brain."

She doesn't just hand over a report; she helps the student build meta-cognition . Understanding how their own brain works is the first step toward the self-advocacy they will need when meeting with a college dean or student support coordinator.

Is Your Student Prepared for the Transition?

If your child is a high school junior or senior, now is the time to update their testing. Waiting until they struggle in their first semester often means waiting months for an appointment while grades suffer.

We offer specialized Transition Evaluations for:

High school seniors heading to 4-year universities.
Community college students transferring to institutions like Rutgers, Montclair State, or TCNJ .
Young adults entering the workforce who require workplace accommodations .

Frequently Asked Questions (FAQ)

1. When should my child have a neuropsychological re-evaluation for college? Most colleges require documentation that is no more than three years old. We recommend scheduling an evaluation during the junior year or the first half of the senior year of high school to ensure the report is ready for college orientation and housing accommodation deadlines.

2. Can my child use their high school IEP to get accommodations in college? No. An IEP (Individualized Education Program) ends when a student graduates from high school. While it can serve as a history of services, colleges require a formal neuropsychological report that follows ADA guidelines to grant accommodations like extra time or private testing rooms.

3. What are "functional limitations" in a college setting? Functional limitations describe how a condition (like ADHD or Dyslexia) restricts a "major life activity," such as learning or concentrating. Colleges look for specific data showing that, without accommodations, the student is at a significant disadvantage compared to their peers.

4. How does a College Readiness Evaluation help with executive functioning? In college, students lose the "external brain" provided by parents and teachers. Dr. Ghilain’s evaluations identify specific gaps in executive functioning—such as working memory or emotional regulation—and provide a roadmap for coaching or strategies to manage a college-level workload.

Don’t let your student face the "18+ Cliff" alone.

Disclaimer: The information provided on this blog is for general informational purposes only and is not intended as, and should not be considered, medical advice. All information, content, and material available on this blog are for general informational purposes only. Readers are advised to consult with a qualified healthcare professional for medical advice, diagnosis, or treatment. The author and the blog disclaim any liability for the decisions you make based on the information provided. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

When Parents Seek Answers Too: The Value of Diagnostic Clarity for the Whole Family

Wed, 11 Mar 2026 15:37:18 GMT

At Brain Health Neuropsychology , one trend has become increasingly common over the last year. Parents come in seeking answers for their child—perhaps due to concerns about attention, learning, emotional regulation, or social development—and during the process, they begin to recognize familiar patterns in themselves. It is becoming more common for parents to schedule their own neuropsychological evaluations alongside, or shortly after, their child’s assessment.

As a lifespan neuropsychologist , I am uniquely trained in how to evaluate individuals across the full developmental spectrum—from early childhood through adulthood. This perspective allows me to understand how the brain changes and adapts over time, while taking into account how neurodevelopmental differences can look very different at various stages of life. When parents pursue their own evaluations alongside their child, it provides a unique opportunity to examine behavioral patterns across generations while taking each individual’s developmental context into account.

Far from being unusual, this experience highlights multiple important facts: neurodevelopmental and psychological traits often run in families, and access to diagnostic clarity is beneficial at all ages and stages. Parents often say, “I want my child to have the support I didn’t have when I was younger,” but those who seek these evaluations alongside of their child recognize that support can start at any age. When both a parent and child seek diagnostic clarity, the evaluation process can become an empowering journey for the entire family.

Recognizing Patterns Across Generations

Many of the conditions evaluated by a neuropsychologist—including ADHD, learning differences, autism spectrum disorders, anxiety or mood disorders, and executive functioning challenges— are strongly influenced by genetics and neurodevelopment.

When parents watch their child struggle with attention, organization, sensory sensitivities, or emotional regulation, it can trigger moments of recognition:

“That was exactly what school felt like for me.”
“I’ve always struggled with that too.”
“This wasn’t something we talked about when I was younger.”

For many adults, especially those who grew up in family situations where challenges were brushed off or framed as “lazy”, these realizations can be profound. A neuropsychological evaluation offers an opportunity to revisit these early life experiences to view them through a new lens—one grounded in neuroscience, psychological science, and an understanding of development across the lifespan.

