Author: NRS Lifespan

The current zeitgeist in neuropsychological “brain health” is a significant wellness trend that has made its way from physical fitness to proactive cognitive health. It focuses upon a number of clinical areas that our neuropsychological rehabilitation staff, including our nationally recognized resident/fellowship students program employing strategies unique to the patient’s profile (sui generis). Neuropsychological “brain health” goes beyond the unfortunate current phenomenon of “diagnose and adios” that is sweeping our profession. Our program utilizes a comprehensive approach, since the neuropsychological examination (NPE) is merely one component of the total package of “neuropsychological care.”  That is, it provides the diagnosis which becomes the “blueprint” for treatment be it, neuropsychological (medical adjustment counseling) or psychological (psychotherapy). We additionally include a variety of original services that serve our population from pediatric to geriatrics.

Areas we focus upon in the “brain health” movement are proactive and holistic that go beyond the conventional reactive treatment to preventative care viewing the brain as needing proper daily nourishment, much like the body. Additionally, the patient’s lifestyle is analyzed in terms of proper diet, exercise, quality sleep, stress management and social engagement. This is followed by our clinical health psychology section. This focus applies to pediatric (home, school, health, social skills, etc.) but also geriatric with the boomers living longer with attention directed at their safety. We have 10 areas that we emphasize for the senior population regarding safety going beyond merely testing their cognition for independent living skills.

Another area our program focuses upon is basic conversation regarding education around cognitive health, particularly with early thinking decline and the more progressive dementia cases. There are things that can be do done to make the situation better, not cured, but better!

In summary, our staff and resident/fellowship students provide the best care for the patient and family, who is unique in all ways, warranting specialized treatment for their needs, be it child, adolescent, mid-life, or senior. We provide in-person care, you are not a number or a quick zoom call, rather our utmost concern.

The neuropsychological zeitgeist “brain health” is an achievable, integrated part of our service/treatment. Not just avoiding the pediatric pitfalls or the senior dementia situation, but for employing every approach to enhance everyday cognition/thinking using science and lifestyle changes to optimize independent functioning, be it for the child or adult, we are here to provide you the best care!

Robert B. Sica, PhD, ABN
Board Certified, Neuropsychologist
Owner/Principal Partner of NRS|LS

The concept that exercise improves mental health is widely accepted. Research across psychology, neuroscience, and medicine has continuously reinforced this idea. However, the typical person may not consider the biological mechanisms that explain why exercise has such powerful effects on the brain. One of the most influential biological explanations for this phenomenon is the role of neurotrophic factors. This blog explains what neurotrophic factors are and explores how exercise influences these important biological processes to support brain health and mental well-being.

Neurotrophic factors are proteins that help brain and nerve cells grow, survive, and function properly. To break it down, “neuro” refers to the brain and nerve cells, while “trophic” refers to nourishment and growth. Therefore, neurotrophic factors are responsible for the growth, protection, and maintenance of brain and nerve cells throughout life.

One of the most important and well-studied neurotrophic factors is the Brain-Derived Neurotrophic Factor (BDNF).  BDNF helps brain cells grow, survive, and communicate, and is essential for brain development, learning, memory, and neuroplasticity. It functions by binding to specific receptors in the brain, which activate signaling pathways that regulate gene expression, promote cell survival, and strengthen neural connections.

Because of its wide range of functions, BDNF has become a focus of research relating to mental health, neurological disorders, and overall brain function. In the context of mental health, BDNF is associated with improved mood and reduced symptoms of anxiety and depression. BDNF plays an essential role in how the brain regulates mood, stress, and emotional functioning. Healthy levels of BDNF are associated with effective brain cell communication, especially in the hippocampus and prefrontal cortex, the brain areas involved in emotion. When these areas function well, people tend to have better emotional regulation and resilience to stress. Through its role in neuroplasticity, the brain’s ability to change and form new connections, BNDF supports recovery from stress, trauma, and emotional challenges.

This information leads to the fundamental question: How can BDNF production be increased? Studies have shown that one of the most natural and effective ways to increase BDNF levels is through aerobic exercise. Activities such as walking, running, and cycling have shown to increase BDNF production in the hippocampus, the area of the brain associated with learning and memory.

