Category: Adolescent Psychology

Are Your Patients Vaping 58 Joints/Day?

11/1/2020

David A. Perna, PhD
Licensed Psychologist
Lecturer in Psychology
Department of Psychiatry
Harvard Medical School

The Clinical Assessment of Vaping Exposure

For: Parents/Therapists/College Counselors

My close friend and professional colleague, David Smelson, PhD, UMASS Medical Center, and his co-researchers from Children's Hospital, Harvard Medical School in Boston, offer an excellent article/quick read to help clarify terminology and evaluation of vaping both cannabis and nicotine. Please be sure to read their article. I have listed the reference below.

I was impressed with the following two usage/statistical points that I had not picked up on in my clinical work with patients in our group practice or in speaking with students in our College Transition Program:

"The amount of THC that some users vape can be dramatic, reaching up 50 mg THC inhaled in a single session, with a total consumption of up to 700 mg per day; in comparison, a typical ‘‘joint’’ of marijuana delivers approximately 12 mg inhaled THC" (Boyer, et al, 2020, p. 4).

That means that a teen/college student using a vape can inhale the equivalent of 58 joints per day. That's right, according to this article, by doing the math, that is what you come up with-think about that. That is why I am seeing so many patients suffering from the impact of severe cannabis intoxication, referred to as Cannabinoid Hyperemesis Syndrome (CHS).

At low levels of use, cannabis causes increased appetite and stimulates eating, which brings about the commonly known term as the "munchies" following use. That is why it was first medically used to help people who struggled with cancer. These medical patients who were being given chemotherapy to treat their illness commonly experienced gastrointestinal distress. Small doses of cannabis allowed them to eat so they would be able to maintain their weight while they proceeded through treatment. However, at the opposite end of the continuum, in extremely high doses, cannabis will commonly cause:

Severe nausea
Vomiting or Cyclical Vomiting (Repeated bouts of vomiting)
Abdominal pain

I have never witnessed patients struggle with the negative effects of such high doses of cannabis until the onset of the vaping boom in the Boston area. I have now had several patients who have struggled with the above-mentioned issues. I have also had several students in our College Transition Program who have decided to stop using cannabis completely since they felt that vaping the higher amounts started to make them feel increasingly anxious and on edge.

The second point that was made in Dr. Smelson's article on vaping that I found was quite helpful was as follows:

"...over 60% of adolescents do not understand that JUUL devices are nicotine delivery devices." (Boyer, et al, 2020, p. 2).

I found this fact to be quite amazing. I never focus on educating kids/teens on the reality that vaping devices deliver either nicotine or cannabis. I assumed that all kids were completely aware of this fact. They know that cigarettes contain nicotine. Why would they inhale the vaping vapor? This issue will allow me to explore their awareness of this fact more closely in our initial sessions when vaping is discussed as a standard part of our intake evaluation process or when vaping is specifically presented as a treatment concern by parents.

Thanks again to Dr. Smelson and his colleagues for such a powerful, information-packed, yet concise article.

Resources for Parents:

Resources for Professionals:

APA Citation For This Article:
Boyer, Edward, MD, PhD, Levy, Sharon, MD, MPH, Smelson, David, Vargas, Sara, et al. (2020). The Clinical Assessment of Vaping Exposure. Journal of Addiction Medicine, Advance on-line publication. Retrieved from http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=ovftw&NEWS=N&AN=01271255-900000000-99270. https://doi.org/10.1097/ADM.0000000000000634

Additional References:
Galli, J. A., Sawaya, R. A., & Friedenberg, F. K. (2011). Cannabinoid hyperemesis syndrome. Current drug abuse reviews, 4(4),
241–249. https://doi.org/10.2174/1874473711104040241

5 Comments

Your Adolescent's Eating Habits: From Soup to Nuts

1/20/2019

1 Comment

Heather Corazzini, MA
Psychology Intern
Copernican Clinical Services

Categories

"There isn’t one single reason eating disorders begin or are maintained"

"For some kids certain food textures make them feel like someone is dragging their nails across a blackboard"

“perfectionistic language” is a common trait shared
between parents and adolescents with disordered eating

Does your adolescent’s eating behavior, weight, or exercise ever appear abnormal to you? Do they seem preoccupied with their physical appearance? Have you considered asking them about it, but weren’t sure how to approach them? Not all eating patterns or behaviors would constitute an eating disorder diagnosis; however, disordered eating patterns and behaviors are real, require careful consideration, and can have serious health implications.