The Power of Diagnostic Clarity

Receiving a diagnosis is not about labeling; it is about understanding. Neuropsychological evaluations help identify the unique cognitive, emotional, and neurological factors that shape how a person learns, processes information, and interacts with the world.

For both children and parents, diagnostic clarity can provide:

�� Language for lifelong experiences
Many individuals have spent years feeling “different” without understanding why. A diagnosis can help make sense of these experiences within a neurodevelopmental framework.

�� Access to appropriate supports and strategies
For children, this may involve school accommodations, targeted interventions, or therapy. For adults, it can include workplace strategies, coaching, or treatment approaches that teach them how to work with their brain, rather than against it.

�� Insight into strengths
Neuropsychological evaluations do not only identify challenges; they also highlight cognitive strengths, creativity, problem-solving abilities, and resilience. Strengths become the skills used to boost areas of weakness.

Because I work with individuals across the lifespan, I am uniquely trained to interpret results within a developmental context—helping families understand how these patterns may have looked in childhood, how they present in adulthood, and how they may evolve over time.

Reducing Guilt and Self-Blame

One of the most powerful outcomes of evaluation is the reduction of unnecessary guilt. Parents frequently worry that they may have “caused” their child’s struggles or that they could have done something differently. At the same time, many adults have carried their own quiet self-criticism for years—wondering why certain things have always felt harder for them than for others.

A neuropsychological framework helps shift the narrative from blame to understanding .

Instead of thinking:

“Why can’t I stay organized?”
“Why is school so difficult for my child?”

Families begin to ask:

“How does my brain work in these situations?”
“What environments help it thrive?”
“What strategies can support my success?”

This shift can be incredibly freeing for both generations.

Modeling Self-Understanding for Children

When parents pursue their own evaluations, they are also modeling something profoundly valuable: self-awareness and growth .

Children learn that seeking help is a sign of strength, not weakness. They see that understanding one’s brain is part of taking care of oneself—just like physical health.

Parents who go through this process alongside their child often demonstrate:

openness to learning about themselves
willingness to use new strategies
resilience in adapting to challenges

In a time when we are prioritizing both physical and mental health, modeling behaviors for children can have a profound impact, for generations to come.

Understanding the Brain, Supporting the Family

Seeking answers for a child can sometimes open the door to understanding an entire family’s cognitive and emotional landscape. For many parents, this process brings not only clarity, but also relief, validation, and a focused sense of direction.

As a neuropsychologist who evaluates individuals across the developmental lifespan , I have the privilege of helping families understand how brain development unfolds over time—and how patterns seen in childhood can often illuminate lifelong experiences in parents as well.

Neuropsychology offers the tools to transform confusion into understanding. When families walk that path together, the benefits can extend far beyond the evaluation itself.

If you are interested in learning more about neuropsychological evaluations for children or adults, please reach out . I welcome the opportunity to join with you on this journey.

Frequently Asked Questions About Neuropsychological Evaluations for Children and Parents

Can a parent discover they have ADHD or autism after their child is diagnosed?

Yes, this is actually quite common. Many neurodevelopmental conditions—such as ADHD, autism, and learning differences—have strong genetic components and often run in families. When a child goes through a neuropsychological evaluation, parents may recognize similar lifelong patterns in themselves, such as difficulties with attention, organization, sensory sensitivities, or social communication. In these cases, a neuropsychological evaluation can help adults gain clarity about their own cognitive profile and better understand how their brain works.

What are the benefits of a parent having a neuropsychological evaluation?

A neuropsychological evaluation can provide adults with meaningful insight into their cognitive strengths, learning style, attention, executive functioning, and emotional processes. For many parents, this leads to increased self-understanding, access to appropriate strategies at work and home, and greater confidence in supporting their child. When parents better understand their own brain, they are often better able to implement strategies that benefit the entire family.

Is it helpful for both a parent and child to go through the evaluation process?