As BDNF levels increase with regular physical activity, the brain is better equipped to grow new neurons, strengthen connections, and regulate emotions more effectively. This biological response helps explain why exercise has been linked to better mood, enhanced cognitive performance, and reduced symptoms of anxiety and depression. Understanding the role of neurotrophic factors, particularly BDNF, shifts the conversation from exercise being a strictly behavioral benefit to a necessity for overall brain health. Exercise is not just a temporary solution to make us feel better, but an essential activity for the growth, survival, and resilience of brain cells. In essence, the science behind neurotrophic factors reinforces the powerful truth that exercise not only strengthens the body but is also a critical driver for brain growth, cognitive function, and mental resilience.

Gia Landino
Monmouth University

This blog post focuses on the topic of health anxiety – a sneaky form of anxiety that can show up at any point in life because, after all, our physical bodies can be noisy, ill, confusing to us and/or doctors, and subject to aging, disease, and, eventually, death. It’s estimated that 20-30% of Americans are preoccupied with their health and that one-third of those with chronic illnesses have a high level of health anxiety (6-8% of the US population is diagnosed with a health anxiety disorder). But, what differentiates “normal worry” about health from “preoccupation” from “health anxiety disorder”? Here’s some points to consider:

1)   Level of dysfunction: How much does thinking about your health interfere with your life or ability to function? Are you having trouble sleeping at night? Do you avoid going out, socializing, or traveling? Are your relationships being impacted by being avoidant, non-commital, scared, or talking repeatedly about your health? Are you having difficulty concentrating in school or work? Did you have to stop working or going to school because physical symptoms dictated what you did each day?

2)   Level of avoidance: Related to the above points, a defining feature of anxiety is behavioral avoidance. For instance, if someone fears having a heart attack because of heart palpitations or an abnormal EKG, he or she might avoid exercising or lifting heavy things to avoid elevating his or her heart rate. For an IBS patient, he or she might avoid going out to eat with friends, drive in a car or be anywhere where the bathroom is not close. Avoidance creates the perception of safety but actually reinforces the fear in the long run.

3)   Level of mental rituals: When a thought or singular episode of worry becomes repetitive, cyclical, or prolonged, it can signal pathological health anxiety. What starts out as productive problem-solving (for example, “I have numbness in my left leg, I should call a neurologist to have it checked out”) turns into rumination, which is a form of unproductive stewing that consumes a large degree of time, energy, and focus. Ruminating has 2 goals – to reduce distress or reduce uncertainty – by trying to achieve an “aha” moment of understanding. But, instead, ruminating is a tease – it’s like trying to solve a 1,000 piece puzzle but you’re missing pieces and you don’t even know it; you can’t solve the puzzle and you’ll get more upset the longer you try.

Health anxiety can be treated by a clinical or health psychologist in an outpatient setting, optimally in collaboration with medical providers. It’s important to remember that a person’s experience of physical symptoms and/or sensations is real and of course warrants legitimate medical evaluation before being viewed through a health anxiety lens. A combination of structured “talk therapy” (cognitive-behavioral, motivational interviewing) and exposure therapy targets the thinking and behavior patterns that undermine functioning and good quality of life. Research suggests that psychotherapy is successful in 60-65% of cases and medications for anxiety symptoms aid in 40% of health anxiety cases. This is a reminder that, like any chronic medical condition, there is no one singular solution but that good long-term management requires multiple tools, resources, and providers in the mix.

If you or someone you know is interested in a consultation appointment or treatment for this issue, call our office 732-788-7645 to schedule an appointment with a clinical health psychologist.

Dr. Lauren Gashlin

Health Psychologist

When people are told that something may be affecting their brain, there is often an immediate assumption that a scan will show visible damage. In clinical practice, however, many of the cognitive, academic, emotional, and behavioral difficulties observed in both children and adults often occur without any clear abnormalities on MRI or CT imaging. Understanding the distinction between structural and functional brain changes is crucial for accurate diagnosis, effective intervention, and informed advocacy.

Structural brain changes refer to physical or anatomical alterations in the brain tissue itself. These changes are typically visible on neuroimaging and may result from conditions such as stroke, traumatic brain injury, tumors, cortical malformations, neurodegenerative processes, or surgical intervention. Because these changes affect the brain’s physical structure, they are often conceptualized as problems with the brain’s “hardware.” Structural abnormalities can be associated with specific patterns of impairment, depending on their location; however, outcomes vary widely due to neural plasticity and individual differences in cognitive reserve.