Trust Your Intuition:
Eating disorders are often disguised in ways that minimize their significance. At times they can be difficult to assess and are often overlooked by adults. If your intuition as a parent tells you something might be “off,” with your child’s eating, listen to it, and consult a professional for guidance. It’s okay to be unsure about what you have noticed.  Speaking with a mental health professional who has experience in this area can help you develop language that will allow you to express your intuitions to your child in a clear and supportive way.

Eating Disorders can be Deadly:
The prevalence of adolescent eating disorders has gained significant attention in the mental health field over the last decade. Some researchers have claimed anorexia nervosa has the highest mortality rate of all psychological disorders (NEDA, 2018).

See: https://www.nationaleatingdisorders.org
for more information.

How does it Start?
Many parents ask, “How did this start? Why and when did my child become so obsessed with what they’re eating?”

Studies offer arguments for why and how eating disorders are developed and maintained. In 2016, a team of researchers examined risk factors they believed to predict onset of eating disorders in adolescent females.  According to their study, adolescent females were most at risk to develop eating disorders if they dieted, idealized thinness, had body dissatisfaction, and displayed unhealthy weight control behaviors (Stice et al., 2016).

Despite research supporting specific reasons for ED development and maintenance, it can be argued such reasons are multifactorial;there isn’t one single reason eating disorders begin or are maintained. Eating disorders may also function as a form of self-punishment, manifestation of anxiety, or addiction—with little to no emphasis on weight loss as a central goal.

Sensory Integration Issues:
Not all eating disorders develop from preoccupation with fear of weight gain. Aversion to texture, fear of choking, fear of swallowing, etc., can also develop into ED (see Avoidant Restrictive Food Intake Disorder, DSM-5 criteria that are listed below).
·       An eating or feeding disturbance (e.g., apparent lack of interest in eating or food; avoidance based on the sensory characteristics of food; concern about aversive consequences of eating) as manifested by persistent failure to meet appropriate nutritional and/or energy needs associated with one (or more) of the following:

Significant weight loss (or failure to achieve expected weight gain or faltering growth in children).
Significant nutritional deficiency.
Dependence on enteral feeding or oral nutritional supplements.
Marked interference with psychosocial functioning.

See:
https://www.nationaleatingdisorders.org/learn/by-eating-disorder/arfid

Many children who struggle with sensory integration disorders have difficulties with their eating, due to their reactivity to strong odors/tastes and certain textures of food. Their eating issues can often be compounded by the presence of muscular weaknesses in their mouth, tongue, and throat that impair their ability to swallow food.

One researcher stated…
“Often when kids display picky eating, especially those with food aversions/extreme picky eating, the touch, taste, or smell of a food is being processed in their brain as dis-pleasurable in some way. And, by dis-pleasurable, I mean down-right uncomfortable. Think of something that makes you shutter… nails on chalkboard or touching a slug?” (Grogan, 2018)

See: https://yourkidstable.com/sensory-processing-and-picky-eating/

What about Boys?
According to the National Eating Disorders Association (NEDA), approximately 0.3 – 0.4% of young women and 0.1% of young men will suffer from anorexia nervosa. Despite the common assumption eating disorders are exclusive to women, NEDA claims 25% of individuals with anorexia nervosa are male. Additionally, NEDA claims disordered eating behaviors (binge-eating, purging, laxative abuse, fasting) are nearly equal across male/female genders. For example, many boys who wrestle in high school manage their calories and exercise level so they can “cut weight” before a wrestling match. Additionally, dehydration can cause poorer performance in these athletes and places them at risk for more serious health concerns.

See: http://pediatrics.aappublications.org/content/140/3/e20171871

Regardless of the severity of source of the ED, the way you communicate about this with your child matters!

Researchers in 2011 conducted a study addressing the relationship between adolescent disordered eating and parent-child communication dynamics. The researchers concluded individuals’ thoughts of defectiveness, failure, and unrelenting standards from their parents contributed to their eating disorder. Findings suggest “perfectionistic language” is a common trait shared between parents and adolescents with disordered eating (Deas et al., 2011). “Perfectionistic language,” looks different within each family.

Do NOT:

Make critical comments about your child’s physical appearance.
Encourage your child to “watch their weight,” or warn them of gaining weight.
Praise your child for appearing as if they lost weight.

Make negative comments about your own appearance/weight in front of your child.

Parents are encouraged to alter their communication style in ways that may discourage the onset or maintenance of an eating disorder.