Yes. When both a parent and child pursue evaluation, it can provide a deeper understanding of how neurodevelopmental patterns appear across the lifespan. This often reduces guilt or self-blame, improves communication within the family, and allows for more coordinated support strategies at home, school, and work. A lifespan neuropsychological perspective can help families understand how cognitive and emotional traits evolve from childhood into adulthood.

How do I know if my child needs a neuropsychological evaluation?

Parents often seek a neuropsychological evaluation when their child is struggling with attention, learning, emotional regulation, or social development. Signs that an evaluation may be helpful include persistent academic difficulties, challenges with focus or organization, emotional or behavioral concerns, or questions about conditions such as ADHD, autism, or learning differences. A comprehensive neuropsychological evaluation examines how a child’s brain processes information and can provide clear diagnostic insight along with practical recommendations for school and home.

What is the difference between a psychological evaluation and a neuropsychological evaluation?

A psychological evaluation typically focuses on emotional functioning, personality, and mental health concerns such as anxiety, depression, or behavioral challenges. A neuropsychological evaluation, by contrast, examines the relationship between the brain and behavior. It includes detailed testing of cognitive functions such as attention, memory, executive functioning, language, processing speed, and learning. This type of evaluation can help clarify neurodevelopmental conditions such as ADHD, autism spectrum disorder, and learning disabilities, while also identifying cognitive strengths and areas for support.

Can adults benefit from a neuropsychological evaluation even if they were never diagnosed as a child?

Yes. Many adults were never evaluated during childhood because awareness and acceptance of neurodevelopmental conditions has increased significantly in recent years. Adults may seek evaluation after recognizing long-standing patterns of attention difficulties, learning challenges, sensory sensitivities, or executive functioning struggles. A neuropsychological evaluation can provide valuable insight into how an individual’s brain works, clarify diagnoses such as ADHD or autism, and offer strategies to support success in work, relationships, and daily life.

A Neuropsychologist’s Guide to Autism Spectrum Disorders

Mon, 13 Oct 2025 10:00:30 GMT

In January 2020, the American Academy of Pediatrics published updated guidelines for the identification, diagnosis and treatment of individuals on the autism spectrum . In today’s post, I walk through the behaviors that are consistent with an autism spectrum disorder.

Autism Defined

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by deficits in social communication/language as well as restricted repetitive behaviors (RRB). While always discussed as a “spectrum,” ASD is now the umbrella term that encompasses many previously unique or stand-alone diagnoses including: Autistic Disorder, Asperger’s Disorder, Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS), Childhood Disintegrative Disorder and Rett Disorder. While there are many opinions about the combination of these disorders, the core symptoms and diagnostic features remain largely the same.

So, let’s briefly review those behaviors that are identified in each domain. Social communication deficits come in many forms. Clasically, it is described as having difficulty with the back-and-forth, or reciprocal nature of social discourse. For example, an individual may only want to talk about their own interests, or may not ask questions of the other person. Their comments may reflect thoughts in their own head, rather than be reflective or appropriate to the conversation at hand. It may be that a child has difficulty understanding sarcasm, or takes comments literally that are meant figuratively (e.g., “Don’t count your chickens before they hatch” may be challenging to understand). There are cases where an individual does not understand when to stop talking about an area of interest, while other cases where the individual is not able to initiate conversation or to join in with others. There may be difficulties with the use and understanding of gestures, nonverbal language (e.g., body language, facial expressions), and appropriateness of eye contact. Again thinking of this as a spectrum, some individuals have difficulty making and sustaining eye contact in conversations. Others may “lock eyes” onto the individual they are speaking with and may not realize when to glance briefly away. Similarly, there may be difficulties or uncertainties when engaging with peers. While some individuals with ASD may be perfectly content to play alone and do not feel compelled to seek out same-aged peers, others desperately want that form of engagement but are unsure or unskilled at securing those friendships. There are many other examples of social communication deficits, but these few examples demonstrate the vastness of the ASD spectrum.