Functional brain changes, in contrast, involve how the brain operates rather than how it is physically formed. In these cases, standard imaging may appear entirely normal, yet the individual experiences real and persistent difficulties in daily functioning. Functional changes reflect inefficiencies in neural networks, problems with communication between brain systems, or dysregulation of cognitive and emotional processes. Conditions such as ADHD, learning disabilities, epilepsy-related cognitive effects, anxiety disorders, post-concussion symptoms, medication side effects, sleep disruption, and chronic stress commonly involve functional rather than structural changes. These patterns affect the brain’s “software,” influencing how efficiently information is processed, regulated, and sustained over time.

One of the most common misconceptions in medicine and education is that normal imaging equates to normal functioning. Neuroimaging is designed to detect structural abnormalities, not to measure how the brain performs under cognitive load, across extended periods, or in complex real-world environments. As a result, individuals may be told that “everything looks normal” while continuing to struggle with attention, memory, processing speed, emotional regulation, academic performance, or endurance. This disconnect can be particularly confusing and frustrating for families and patients seeking answers.

This is where neuropsychological evaluation plays a critical role. Neuropsychology focuses on how the brain functions in practice by assessing attention, memory, language, executive functioning, processing speed, and emotional regulation through standardized, performance-based measures. Rather than relying solely on structural findings, neuropsychologists interpret patterns to understand how efficiently neural systems are working together. These evaluations provide essential insight into functional brain changes that are not captured on scans or EEGs.

Distinguishing between structural and functional brain changes has important clinical and educational implications. When functional difficulties are misunderstood or minimized due to normal imaging, individuals may experience delayed diagnosis, inadequate support, or inappropriate expectations. Functional brain changes are no less real or impactful than structural ones, particularly in children whose brains are still developing and in individuals managing chronic neurological or medical conditions.

Ultimately, neuropsychology bridges the gap between medical findings and everyday functioning. By translating brain-based patterns into meaningful explanations and practical recommendations, neuropsychologists help individuals, families, schools, and treatment teams understand not just what the brain looks like, but how it actually works. A normal scan does not necessarily reflect a normal experience, and recognizing functional brain changes is often the key to effective intervention and improved quality of life.

Laura Brockman, PsyD
NJ Temporary Permit #: 253-033
Postdoctoral Fellow

Parents are often told their child is “so smart, but…”
So smart, but struggles in school.
So smart, but disorganized.
So smart, but emotionally dysregulated.

For many families, this puzzling combination reflects twice exceptionality, commonly referred to as 2e. Twice-exceptional children have both high intellectual ability and a learning, attention, or emotional challenge. Because these children show remarkable strengths alongside real difficulties, they are often misunderstood, overlooked, or incorrectly labeled.

A twice exceptional (2e) child is a child who is intellectually gifted and has a co-occurring neurodevelopmental, learning, or emotional condition. Common co-occurring diagnoses include:
• Attention-Deficit/Hyperactivity Disorder (ADHD)
• Learning disabilities (such as dyslexia, dysgraphia, or dyscalculia)
• Autism Spectrum Disorder
• Anxiety or mood disorders

Twice exceptional children often show a highly uneven profile of development.
Cognitive and personal strengths may include:
• Advanced vocabulary or verbal reasoning
• Exceptional creativity or imagination
• Strong problem-solving skills
• Intense curiosity or deep, focused interests
• Advanced understanding of complex topics
Areas of difficulty may include:
• Organization, planning, and time management
• Sustaining attention or regulating effort
• Written expression or academic output
• Emotional regulation or frustration tolerance
• Social communication or peer relationships
• Perfectionism or fear of failure

Why 2e Children Often Struggle in School
Despite high ability, many 2e children experience significant school-related challenges.
They may:
• Underachieve relative to their intellectual potential
• Appear inconsistent in performance
• Become easily frustrated or emotionally overwhelmed
• Avoid tasks that expose areas of weakness
Because of their intelligence, these children are sometimes perceived as lazy, unmotivated, or even oppositional. Over time, this misunderstanding can lead to anxiety, reduced self-confidence, and negative feelings about school.

