Category: News

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

To all new up and coming neuropsychological residents/fellows, consider the following points in your application process to whatever national program you are seeking.  You will need them in view of the competitive market besides being a valuable prospective for life success.

Our professional culture here at Neuropsychology Rehabilitation Services| LifeSpan focuses upon a well rounded perspective to professional success above and beyond obtaining clinical development skills.

Our program points:
Learn to use your God given talents and purpose.
Remember, if your upcoming training was easy, everyone would pursue it.
Common sense is an important trait.
Say what you mean, and mean what you say. Authenticity of character is almost extinct.
Have a GIDN attitude (Get it done now) mentality.
Apply motivation/initiative.
Know who you are.
Don’t compare yourself with others.
Discipline is mandatory.
Be yourself.
Be on time, and demand it from others. Early is on time, on time is late.
Learn from your mistakes without making excuses. Assume professional responsibility.
Remember there are 3 opinions: A, B, and the truth.
Opportunity knocks once is a misnomer. Opportunity does not knock at all. You have to pursue it, and when it presents itself, you have to move on it.
Read all you can about your selected discipline.
Don’t worry when there is no need. Today is the tomorrow you worried about yesterday,
The patient is the most important priority.
We are here to serve others.

All are welcome to apply to our program!  We will help you not only refine your neuropsychological abilities but also provide mentorship in all facets of life.
We would be happy to interview you if the above fits with your aspirations.

Sincerely,
Dr. Rober B. Sica and Dr. Steven P. Greco

In a prior blog post on the process of habit change, the idea of “top down control” was introduced as a fancy term for willpower. Top down control explains the neuroscience behind long-term habit change. By default, our subconscious, reflexive brain is in the driver’s seat steering our daily behaviors. It’s like our pre-programmed autopilot mode which we can use if we want to stay comfortable. However, if we want to start manifesting habits that better serve our interests, desires, goals, etc. we need to put another area of our brain, our prefrontal cortex, into the driver’s seat to manually steer the car. When the prefrontal cortex is confidently in the driver’s seat, we have achieved “top down control”.

This process does not happen without conscious awareness or without effort, of course. But in a busy, modern society, people are understandably interested in specific strategies that steer effort in the right direction. This blog post elaborates on science-supported behaviors and thought patterns that help build healthy habits.

(1)   Retrain your brain to focus on the “later” version of yourself instead of the “now” feeling. While there are positives to “living in the now”, the now brain prioritizes familiarity and comfort over things that appear “hard” unless the discomfort of change is paired with a positive mindset. Therefore, investing in how you want to feel “later” on in the journey not only increases motivation to push through hard times but it also changes brain chemistry and structure. The anterior midcingulate cortex is a special structure in the brain that grows when people do something they don’t want to do but feel like it’s best for them long-term. Work that emotional and structural muscle to see the best possible results.

(2)   Copy people that inspire you. We know that we learn partly by observation. It’s not just knowledge that we acquire though. It’s motions and physical movements that our brain is also interested in. Mirror neurons in the brain watch the behavioral movements of people who engage in healthy habits. So even if you don’t exactly have the energy or motivation to start doing a certain behavior (like exercising, for instance), watch someone else engage in the behavior you want to do and trust that your brain is mapping the pattern.

(3)   Exercising spreads to other habits. This is a relatable finding for many people; when they exercise, they tend to want to eat better to support their effort and not let it go to waste. But this effect is way bigger than dopamine hits or runner’s highs – when you exercise, you increase endothelial growth factor and brain-derived neurotropic factors. Literally, new capillaries growth in your brain and BDNF, serotonin, and glutamate all team up to increase your learning capacity. These changes help your prefrontal cortex give a deeper meaning to other behavioral changes and the reasons why you would be better off in the later doing other hard things.

(4)   Dial in your reasons for changing. As discussed in the prior blog post, many people fail in their efforts to change because they actually aren’t as ready for change as they think they are. Habit change isn’t just about behavior; habit change is a commitment to identity change, at least on some level. It takes humility to learn from past mistakes, the downsides of the unwanted behavior, and the willingness to be a beginner at something new; at the same time, a mindset of “I am someone who does…(insert desired behavior change)” allows for the adoption of a new version of the self.

(5)   Accept and plan for failure. Old habits die hard. It’s very common to relapse and “fall off the horse” so to speak. Getting back on the horse successfully is itself a process that can be learned — resetting your expectations, identifying your vulnerabilities and sneaky cues that led to relapse, adopting a mentality of resilience, eliminating myths about what progress “should” look like, and finding balance in real life. Specialized counseling exists to build insight into these areas and help people sustain new habits for longer periods of time in between relapses.

If you are interested in counseling services to assist with the process of adopting healthier lifestyle habits, call 732-988-3441 to schedule a consultation appointment with our clinical health psychologist.