Restricted and Repetitive Behaviors are the second component of the diagnostic criteria. These may manifest as intense interest in a particular topic, repetitive actions (e.g., flicking a doll’s eyelashes, hand flapping/body rocking, lining up of toys or other objects repeatedly), insistence on sameness in the placement of objects or in the following of a daily routine, or repetitive repetition of phrases or quotes. Often these individuals have a difficult time with unexpected change, or have an intense response to a loud or sudden noise (e.g., fire alarms, car horns, large crowds). Savant skills are also captured under this domain, as often individuals on the autism spectrum are known to have incredible talents in art, math calculation (have you ever seen Dustin Hoffman in “Rainman”?) or knowledge of historical facts- among many other examples. Atypical sensory responses are also discussed under RRB . Specifically, some individuals may show reduced sensitivity to pain or may have a particularly unique response to changes in light patterns or sound. They may fixate on these interests, or may excessively touch or smell or gaze upon a particular object. Again illustrating the vastness of the spectrum, some responses are considered hypoactive (not strongly affected), while others are hyperactive (intensely responsive).

Hopefully by now, the image of the “spectrum” makes more sense. Nonetheless, with the great advancements of research into identification, diagnosis and treatment, there are many wonderful, evidence-based supports for children with ASD, their siblings and families. Before delving deeper into the supports available and the typical diagnostic process, it is important to note that many individuals with ASD are deeply (and rightfully!) proud of their diagnosis. This is particularly common in those individuals previously diagnosed with Asperger’s Disorder, or those on the higher-functioning end of the spectrum. A diagnosis of ASD does not stifle or hinder them, but rather allows them to celebrate their uniqueness and gives them a space in which to feel special. While the initial diagnosis can be a shock to some families, others express a deep sense of relief that they have gained valuable insight into their family member. This knowledge is empowering, and allows families to see appropriate treatments or supports for their loved ones.

Diagnosis

Step one is the diagnostic process. Please check out Dr. Ghilain’s blog discussing the importance of early intervention and the tremendous outcomes that follow when individuals are properly diagnosed and subsequently provided appropriate supports early in life. To evaluate for ASD, neuropsychologists will complete a comprehensive evaluation looking at cognitive, behavioral, social and emotional functioning. It will involve interviews with parents or family members, and multiple assessments. While this may initially sound daunting, families are comforted by the amount of time we spend with them and their child, and are appreciative of the opportunity to share concerns and receive feedback. It is also not uncommon for individuals with ASD to have co-occuring diagnoses, such as Attention-Deficit/Hyperactivity Disorder (ADHD), mood difficulties (e.g., depression, anxiety) or other neurological conditions (e.g., epilepsy). Each of these components needs careful evaluation, and families need a plan for how to intervene going forward.

Evidence-Based Therapeutic Interventions

Once diagnosed, many evidence-based therapeutic interventions are available. “Evidence-based” is important, as this means that there is research to support not only its use with individuals on spectrum, but proof that the therapy works in the way that it claims. Unfortunately, there are many programs, classes, and interventions that tout huge impacts, with little evidence to support their claims. This can be frustrating when we hear parents share that they spent thousands of dollars on a therapy program that provided little to no benefit to their child. Our recommendations are well-established and scientifically supported. Broadly, some of the most common interventions for individuals with ASD include Applied Behavioral Analysis (ABA) therapies, or social skills groups such as the UCLA Peers Program. Just as every individual on the spectrum is unique, we tailor interventions to the child based on their personal needs.

We also acknowledge that an ASD diagnosis has differential impacts on each member of the family. Siblings, parents and others may benefit from support to adjust to this new diagnostic label, interact with their child in meaningful ways, or prepare for the future. Recommendations for all family members are provided during our evaluation.

So why does it seem like the rates of diagnosis are increasing so dramatically? In short, there is a better understanding of the behavioral characteristics of ASD. Therefore, parents, educators, and physicians are able to diagnose and intervene at the earliest stage possible. There is also a reduced stigma associated with the diagnosis, and many interventions available. While we have a long way to go with destigmatizing diagnoses, it appears more individuals are seeking the diagnosis for their child when the smallest concern arises. Encouragingly, there is evidence to support that some individuals “grow out of” or stop meeting diagnostic criteria for ASD as they mature. This is often associated with higher intellectual functioning, milder symptom presentations, and more intensive interventions at younger ages. While this is not the case for all children, it again is reflective of the vastness of the ASD spectrum.