How Neuropsychological Testing Helps Identify 2e Profiles
A comprehensive neuropsychological evaluation is necessary to identifying twice exceptionality.

Neuropsychological testing allows clinicians to:
• Assess intellectual strengths and reasoning abilities
• Identify subtle learning differences
• Evaluate attention and executive functioning
• Understand emotional and behavioral functioning
• Explain discrepancies between potential and performance

Rather than focusing on a single score, neuropsychological assessment examines the whole child, revealing how strengths and weaknesses interact in daily life.

Supporting Twice Exceptional Children

Support at School
Helpful strategies may include:
• Individualized Education Programs (IEPs) or 504 plans
• Accommodations for executive functioning challenges
• Explicit instruction in organization and planning
• Opportunities for advanced or enriched learning
• Flexible ways to demonstrate knowledge
Support at Home
At home, support should focus on:
• Validating both strengths and challenges
• Encouraging self-advocacy
• Reducing perfectionistic pressure
• Emphasizing growth and effort over output
• Helping children understand how their brain works

Twice exceptional children are not defined exclusively by their strengths or their struggles. They are defined by the interaction between the two. When giftedness and challenges are both recognized and supported, 2e children can thrive academically, socially, and emotionally. With the right understanding and strategies, these children can learn to embrace their unique profiles and reach their full potential.

Natalie Angelo, PsyD
Pediatric Neuropsychology Fellow

Standardized tests play a major role throughout education. While these assessments are designed to measure cognitive abilities and academic skills in a consistent way, performance on standardized tests is influenced by factors excluding ability alone. Anxiety, motivation, cultural background, and prior experiences with testing can all shape outcomes. Understanding the psychological processes behind test performance helps paint a fuller picture of an individual’s standardized test score.

One of the most well-documented psychological influences on standardized testing is test anxiety. Research shows that heightened anxiety can impair working memory, reduce attention, and interfere with problem-solving—particularly on timed or high-stakes exams. Over time, repeated experiences of anxiety around testing can lead individuals to disengage or exert less effort, reducing motivation and reinforcing a cycle of avoidance.

Another critical factor is the concept of stereotype threat, which occurs when individuals fear confirming a negative stereotype about a group they belong to. One study by Steele and Aronson demonstrated that simply making stereotypes evident can significantly reduce test performance among capable individuals. Internalized beliefs such as “I am a bad test taker” or “I am not good at math” can undermine performance, highlighting the importance of positive self-talk.

Ultimately, standardized tests are valuable tools, but they are not neutral snapshots of intelligence or ability. In neuropsychological practice, test scores are best understood as one piece of a larger clinical picture that includes history, behavior, emotional functioning, and context. By recognizing the psychological factors that affect standardized testing, clinicians can provide more accurate interpretations and offer recommendations that truly support each individual’s strengths and needs.

Julianna Greco
Seton Hall University, 2027

Recovery from a brain injury is often viewed as a physical process. Yet for many, the most life altering changes are the ones no one can see.

Even after being medically “cleared,” many notice their thinking feels different. They describe feeling foggy, easily overwhelmed, and mentally drained by tasks that once felt automatic, like following a conversation, keeping track of time, or remembering what they came into a room for.

These experiences can be frustrating and confusing, especially when others expect them to be “back to normal.” But there’s a reason for these changes and understanding that reason is the first step toward healing.

From a neuropsychological perspective, these complaints of “feeling off” make perfect sense. They often reflect microscopic axonal injuries or tiny disruptions in the brain’s communication networks. The patient’s day to day struggles are simply the functional expressions of these disrupted neural connections.

Even when imaging appears “normal,” the brain may still be working overtime to compensate, like driving a car with the emergency brake partially on. Emotional factors such as anxiety and depression can add to the strain, draining mental energy, narrowing attention, and disrupting memory. This cycle of fatigue, frustration, and self-doubt can reinforce cognitive overload and slow progress.

While many physical symptoms like headaches or dizziness improve over time, cognitive deficits often linger and have the greatest impact on daily functioning. People recovering from brain injury frequently describe difficulty learning new information, following conversations, or keeping up with the pace of daily life. These difficulties are common expressions of changes in attention, processing speed, memory, and executive functioning.