Lauren Gashlin, PsyD
Health Psychologist

Presently in 2025, people aged 65 and older now outnumber children under 5.  This statistic is according to the United Nations.  At first, this seems like a good thing when considering people born in 1900 never lived past 50.  However, as we get older, the risk for long-term intractable disease of the body and brain occurs.  By 2050, the World Health Organization estimates that 135 million people around the world will have dementia.

Neuropsychologists along with medical colleagues have been working hard in gaining information about aging normally versus cognitive deterioration.  Research has established that everyday cognitive tasks, for instance, knowing when a prescription has to be refilled, looking through bank statements or the cellphone for numbers – declines over time, despite research scientists’ previous assumptions that these skills remained relatively stable and considered consolidated skills.  Research is also now finding that there is a parallel decline in reasoning, problem solving, abstraction, and organizational abilities which collectively play a greater role in limitations of daily functioning associated with age than what was preconceived as memory decline.  This overall cognitive ability integrates multiple areas of reasoning and summarizes it into an efficient daily behavior.

Decision-making, with regard to the aging person’s ability to hold and manipulate information, coupled with multitasking, deteriorates with age and is more critical to daily life as just described memory, which many people can work around

In looking at healthy individuals, healthy aging people and the errors that they make in daily activities has been compared with patients who have mild cognitive impairment (MCI) or dementia.  When looking at these three populations in terms of how they perform basic daily activities such as cooking, answering the phone, and associated other basic activities of daily living tasks and watch how they completed them, the healthy older adults were less efficient at tasks overall, often having to backtrack looking for multiple locations for items, correcting mistakes or repeating a step.  However, the individuals with mild cognitive impairment omitted key steps from the same tasks or did alternate actions, for instance, dusting the kitchen instead of the living room.  Finally, the more severe dementia patients were incapable of efficiently completing these tasks, let alone multitasking.

Finally, research has shown that the effects of physical activity and cognitive training with patients in very early cognitive decline, as well as in healthy seniors is beneficial.  Both these interventions lead to improvement in cognition in healthy individuals.  In closing, research is showing the old idea that aging produces immutable changes is no longer true.  Nonetheless, there are things we can do particularly in the very early stages of cognitive decline, whether it is normal cognitive aging or MCI, they are some helpful measures.  This consists of seeing a neuropsychologist who will administer a neuropsychological examination, which is for all practical intents and purposes, a functional expression of the older person’s cognitive capacity.  Pending results from that, recommendations will consist of possible referral to neurology, radiological studies, and blood lab work in order to confirm the profile.  The neuropsychologist can then recommend strategies and adjustments based upon the examination in order to enhance the person’s quality of life.

If there are any questions about a family member’s thinking abilities, give us a call and we shall be happy to see you in consultation and make the appropriate recommendations.

Robert B. Sica, PhD, ABN
Director, Principal Partner NRS|LS
Board Certified, Neuropsychology

Do you know anyone who doesn’t have a single habit that they wouldn’t want to change? Probably not – most people say they want to exercise more, eat healthier, try meditating, read more and doom scroll less, cut down on vaping or drinking, you get the point. Changing habits is a tricky thing hence why New Years resolutions usually fade out by April and millions of American suffer from chronic health conditions that are influenced by lifestyle behaviors and habits. This blog post is designed to educate people on the habit change process and promote personal reflection. In an upcoming blog post, strategies that increase habit change success will be discussed.

Point #1: Habits are automatic behaviors that promote well-being. This may be surprising because it seems like many habits can sabotage health. But here’s an essential point — the brain was built to favor solutions that are adaptive in the short-term. This adaption comes from our subconscious/reflexive brain. Habits that serve us in the long-term have to be nurtured from our prefrontal cortex and override that feature. This is called “top down control” also known as “self-regulation”, “self-control”, “willpower”, and the “mental muscle”.

Point #2: Habits are not pleasure-driven; they are reward-driven. Rewards can mean lots of things – to some, rewards are treats like getting or spending money, eating or drinking delicious things. Rewards can also come in the form of personal accomplishment or living in a way that’s aligned with a value system. These two forms of rewards are clearly in different categories and, in fact, they correspond to different brain processes. Both sets of rewards operate on dopaminergic activity in the brain but have divergent paths. Short-term rewards have a peak-and-valley effect – dopamine spikes high and then drops hard while long-term rewards have a slow, uphill grind effect – dopamine rises more slowly but consistently over time.

Point #3: Self-regulation, or top-down control, has a lot of enemies. Stress, fear, and anxiety all diminish our capacity for healthy habit change because these emotions wake up the subconscious parts of the brain that want quick, easy solutions that get rid of negative emotion and restore baseline levels of happiness. This brain cares about the now, not the later problems down the road. Diabetes, cancer, dementia are all “later” problems when the brain is stressed or living in fight or flight mode. Another threat to self-regulation? Trying to change to many things at once. The prefrontal cortex does not have an unlimited supply of change capacity – like an army fighting battles on too many fronts, it can be worn down by trying to be disciplined on too many fronts.