A Neuropsychologist’s Guide to Concussion: Promoting Facts over Media-Sensationalized Fiction

Fri, 22 Oct 2021 10:46:20 GMT

The discussion of concussions has exploded in popular media in the last few years. It seems nearly every popular media site has done at least one or two pieces, sometimes many more, on the impacts of concussion and its related symptoms. In today’s blog post, Dr. Ghilain goes over the symptoms of concussion and provides readers with the facts- while dispelling common myths.

What is a Concussion?

A concussion is a mild blow to the head that causes a neurochemical response in the brain. It is described as neurochemical because there is no change to the physical structure of the brain itself. Common causes of concussion include falls, sports injuries (such as collisions on a football field or head-to-head contact during a soccer game), or the accidental striking of the head on an object.

Typically, the initial symptoms of a concussion can include dizziness, lightheadedness, sensitivity to light or sound, nausea, feelings of fogginess, clumsiness, or other similar experiences. It is possible that the individual might lose consciousness for a brief period of time or may have difficulty recalling details about events that occurred just prior to the concussion. Neck sprains or tightened neck muscles are common and can cause stiffness and headache pain as well. All of these symptoms are completely normal, and these symptoms typically subside within a couple of weeks.

If the individual is taken to an emergency department for evaluation immediately following concussion, it is unusual for a hospital to complete a brain scan (e.g., a head CT or MRI). Typically, a scan is not ordered unless the person is coming in and out of consciousness, difficult to arouse, repeatedly vomiting, or having seizures. These symptoms are indications that a more significant brain injury may have occurred. If a scan is ordered (out of an abundance of caution), brain neuroimaging is typically normal following concussion- hence why it is rarely ordered.

What is important for parents/family members to realize, as well as the individual who suffered the concussion, is that the concussion sufferer will likely feel not so great for a couple of weeks. They may have difficulties sustaining focus and attention, may sleep more or less than usual, and may have ongoing headaches, light sensitivity, or general feelings of fogginess. Again, this is completely normal and will subside. It is important to know that symptoms of a concussion, while inconvenient, will go away. Individuals will recover fully from a concussion and resume a perfectly normal life.

Why can recovery take longer for some people?

So why is it that some individuals seem to have a concussion that goes on much longer than a few weeks? Research has demonstrated that there are five major factors that can cause an individual to experience symptoms of a concussion for longer than expected. Nonetheless, these individuals also recover fully, it just takes them a bit longer.

These exacerbating factors include:

a history of a learning disability
attention deficit hyperactivity disorder (ADHD)
a previously diagnosed concussion
a history of migraine headaches
a history of mood disorder (e.g., depression, anxiety)

As you can see, there are many reasons why an individual may experience additional concussion symptoms for longer than a few weeks. In these cases, symptoms may last closer to a month or two, but then will subside.

Myth Busting!

Getting into some of the myths that are floating around popular media, while a concussion is termed a mild traumatic brain injury (mTBI), it does not mean the individual is brain damaged. It also does not mean that the individual will not recover. As discussed above, individuals recover fully from a concussion and neuroimaging (in the rarest of cases when it is ordered) is normal.

A second myth is that the individual requires a dark room with little to no stimulation for weeks on end to promote recovery. In next weeks blog, Dr. Ghilain will discuss ways to support rapid recovery following concussion. Though Dr. Ghilain creates “return to sport” and “return to learn” protocols specifically tailored to the individual patients with a concussion they see, there are general things family members can do to promote recovery. While supports may be encouraged, it is important to note that these are temporary and not permanent modifications to a person’s life.

Finally, during the recovery period, individuals may experience an increase in concussion symptoms while exerting themselves (e.g., when gradually returning to activities or sports or when initially returning to work or school). Though uncomfortable at times, these symptoms do not mean that the individual is further “damaging” their brain. Just like any other muscle in the body, the brain requires gradual ramping up of activities that may temporarily cause soreness (e.g., headache) or fatigue. This is not a sign that the person is re-injuring or damaging their brain in some way, it means they are on the road to recovery!