Identifying these cognitive patterns is the first step toward recovery. Neuropsychological testing provides a clear roadmap, showing which abilities have been affected and which remain strong. This understanding lays the groundwork for effective treatment that empowers patients with the knowledge and tools to regain control of their everyday lives.

Once a patient has a solid understanding of their unique cognitive profile and how these changes appear in daily life, treatment focuses on compensating for deficits through environmental adjustments and structured routines. Brain injury recovery also involves cognitive exercises designed to strengthen neural connections in the brain regions responsible for attention, memory, and executive functioning. As progress builds, the emphasis shifts toward real-world reintegration, helping patients apply these strategies across home, work, and social settings.

Ultimately, brain injury recovery is about more than retraining cognitive skills; it is about restoring self-efficacy and rebuilding a sense of identity. As individuals begin to experience success, such as remembering tasks, finishing projects, or managing their day without burnout, anxiety decreases and confidence returns. Over time, patients can finally begin to feel like themselves again.

If you or someone you care about has experienced a brain injury, contact us today to schedule a neuropsychological consultation and take the first step toward recovery.

Victoria Barnett, PsyD
NJ Temporary Permit #253027
Postdoctoral Fellow

Amplified Musculoskeletal Pain Syndrome (AMPS), also known as Juvenile Fibromyalgia (whole-body pain) or Complex Regional Pain Syndrome (regional pain), is a complex and immensely painful condition that causes widespread pain in children and adolescents that cannot be explained by injury or illness alone. This pain often causes typically harmless stimuli, such as light touch from clothing or another person, to be incredibly painful. According to the Children’s Hospital of Philadelphia’s (CHOP) Center for Amplified Musculoskeletal Pain Syndrome, AMPS pain can be intermittent or constant, and can affect the entire body or just certain regions (Sherry, D.D., 2020). Besides persistent pain, symptoms of AMPS may include fatigue, trouble sleeping, severe headaches, joint pain, and dizziness. Anxiety and depression have been commonly linked with AMPS as well. AMPS is most commonly diagnosed in preteen and teen girls, especially those with previous anxiety and/or depression (Sherry, D.D., 2001).

Amplified pain follows different neural pathways than typical pain responses in the brain. While normally, damage to a body tissue sends a signal through the pain nerve to the spinal cord, which sends the signal to the brain and is processed as being painful, amplified pain follows an abnormal circuit in the spinal cord, sending pain signals not only to the brain, but also to the neurovascular nerves, which causes blood vessels to constrict. The lack of blood and oxygen causes waste to build up in the muscles and bones, which leads to pain. This cycle continues, leading to an amplification of pain in areas of waste buildup (Sherry, D.D., 2000).

It is believed that a combination of psychological/psychosocial, family, biological, and other factors contributes to AMPS development. While the causes of AMPS are still being studied, there are thought to be three main causes for amplified pain. Severe injury, such as a broken bone, musculoskeletal injury, or significant surgery, may cause AMPS symptoms to develop. While not as common as injury-induced AMPS, illnesses may also cause AMPS to develop. Both inflammatory conditions, such as arthritis, tendonitis, and enthesitis, and infections, such as mononucleosis and influenza, can serve as catalysts for AMPS pain development (Kaufman et al, 2017).

Perhaps the most complex cause of AMPS is psychological stress. While many assume that this stress must be negative, both positive and negative stressors can cause amplified pain. AMPS research has also shown that children with certain personality traits, such as perfectionistic and/or neurotic, are more likely to develop AMPS. Over half of children diagnosed with AMPS have received previous psychological care, indicating a significant connection between psychological symptoms and chronic pain (Sherry, D.D., 2020). Therefore, psychological evaluation of both individual and family dynamics is crucial to understanding AMPS diagnosis and treatment (Sherry, D.D., 2000; 2020).

The presence of AMPS in children has significant neuropsychological implications, including cognitive and psychosocial functioning, physiological development, and psychological well-being. In a study conducted by the Children’s Hospital of Philadelphia’s Center for Amplified Pain, children with AMPS are more likely to present with mental health symptoms, with more than half reporting anxiety, 35% reporting depression, and 22% reporting suicidal ideation. Children and adolescents with AMPS are much more likely to miss multiple days of school, with many missing a quarter or more of a school year (Namerow, 2016). Sleep disorders are also common among those with AMPS, as pain flare-ups are likely to disrupt sleep patterns.