Point #4: Habits are hinged to a “readiness to change” process that actually unfolds in a series of stages. To keep it brief, here they are: Stage 1 – Precontemplation = “All good here, no need to change”. Stage 2 – Contemplation = “Maybe this habit isn’t healthy, but I’m not sure I want to change it”. Stage 3 – Preparation = “Change is the right thing to do, let me get myself ready to do this”. Stage 4 – Action = “It’s go time, I’m doing this”. Stage 5 – Relapse & Maintenance – “I slipped up, how do I get back on the horse?” Habit change is much more difficult when people haven’t resolved these stages completely. Simply put, many people aren’t as mentally ready to change as they think they are.

Counseling is a forum that addresses all these above mentioned snags to behavior change. If you or someone you know is interested in improving health habits and wants to have a consultation with a health psychologist, call Dr. Lauren Gashlin at 732-988-3441 to set up an appointment.

If your child frequently has intense emotional outbursts that seem extreme for their age, you may be wondering if something deeper is occurring. One possible explanation is Disruptive Mood Dysregulation Disorder (DMDD), a condition that involves chronic irritability and severe temper outbursts in children and teens.

What Is DMDD?

DMDD is a mood disorder diagnosed in children ages 6–18. It is more than typical moodiness or acting out, it involves:

Frequent outbursts (3+ times a week)
Chronic irritability or anger most of the day, nearly every day
Symptoms lasting at least 12 months
Difficulties across settings (home, school, peers)

Unlike bipolar disorder, DMDD does not involve mood cycles like mania; instead, the mood issues are persistent and ongoing.

What Causes It?

DMDD may be associated with differences in brain function, family history of mood disorders, or high-stress environments. It is often a combination of biological and environmental factors.

How Is It Treated?

DMDD is treatable. A plan may include:

Therapy: Cognitive Behavioral Therapy, emotion regulation skills, or family therapy.
Parent training: Learning techniques to respond calmly and consistently.
Medication: Sometimes used to manage mood symptoms.
School support: Collaborating with educators to reduce triggers.

What Can Parents Do?

Stay consistent with rules and routines
Consider psychological testing
Remain calm during outbursts, your response sets the tone
Focus on connection over control
Get professional support
DMDD can be incredibly tough on families, but with the right tools, children can learn to manage their emotions and grow in healthy ways. If you are concerned, please call our office.

Processing speed refers to how quickly a child can take in, understand, and respond to information. It is separate from intelligence, as a child can be very bright but still need extra time to complete tasks. Difficulties in this area can affect academic performance, especially on timed assignments, and may also contribute to frustration, fatigue, or reduced self-confidence.

How processing speed affects learning:

Reading – slower fluency, even with strong comprehension
Math – difficulty with timed tasks
Writing – difficulty translating thoughts onto paper
Attention – may appear distracted or disengaged

How to support your child:

Allow extra time on tests and assignments
Break down tasks into smaller, manageable parts
Use visual aids and checklists
Reduce distractions and provide encouragement
Focus on effort and persistence, not speed
Neuropsychologists assess processing speed through a variety of ways. For example, using standardized, timed tasks involving symbol matching, visual scanning, and simple problem-solving can better determine your child’s speed of processing. When a child shows a significant gap between processing speed and other abilities, it can offer important insight into learning or psychological challenges.

Understanding and supporting your child can make a world of difference. If you have concerns about processing speed or other cognitive areas, please contact our office at 732-988-3441 to learn more or to schedule a consultation.

Gianna Scimemi, M.A.
Psychometrician & Doctoral Student

Behavioral parent training (BPT) is a method of treatment that focuses on teaching parents about behavior management and discipline skills to help manage their ADHD child’s behavior. In BPT, parents are taught to use positive preventative strategies and consistent discipline to manage behavioral issues. Changes made to parent behavior in BPT include using labeled praise and discouraging harsh and inconsistent discipline. There are many variations in this training method, and some may benefit more from integrated parent-child treatments, parent-directed treatments, or youth treatments with adjunctive parent involvement, depending on the specific situation. In integrated parent-child interventions, parents and their children are both being treated, with a focus on implementing effective positive parenting strategies, consistent monitoring, and effective discipline. Parent-directed treatment focuses treatment on the parents and, like integrated parent-child interventions, teaches positive parenting strategies and effective monitoring and discipline. Youth treatment with adjunctive family involvement directs skills-based treatment programs to the children and involves parents to varying extents (i.e. parents interacting with school and clinic personnel to set up behavioral contracts or through separate parent treatment).