Attention Deficit Hyperactivity Disorder (ADHD): A Neuropsychologist’s Review of the 3 Types

Fri, 01 Oct 2021 10:37:21 GMT

Attention Deficit Hyperactivity Disorder (ADHD) is a common disorder seen in my practice. Often co-occurring with other diagnoses such as dyslexia or epilepsy, my clients are often surprised to learn that ADHD is diagnosed based on 3 different behavioral profiles. In today’s blog, I share the 3 different types of ADHD, and the reasons why some individuals may be diagnosed as a child, while others may not be diagnosed until later adolescence or adulthood.

ADHD-H: The Hyperactive Client

When I think about how ADHD is portrayed in the media, the hyperactive subtype comes to mind. Perhaps you can think of someone who struggles to sit still, or acts as though they are powered by a motor! These individuals, try as they might, have difficulty containing their energy and are often moving about their space. In young children, this might be reflected in a child who bounces from toy to toy. In teenage years, this looks more subtle, such as a teen constantly tapping his or her toes or flicking a pen cap or paper clip. When able to release their energy, such as by sitting on a stability ball or shifting their weight when standing, these individuals can focus and attend to their surroundings.

ADHD-I: The Inattentive Client

Less well known is the Inattentive subtype of ADHD. Individuals with ADHD-I may look like they are paying attention, but they are frequently distracted. You may notice their attention is quickly pulled to other things going on in their environment, or they may look like they are zoning out or daydreaming. Often, ADHD-I is not diagnosed as early as the other subtypes, as children appear behaviorally complaint. They do not catch a teacher’s eye for being disruptive, and thus they are more likely to fly under the radar.

ADHD-C: The Combined Presentation

Individuals with ADHD-C struggle with both hyperactivity (ADHD-H) and inattention (ADHD-I). They are often diagnosed early because of their hyperactive traits, but upon further testing, they struggle to sustain their attention to longer or more monotonous tasks.

ADHD: Behavioral Intervention or Medication?

As a neuropsychologist, I am a behaviorist at heart and do not typically recommend medication as an initial treatment strategy. However, there are some clients who benefit from medication to allow them to regulate their behavior long enough to learn those behavioral strategies I recommend. While parents understandably struggle with placing their child on medication, it is often a time-limited strategy that can be removed as the child matures. Without a doubt, there are many behavioral strategies that can be implemented and tailored to a person with ADHD. To learn more about ADHD and the diagnostic process, check out my YouTube video !

When A Neuropsychologist Recommends A Section 504 Plans vs. Individualized Education Programs (IEPs)

Wed, 01 Sep 2021 10:43:16 GMT

As a neuropsychologist, I work with schools to support struggling students. I enjoy this aspect of my job, as it brings together two of my biggest academic passions: education and neuropsychology. You may not know this, but I was both a psychology and education major in college and had thought I would become a teacher after graduation. Growing up with a mom who worked as a special education teacher for over three decades, teaching just felt like it was in my blood. I worked as a substitute teacher in New Jersey when home on college breaks, and I absolutely loved working in schools.

Though my career evolved from teaching to clinical neuropsychology over the years, my interest in supporting students remains to this day. So, in this blog post I want to discuss the differences between Section 504 Plans and Individualized Education Programs (IEPs). I often recommend one of these plans based on the results of my evaluation, but it is important for parents to understand the differences between these two types of service plans and why one plan may be recommended (or supported) versus another.

Section 504 Plans

Let’s start with a Section 504 plan. Stemming from Section 504 of the Rehabilitation Act of 1973, this federal civil rights law was put into place to stop discrimination against people with disabilities. A Section 504 Plan outlines how schools will provide support to a student who has a disability without removing the student from their classroom setting. Students who have a Section 504 plan remain with their peers, and the services are based on changes to the environment that allow students to learn or more easily access classroom material.