From the perspective of child psychology, AMPS highlights how the emotional and physiological health of children and adolescents interact. Prolonged anxiety is one of the most common causes of AMPS, and AMPS treatment, therefore, consists of intensive psychotherapy to treat the trauma experienced as an AMPS sufferer, as well as potential underlying psychological issues that led to the development of amplified pain. Neuropsychological testing can inform practitioners about the underlying conditions that may exacerbate symptoms, as well as risk factors for the development of AMPS. AMPS treatment also consists of intense outpatient and/or inpatient occupational and physical therapies, including aerobic exercises and desensitization therapies for the reduction of pain responses.

Any additional questions about AMPS and its connection to neuropsychology can be directed to NRS/Lifespan at (732) 988-3441.

Madeline Williams
Student Intern at NRS|LS

Sources Cited

Sherry, D. D. (2000, April). An overview of amplified musculoskeletal pain syndromes. The Journal of Rheumatology. Supplement, 27(58), 44-48. https://www.stopchildhoodpain.org/wp-content/uploads/2020/06/An-Overview-of-Amplified-Musculoskeletal-Pain-Syndromes-2000.pdf

Sherry, D. D. (2001). Diagnosis and treatment of amplified musculoskeletal pain in children. Clinical & Experimental Rheumatology, 19(5 Suppl 23), 617-620.

Sherry, D.D., Sonagra, M., & Gmuca, S. The spectrum of pediatric amplified musculoskeletal pain syndrome. Pediatr Rheumatol 18, 77 (2020). https://doi.org/10.1186/s12969-020-00473-2

Kaufman, E. L., Tress, J., & Sherry, D. D. (2017). Trends in the medicalization of children with amplified musculoskeletal pain syndrome. Pain Medicine, 18(5), 825-831. https://doi.org/10.1093/pm/pnw188

Namerow, L. B. (2016). Pain amplification syndrome: A biopsychosocial approach. Journal of Pediatric Psychology, 41(5), 540–548. https://doi.org/10.1016/j.janxdis.2016.06.027

At times we may see our children struggling in school whether behaviorally, social-emotionally, or academically and as parents, want to be proactive. However, we find that rather than schools providing special education services they are discussing things like providing services within the general education classroom and through Response to Intervention (RTI) before they consider testing for special education services. Responses like this sound like a “wait to fail” mentality and may end up leaving parents feel dismissed and frustrated. Some families will then choose to seek a private evaluation, typically conducted by a neuropsychologist, which will include recommendations for the school. Then if the evaluation confirms that the child has a disability, it is taken to the school, where sometimes it’s streamlined, and your child is able to receive services through an Individualized Education Plan (IEP). However, there are times when not, which leads to more frustration, and parents are left wondering why.

To start, it’s important to remember that schools have their own rules and regulations that they have to abide by before they consider testing or discussing eligibility for special education services. To help us understand the process better it is important to look at what special education is looking for when determining eligibility for services through an IEP. New Jersey public schools are looking at the three prongs of special education which include: 1) the child has a disability, 2) the disability adversely effects their educational performance, and 3) the child needs special education services (i.e. modifications, special classroom, related services, etc.) in order to make progress.

When thinking about what classifies as having a disability, it’s important to remember that schools are not held to the same diagnostic criteria that professionals are held to in the medical world. Neuropsychologists and psychologists follow a diagnostic book called the ICD or DSM-V-TR which lays out their diagnostic criteria. In regard to eligibility for special education services, schools in New Jersey must follow New Jersey special education law through the state, which is called N.J.A.C. 6A:14, Special Education. This law includes 13 eligibility categories that a child can fall under, and while some diagnoses and criteria have the same guidelines, other’s do not, and your child study team (who writes the IEP) has to abide by these 13 categories.

Next, let’s look at what is meant by “adversely” effects. For example, a child may have a disability such as Autism or Attention-Deficit Hyperactivity Disorder, but there is no educational impact. What does this mean? It means your child is preforming where they should be academically. If this is the case, having a disability alone would not allow for your child to receive special education services. NJ law states that we have to abide by Least Restrictive Environment (LRE). LRE states that children are required to be educated with nondisabled peers to the maximum extent possible. This means that they are not pulled out for services if they are able to meet success in the classroom, which is why schools work to provide services within the general education setting before they consider special education services.