Do try to:

Praise your child based upon their achievements to enhance their self-esteem
Encourage healthy eating without rigidity; everything in moderation!
Work hard to make your child feel their weight/physical appearance is not everything. Instead, try to focus on their uniqueness in ways that will strengthen their mental health.
Consult with professionals about rising concerns, so you can feel equipped with positive and effective language to use with your child

Try not to forget:
It is your child, so it’s up to you.-Notice, listen, and speak up.

References:
Deas, S., Power, K., Collin, P., Yellowlees, A., & Grierson, D. (2011). The relationship between disordered eating, perceived parenting, and perfectionistic schemas. Cognitive Therapy And Research, 35(5), 414-424.

Stice, E., Gau, J. M., Rohde, P., & Shaw, H. (2017). Risk factors that predict future onset of each DSM-5 eating disorder: Predictive specificity in high-risk adolescent females. Journal Of Abnormal Psychology, 126(1), 38–51.

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Anger Research: Staff at the Yale Child Study Center Provide a Helpful Summary Article

1/19/2019

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David A. Perna, PhD
Licensed Psychologist
Lecturer in Psychiatry
Harvard Medical School

MIT/Dyslexia/New Research: Reading Challenges are More Pervasive than Previously Thought

11/22/2018

1 Comment

David A. Perna, PhD
Licensed Psychologist
Lecturer in Psychiatry
Harvard Medical School

"Dyslexia affects many brain regions, not just those involved with language."

Gabrieli-2016

MIT Researcher John Gabrieli published fascinating findings in the journal Neuron as part of his research and the research of his team (See Reference below) into the roots of dyslexia. His research revealed that dyslexia impacts many different systems within the brain which in turn impact the ability of the dyslexic child to adapt to his/her environment.

Gabrieli also noted:

That there were other systems impacted in the dyslexic brain that had nothing to do with language development and aquisition.
He specifically noted a decrease in "Neural Adaptation." He defined this as the brain's ability to adapt to repeated information.
He also posited that the brain has many neural systems to work-around challenges in areas of brain funtion that are evolutionarily older. He indicated that the brain had not developed these compensatory systems in reading to date since reading is a much newer brain function.

I found this article fits my clinical impressions of the complex nature of many child and adolescent patients who struggle with dyslexia. It also highlights the numerous systems that we need to address in our treatment in an applied clinical setting with this population. In our work, we commonly address the degree to which these patients struggle with anger outbursts, poor frustration tolerance, and impulsivity, all of which bring them to our door for treatment. In treating such a complex population, our treatment interventions are equally complex, including familial support, school support, self-esteem support, referral for specialized testing (Such as Central Auditory Processing Evaluations), and individual/family therapy that are all intertwined to address each patients specific learning/mental health concerns.

It is beyond the scope of this review to reveal the complexity of this MIT team's work in this area. A thorough reading of the article that is listed below is recommended.

Perrachione et al., 2016, Neuron 92, 1383–1397 December 21, 2016

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Executive Function Challenges and Anger

9/2/2016

1 Comment

David A. Perna, PhD
Licensed Psychologist
Lecturer in Psychology
Department of Psychiatry
Harvard Medical School

"Executive functions are viewed to be primary learning challenges that impact functioning across a variety of learning contexts."

Many children with anger issues suffer from executive function deficits. These deficits impact their ability to make effective academic progress in school in addition to impacting their functioning in a variety of other social-learning contexts. Executive functions are viewed to be primary learning challenges that impact functioning across a variety of learning contexts. Unlike a specific learning disability, such as dyslexia, which is viewed to impact a specific learning category, such as reading, an executive function deficit generally, impacts multiple categories of learning.

For example, an attention deficit disorder would impact an individual’s ability to make progress in many learning categories, whether they are academic or social. The inability to pay attention in class can impact the ability to learn history as well as the ability to drive a car safely. Organizational deficits are pervasive as well. For example, the inability to organize one’s assignment pad would impact school performance, while it could also impact the ability to socialize with friends (calling friends to get together too late on a friday night rather than earlier in the week).

"Cognitive flexibility allows kids to adjust to the curve balls that life throws at them."

Common Executive Function Deficits
Associated with Anger Management Disorders:

1. Causal Linking Challenges:
The inability to understand that one event causes the other. An example would be a patient who thinks that his probation officer is causing him to have a limited social life, forgetting the fact that the probation officer was assigned to work with him because he had made the poor choice of assaulting another person. In this situation the patient loses track of his own behavior as the primary reason why he has lost many age-appropriate freedoms. Within school it might include the lack of understanding that completing homework will increase one’s understanding of the class material and subsequent performance on tests.