Section 504 plans apply to any child with a disability, though the disability has to interfere with the child’s success in learning in a general education classroom setting. It is most often a written document outlining specific accommodations, supports or services for the child. Technically, it does not have to be written, but I’ve never come across a verbal Section 504 plan! There is no specific expectations around who is involved in the creation of a Section 504 plan, but often parents, a teacher, and the principal (or other school representative) are involved.

Individualized Education Programs

Shifting gears to an Individualized Education Program (IEP), this type of plan stems from a federal special education law for children with disabilities called the Individuals with Disabilities Education Act (or IDEA). An IEP is granted if a child has one (or more) of the 13 disabilities outlined in IDEA. You can learn more about the different classifications here. If you are looking for the full New Jersey State Regulations, check this page out for more information. The disability must negatively impact a child’s ability to learn, and the child must require specialized instruction to make progress. Often, this means the child would benefit from services outside of the general classroom setting, which may include pull-out instruction, supportive therapies (speech/language, occupational or physical therapy) or other supplemental services.

The IEP is created by a very specific team of individuals, including the child’s parents, a general education and special education teacher, a school psychologist, and someone who represents the district. IEP update meetings must occur yearly, and the child is reevaluated every 3 years to be sure he or she remains eligible for services. IEP plans are formal, written documents, that include information about the child’s level of academic functioning, specific goals and progress monitoring, support services and their frequency/duration, as well as accommodations and modifications. It is important to note that an accommodation is made to a child’s environment, allowing the child to more easily access the content he or she is learning. Modifications, on the other hand, are changes to the class content or curriculum itself.

With both Section 504 and IEPs, parents are notified when changes are made. While Section 504 changes do not have to be in writing, changes to an IEP must be made known to a parent in writing before they are initiated.

With regard to the evaluation process that occurs every 3 years, a parent or guardian has the right to request an Independent Educational Evaluation (IEE), though the district does not have to agree to it. Similarly, a family can choose to have their child independently evaluated outside of the district, but again, the district does not have to accept the evaluation. Though I am not aware of any district “rejecting” my evaluation, I strive to be a beneficial resource to both school personnel and families. I cover all the domains that a school evaluation includes (e.g., overall intellectual functioning, academics, social and emotional functioning), but extend the evaluation to include measures of executive functions, memory, language and visuospatial functioning, adaptive functions or daily independence, etc. You can read more about the IEE process by clicking here .

Overall, Section 504 Plans and IEPs provide different types of services and supports to children who need them. It is best when parents and school personnel can agree to these plans without conflict, but there are formal processes that can be initiated if disputes arise. Hopefully, if you are reading this blog, those processes do not pertain to you!

As this new school year begins, I wish all families, educators, and students a happy and successful year ahead!

What To Expect During A Neuropsychological Evaluation

Sat, 03 Jul 2021 10:28:39 GMT

When an individual comes for a neuropsychological evaluation, they are often unsure of what exactly to expect. In today’s blog post, I will review what to expect during a neuropsychological evaluation: from scheduling through feedback!

Initial Phone Consultation & Appointment Scheduling: Typically, a family member will call to request an appointment, either for themselves or for a loved one. At this time, I will ask about current concerns, explain the steps of the evaluation, and schedule the appointment. This is a great time for family members to ask questions and learn more about the process.
Intake Appointment: I schedule the 1-hour intake interview with the client (or parent) approximately 1-2 days before the full-day evaluation. During this HIPAA-secure video call, I will ask about current concerns, gather the client’s history (e.g., medical history, educational history, etc.) and further outline what to expect on the evaluation day. For those that prefer, the intake interview can occur on the day of the evaluation, but I find that most families welcome the opportunity to speak candidly about their concerns from the comfort of their own homes.
Evaluation Day: Evaluations last from approximately 9:00 in the morning to mid/late afternoon. I block the full day for the client, leaving ample time for rest breaks, brain breaks, and lunch! The client spends the day completing various tests or activities, including paper and pencil tasks, iPad tasks or computerized tasks that assess the different ways the brain is working. I assess memory, speed of processing, language, attention- the list goes on! The evaluations are comprehensive in order to gain a full picture of the individual’s thinking, learning, emotions and behavior.
Report & Feedback: Within 2 weeks, a comprehensive report is provided to the client or family. This includes information gathered during the initial interview, the results of the testing, a summary and integration of findings, provision of any diagnoses I feel are appropriate, as well as a list of home, school/vocational, and community-based recommendations. I most often schedule a video conference to review the report and my recommendations, though clients are welcome to return to the office if they would prefer to review the results in person. I want to be sure the information makes sense, and that families feel well-equipped to navigate the recommendations provided.