All of these treatment methods have been associated with broad improvements in self-reported and observed family functioning, parent behavior, and family stress. Typically in these sessions, the goals will be to establish a home and school behavioral checklist and learn to attend to appropriate behavior and ignore minor, inappropriate behaviors. Therapists will also teach how to give effective commands and reprimand and how to enforce rules as well as how to plan ahead for misbehavior outside the home. The most important parts of this is providing parents with problem solving techniques and making sure behavioral improvements can be maintained after contact with the therapist ends.

Overall, behavioral parent training has been shown to be an effective method of treating ADHD in children. It helps parents be better prepared to take care of their child and help them manage their behavior.

If you are interested, please call our office for further information or to schedule a consultation.

Julianna R. Greco
Seton Hall University

Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmental disorders affecting children today. Characterized by symptoms such as inattention, impulsivity, and hyperactivity, ADHD can make it difficult for children to focus, follow through with tasks, and regulate their emotions. After a neuropsychological examination is completed and a child is diagnosed with ADHD, addressing nutrition is a common recommendation. Research has shown that diet and nutrition can play an important role in managing ADHD symptoms.

The Role of Nutrition in ADHD

Nutrition has a substantial impact on brain development, mood regulation, and cognitive function. Certain nutrients are essential for maintaining brain health and can affect a child’s ability to concentrate, manage emotions, and control impulsive behaviors. Here are some examples of how diet plays a role in ADHD:

Blood Sugar Levels: A diet high in refined sugars and processed foods can cause fluctuations in blood sugar, leading to periods of hyperactivity followed by crashes in energy, which can exacerbate ADHD symptoms. Stable blood sugar levels help support concentration and emotional regulation.
Omega-3 Fatty Acids: Studies have shown that children with ADHD may have lower levels of omega-3 fatty acids, which are essential for brain function. A lack of omega-3s can lead to difficulties with attention, focus, and impulse control.
Micronutrient Deficiencies: Nutrients such as iron, zinc, magnesium, and vitamins B6 and B12 are crucial for the proper functioning of the brain. Deficiencies in these nutrients have been linked to increased ADHD symptoms, including poor concentration, irritability, and hyperactivity.
Food Additives and Preservatives: Research has suggested that certain artificial food colorings and preservatives may contribute to hyperactivity in some children with ADHD. While this doesn’t apply to every child, some parents find that eliminating processed foods or artificial additives from their child’s diet leads to improved behavior.

Nutritional Strategies to Support Children with ADHD

While no single dietary change can “cure” ADHD, nutrition plays a key role in supporting a child’s cognitive function, attention span, and emotional regulation. Here are some practical tips for parents looking to optimize their child’s diet:

1. Focus on Protein-Rich Foods

2. Incorporate Omega-3 Fatty Acids

3. Avoid Excessive Sugar and Processed Foods

4. Ensure Adequate Micronutrient Intake

5. Eliminate Artificial Food Colorings and Additives

6. Consider Probiotics for Gut Health

If you are concerned about your child’s diet and its impact on ADHD symptoms, speak with a healthcare provider or nutrition expert to develop a personalized plan that supports your child’s unique needs.

For additional information or to schedule a consultation, please contact our office at 732-988-3441.

Natalie Angelo, Psy.D.

Temporary Permit # 243-090

Neuropsychology Post-Doctoral Fellow

Resources:

A. B. McCann, D. E. McGinnis, G. J. McNamara. (1995). Effects of dietary sugar on behavior and cognition in children. American Journal of Clinical Nutrition, 62(6), 1071S-1075S. DOI: https://doi.org/10.1093/ajcn/62.6.1071S

B. P. Faraone, M. C. Biederman, K. P. Mick. (2010). Micronutrient deficiencies in children with attention-deficit hyperactivity disorder. Journal of Child Neurology, 25(5), 590-594. DOI: https://doi.org/10.1177/0883073809334583

Chang, J. P., Su, K. P., Mondelli, V., & Pariante, C. M. (2018). Omega-3 Polyunsaturated Fatty Acids in Youths with Attention Deficit Hyperactivity Disorder: A Systematic Review and Meta-Analysis of Clinical Trials and Biological Studies. Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology, 43(3), 534–545. https://doi.org/10.1038/npp.2017.160

L. M. Schab, P. R. Trinh. (2008). Food additives and hyperactive behavior in children: A review of the literature. Pediatrics, 121(1), e151-e157. DOI: https://doi.org/10.1542/peds.2007-0105

Pinto, S., Correia-de-Sá, T., Sampaio-Maia, B., Vasconcelos, C., Moreira, P., & Ferreira-Gomes, J. (2022). Eating Patterns and Dietary Interventions in ADHD: A Narrative Review. Nutrients, 14(20), 4332. https://doi.org/10.3390/nu14204332