Finally, in order to be eligible for an IEP, a child must meet the above and also need special education services.  This may include a need for a special education teacher in the larger room , a special education classroom, or it may include related services such as occupational therapy, counseling, or speech therapy services. If a child meets the above but does not need specialized services, they would not meet eligibility for an IEP. However, if they need accommodations in the classroom alone and meet the first two prongs, they could be eligible for a 504 plan. A 504 plan also provides services to children with disabilities that may not need as intensive supports in the classroom.

Although receiving an outside evaluation is beneficial for schools to better understand your child and see what their needs are, it does not guarantee services. In summary, it comes down to the fact that the medical world and school world do not abide by the same guidelines. Schools are required to follow their specific laws when looking at eligibility, and while they may consider outside evaluations, they do not have to follow them. With this said, it is important to know your rights as a parent.  Ultimately, comprehensive neuropsychological examination will provide objective data to better understand your child, provide accurate diagnosis, and provide direction for your child’s specific needs.

If you have any questions, please call our office.

Angela Raghib, PsyD
NJ temporary permit, # 253-017
Psychology Post-Doctoral Fellow

Absence seizures, sometimes referred to as petit mal seizures, are brief but frequent interruptions in awareness that can have significant ripple effects on a person’s daily functioning. While they are most often seen in children between the ages of four and fourteen, absence seizures may also occur in adolescents and adults. Characterized by sudden lapses in consciousness lasting only 5 to 15 seconds, these seizures can occur dozens or even hundreds of times per day. From a distance, they may look like harmless “staring spells” or daydreaming episodes. Yet, when considered through the lens of cognitive science and neuropsychology, absence seizures represent much more than fleeting moments of inattention. They interfere directly with core processes of learning, memory, and attention, often shaping a child’s educational and developmental trajectory.

During an absence seizure, the brain experiences a sudden, generalized disruption in thalamocortical networks that support attention and consciousness, producing the classic 3-Hz spike-and-wave pattern on EEG. Neuropsychologically, these events interrupt ongoing cognitive processing in ways that can mimic other developmental conditions, i.e. Attention Deficit Hyperactivity Disorder (ADHD). A child may appear to “zone out,” miss directions, fail to follow through on tasks, or seem inattentive and forgetful. Because absence seizures are brief and recovery is immediate, the child is often unaware that anything happened, leading teachers and parents to interpret the behavior as distractibility, poor effort, or daydreaming.

Over time, the repeated disruptions can fragment learning. Frequent lapses interfere with sustained attention, working memory, and processing speed, core areas also implicated in ADHD. For example, a child may hear the first step of a multi-step direction, have a seizure, and then look confused when unable to complete the task. Similarly, when reading, the child may lose the flow of information and struggle to encode material into memory. This can create inconsistent recall, reduced academic efficiency, and patterns of “forgetting” that mimic ADHD, even though the underlying cause is seizure activity rather than a primary attentional disorder.

The behavioral profile of absence seizures are mainly characterized by missed information, inconsistent work output, incomplete assignments, and apparent inattention, a comprehensive neuropsychological evaluation is essential for accurate differential diagnosis. Assessment of sustained attention, working memory, processing speed, and learning helps clarify how seizure-related lapses disrupt cognition and distinguishes brief, neurologically driven interruptions in consciousness from enduring attentional deficits or learning impact. These results directly inform targeted school supports, as children with absence seizures often benefit from repetition of key information, periodic comprehension checks, and instructional strategies that compensate for missed moments in learning.

In short, absence seizures do not simply cause brief lapses in awareness; they disrupt the continuous cognitive processes that support attention, memory, and classroom learning. Without careful assessment, these disruptions could be mistaken for ADHD, learning disability, etc., delaying appropriate treatment and educational support.

If you suspect that your child may be experiencing seizures, please inform your pediatrician or neurologist who will begin the medical process of evaluation and treatment.

Laura Brockman, PsyD
NJ Temporary Permit #: 253-033
Postdoctoral Fellow