Though the evaluation is typically a one-day process, I remain available to clients, families and their related service providers to answer questions, discuss recommendations, consult with schools, and provide support. I am happy to hear when clients or family members are thriving, and equally as motivated to assist if future challenges arise.

I am grateful to families for entrusting me with the care of their loved one. I look forward to an ongoing partnership – here’s to many successes ahead!

Welcome to Brain Health Neuropsychology!

Wed, 05 May 2021 10:52:54 GMT

Welcome to Brain Health Neuropsychology! My name is Dr. Christine Ghilain and I am a board-certified clinical neuropsychologist in private practice. I wanted toy introduce myself, and to walk through some of the key pages on my website where you can find information about the clients I serve and the services I provide.

A Review of the Website

To begin, the home page welcomes you to the site, and points out those unique qualifications that separate me from other neuropsychologists who might have popped up on your google search. To that end, clicking on Meet Dr. Ghilain gives you more information about my education and q ualifications as a neuropsychologist, some of the most common neurological or developmental conditions I see in my practice, as well as a selection of recent talks and presentations I gave at national and international conferences. I include this information so that you can feel confident that I attained the appropriate training and have the skills necessary to serve you or your family’s needs. I’ll touch on conscious consumerism in a future blog! Unfortunately, there are some individuals who call themselves neuropsychologists who have not met even the minimum standards of competence in the field. Thus, I am happy to be transparent about my background and training.

So what is neuropsychology all about? Some of the first questions I answer when clients call to schedule with me include: (1) what exactly is a neuropsychological evaluation , and (2) why would someone need to seek out a neuropsychologist for an evaluation? Therefore, I included pages on the site discussing those two very common questions! I include other common questions that arise when individuals call to learn more about the process, and I am always glad to talk through additional concerns of family members. Future blog posts will address these two main questions, but for now, clicking the links to learn answers to those questions.

I see individuals for evaluations across two broad categories: clinical and forensic. Clinical evaluations are for individuals who notice changes to their thinking, learning or productivity, or for those who struggle at school or work. For infants, this may be due to an early stroke in utero or delayed developmental milestones. For preschool-aged children, this evaluation can provide an understanding of whether the child is ready for kindergarten, or if they need to be set up with a school support as they enter elementary school. Across late childhood and teenage years, I see clients whose parents are concerned for attention difficulties, disorganization, sadness, worrying, or learning challenges (amongst many other things!).

In adulthood, I see individuals who may have struggled their whole life with difficulties socializing or maintaining consistent employment. Others may have suffered a stroke or brain injury, and want to understand how their injury may impact their functioning as they age. Finally, in older adulthood, clients see me with concerns for dementia, changes to their mood, or difficulties at work. A family member can also bring them due to personality changes, for example. Often, an individual who is diagnosed with a neurological or developmental condition comes to me to understand how they can maximize their success in the context of their diagnosis. My goal is to empower clients to use their areas of strength to bolster areas of weakness. My clients leave with a roadmap for exactly how to do just that!

On the forensic side, I see clients who have known or suspected brain injury or insult as a result of an accident or incident. They may be seeking financial compensation, or they may be referred by their insurance company in order to determine their eligibility for disability benefits. Finally, I am often retained by school districts to complete Independent Educational Evaluations. These evaluations support schools in providing the best services for their students.

In the final pages of this site, I answer frequently asked questions, blog about new topics of interest, and provide a method for interested individuals to contact me for consultation . I look forward to providing more information in the weeks, months and years ahead!