2. Organizational Deficits:
Difficulties with the ability to keep track of details that allow the patient to successfully negotiate a myriad of social interactions and learning opportunities. An adolescent might be upset that she has misplaced her homework assignment and cannot complete her homework. However, within her social interactions she might become angry at a parents when she misplaces a slip of paper that contained a phone number that she felt was essential to her social life.

3. Sequencing Challenges:
Difficulties with the ability to keep track of sequences of events that are needed to facilitate a positive outcome in a learning situation. The inability to follow a given sequence to solve a math problem will generally result in the wrong answer. In a job situation, an adolescent might sanitize the counters of a fast-food establishment and then place a package with raw chicken onto the cleaned counter in front of his boss just prior to being terminated. A hard-working kid would have lost a job over the likelihood that his sequencing challenge could result in someone going to the hospital.

4. Time Management Issues:
Difficulties with allocating time to complete/attend events and activities that are of meaning to the patient or other people in his/her environment. An example would include having an adolescent plan on completing a major project for school on a weekend when relatives were visiting from out of town resulting in a huge family fight. Within the social realm it might include being bombarded by complaints from peers as a result of being late for a movie.

5. Transition Issues:
Difficulties with the ability to transition between two activities. Examples of these difficulties range from obvious difficult transitions, such as ending summer and starting school in September to less clear transitions, such as the movement from a sleeping state to a waking state each morning. The resulting morning tirades can be overwhelming for parents. Within a middle school environment the process by which kids constantly move from class to class could prompt a student with this challenge to feel unsettled throughout the school day. As soon as he feels settled in class the bell rings and he has to head off to the next one. As the day progresses the sense of stress increases to the point where an explosion can occur in the last period of the day.

6. Cognitive Flexibility:
The ability to learn new ways of coping with ever-changing stressors in a fluid manner. This issue is many times referred to as the ability to be prepared for all of the “Curve balls” that life throws one’s way. A child who was taught one way of solving a math problem using long division in 5th grade becomes enraged when her 6th grade teacher introduces a new method. Or in social settings it might represent the ability to quickly respond to the fickle interests of a peer group who wanted to go to the mall on Friday night when plans were made earlier that day during school lunch, to the movies when plans were made at 6PM Friday night, and out for food at 9PM when all the peers at the theater realized that the popular kids were having dinner at a nearby Shake Shack. For the average teen popularity always tops planning, however, for the teen with cognitive flexibility issues the plan is written in stone. This skill challenge is closely tied to transitioning challenges and challenges in understanding other people’s perspectives (theory of mind).

7. Memory:
The ability to remember information in a manner that allows it to be readily available for quick and efficient access. For example, a child might erupt at the thought that he had to get his hair cut when in fact both parents informed him of the hair cut days earlier. In school it might include the embarrassment of walking into class on a Monday morning and being handed a test by the teacher after forgetting to study over the weekend.

8. Generalization:
The ability to generalize from one situation to the other. For example, a student is told not to write on his desk at school, which he agrees not to do, but is then caught writing on a table in the cafeteria. In such a situation the child may be incredibly frustrated that the teacher did not clarify this issue to a greater extent and may become highly focused on the fact that he has not written on his desk since the teacher asked him to stop. The connection between the two situations is simply not apparent to the student, while the teacher may start to feel that the student is playing him/her. In reality the student is simply clueless to the connection between the two contexts.

Today's Social Media: Windows into a Violent World

6/5/2015

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David A. Perna, PhD
Licensed Psychologist
Lecturer in Psychiatry
Harvard Medical School

"Parents Should Use Their Values to Guide Their Parenting"

Parents, educators and fellow clinicians have asked me the same question:
"What impact does violent social media have upon my child/student/patient?"

I recently had the opportunity to address this topic along with my colleague Liz Barcewicz, PsyD. We were asked by Court Booth, Director of Community Education in Concord-Carlise (He is also a LinkedIn Member), to speak about the impact of violent social media on our youth. We had the added pleasure of presenting at Concord-Carlisle's new high-tech high school. The school was only seven days old when we walked into the new multi-media center.
Our primary talking points were as follows:

Engagement Rather Than Containment: The Internet is here to stay. Parents must learn how to engage their children in discussions about all forms of cyber-media rather than simply focusing on containing/limiting their access.

Values: Parents should use their values as a frame of reference or “pathway” that will help guide their kids as they confront these issues. Although it is not readily apparent, kids feel safer when such values are clearly articulated by their parents. Values serve as a filter that can be used to understand and process the wide breadth of information that is available on the Internet. Parents were surprised to learn that research into family values shows that many kids gradually adopt their parent’s values as they mature (Knafo, 2004).

"Help younger children by placing upsetting news stories into a larger context"

“Note your child’s temperament and adjust media exposure to suit his/her needs”

Passive vs. Interactive Media: Parents were informed that prior research on the topic of passive media does not readily apply to the internet/social media, given that the latter involves interaction, choice, and active decision-making.

Who Can They Trust? We reviewed how much of the recent research on interactive media use is plagued by poor definitions of cyber behavior (Patton, 2014) and in many ways is riddled with researcher bias (Ferguson, 2013).

Developmental Approach: Parents were informed about how to discuss these issues with younger children versus adolescents.
Younger Children: Younger children require more supervision/monitoring and need more help in being able to identify their feelings. At times they also need help in distancing themselves from imagery/thoughts that are disturbing. Dr. Barcewicz discussed how to use Mindfulness Techniques, such as comforting images (thoughts of leaves floating down a river or clouds floating through the sky) to help kids clear their thoughts. She also mentioned how helping children shift to different activities, particularly physically engaging activities can have a positive impact on mood (Siegal & Bryson, 2011). One of the most comprehensive summaries of how terror/violent media impacts younger children was summarized on the National Association of School Psychologist’s website in 2002, following the World Trade Center terrorist attacks. Both Dr. Barcewicz and I found it to be the most comprehensive listing of information on this topic and we highly recommend it to parents and professionals (http://www.nasponline.org/resources/crisis_safety/children_war_general.aspx)

Older Children: Older children need to feel that their parents listen to them and respect their opinions. Dr. Barcewicz talked about the biological underpinnings of adolescent brains and their need for high stimulation/ excitement. She cited recent research and a helpful book on the topic, "Brainstorm," by Daniel Siegel (Siegel, 2014).

Talking to Adolescents: I covered how parents could discuss the recent series of civil rights violations and civil unrest that has arisen in many US cities with their adolescents. I emphasized how to connect emotion with thought by talking with adolescents about a recent NY Times article that discussed the relationship between “Missing Black Men” in US cities and the subsequent likelihood of racial unrest (Wolfer, 2015). Parents found this example helpful since it provided them with a practical way to connect their values with their child’s media experience.

“Teach your kids how to take responsibility for their down-time and boredom”

Boredom Management: At the end of the presentation, I reviewed how adolescents need to learn how to manage “down-time” when they are not exposed to social media. We also talked about how parents can guide them in structuring their own time in order to decrease boredom. Parents learned that they need to encourage their kids to take responsibility for their boredom rather than asking others to manage it for them.

References:

Alia-Klein, N. et al. (2014). Reactions to media violence: It’s in the brain of the beholder. Viewing Media Violence, 9, 1-10.
Becker-Blease, K.A., Finkelhor, D., & Turner, H. (2008). Media exposure predicts children’s reactions to crime and terrorism. Journal of Trauma and Dissociation, 9, 225-248.
Brown, K.D. & Hamilton-Giachritsis, C. (2005). The influence of violent media on children and adolescents: A public health approach. www.thelancet.com, 365, 702-710.
Ferguson, C.J. (2013). Violent video games and the supreme court. American Psychologist, 68, 57-74.
Ito, M. et al., Living and learning with new media: Summary of findings from the digital youth project. (2009). Cambridge, MA: MIT Press.
Knafo, A., & Schwartz, S. (2004). Identity formation and parent-child value congruence in adolescence. British Journal of Developmental Psychology, 22, 439-458.
O’Keeffe, G.S., Clarke-Pearson, K., & Council on Communications and Media (2011). Clinical report-The impact of social media on children, adolescents, and families. American Academy of Pediatrics, 127, 800-804.
National Association of School Psychologists (2002),Children and Fear of War and Terrorism. Retrieved from http://www.nasponline.org/resources/crisis_safety/children_war_general.aspx.
Patton, D.U. et al. (2014). Social media as a vector for youth violence: A review of the literature. Computers in Human Behavior, 25, 548-553.
Siegel, D. & Bryson, T. (2011). The whole-brain child: 12 revolutionary strategies to nurture your child’s developing brain. New York: Delacorte Press.
Siegel, D. (2014). Brainstorm. Brunswick: Scribe Publications.
Wolfers, J., Leonhardt, D., Quealy, K., (2015, April 20). 1.5 Million Missing Black Men. The New York Times Retrieved from http://www.nytimes.com/interactive/2015/04/20/upshot/missing-black-men.html?abt=0002&abg=1.

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Are Your Patients Vaping 58 Joints/Day?

David A. Perna, PhD
Licensed Psychologist
Lecturer in Psychology
Department of Psychiatry
Harvard Medical School

The Clinical Assessment of Vaping Exposure

Your Adolescent's Eating Habits: From Soup to Nuts

Heather Corazzini, MA
Psychology Intern
Copernican Clinical Services

Categories

Anger Research: Staff at the Yale Child Study Center Provide a Helpful Summary Article

David A. Perna, PhD
Licensed Psychologist
Lecturer in Psychiatry
Harvard Medical School

Categories

MIT/Dyslexia/New Research: Reading Challenges are More Pervasive than Previously Thought

David A. Perna, PhD
Licensed Psychologist
Lecturer in Psychiatry
Harvard Medical School

Categories

"Dyslexia affects many brain regions, not just those involved with language."

Gabrieli-2016

Executive Function Challenges and Anger

David A. Perna, PhD
Licensed Psychologist
Lecturer in Psychology
Department of Psychiatry
Harvard Medical School

"Executive functions are viewed to be primary learning challenges that impact functioning across a variety of learning contexts."

"Cognitive flexibility allows kids to adjust to the curve balls that life throws at them."

Categories

Today's Social Media: Windows into a Violent World

David A. Perna, PhD
Licensed Psychologist
Lecturer in Psychiatry
Harvard Medical School

"Parents Should Use Their Values to Guide Their Parenting"

"Help younger children by placing upsetting news stories into a larger context"

“Note your child’s temperament and adjust media exposure to suit his/her needs”

“Teach your kids how to take responsibility for their down-time and boredom”

References:

COPERNICAN CLINICAL SERVICES

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Copernican Clinical Services:
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Reach Out To Us At:
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​David A. Perna, PhDLicensed PsychologistLecturer in PsychologyDepartment of PsychiatryHarvard Medical School

The Clinical Assessment of Vaping Exposure

Categories

David A. Perna, PhDLicensed PsychologistLecturer in PsychiatryHarvard Medical School

Categories

Categories

"Dyslexia affects many brain regions, not just those involved with language." Gabrieli-2016

David A. Perna, PhD​Licensed PsychologistLecturer in PsychologyDepartment of PsychiatryHarvard Medical School

"Executive functions are viewed to be primary learning challenges that impact functioning across a variety of learning contexts."

"Cognitive flexibility allows kids to adjust to the curve balls that life throws at them."

Categories

David A. Perna, PhDLicensed PsychologistLecturer in PsychiatryHarvard Medical School

﻿"Parents Should Use Their Values to Guide Their Parenting"

"Help younger children by placing upsetting news stories into a larger context"

​“Note your child’s temperament and adjust media exposure to suit his/her needs”

﻿​“Teach your kids how to take responsibility for their down-time and boredom”

References:

COPERNICAN CLINICAL SERVICES​Welcome To Our Posts

Archives

Categories

Copernican Clinical Services:"We Help People Change"

Reach Out To Us At:Ph: 617-244-2700Fx: 617-244-2774E-mail: admin.help@copernican.solutions

David A. Perna, PhD
Licensed Psychologist
Lecturer in Psychology
Department of Psychiatry
Harvard Medical School

David A. Perna, PhD
Licensed Psychologist
Lecturer in Psychiatry
Harvard Medical School

"Dyslexia affects many brain regions, not just those involved with language."

Gabrieli-2016

David A. Perna, PhD
Licensed Psychologist
Lecturer in Psychology
Department of Psychiatry
Harvard Medical School

David A. Perna, PhD
Licensed Psychologist
Lecturer in Psychiatry
Harvard Medical School

"Parents Should Use Their Values to Guide Their Parenting"

“Note your child’s temperament and adjust media exposure to suit his/her needs”

“Teach your kids how to take responsibility for their down-time and boredom”

COPERNICAN CLINICAL SERVICES

Welcome To Our Posts

Copernican Clinical Services:
"We Help People Change"

Reach Out To Us At:
Ph: 617-244-2700
Fx: 617-244-2774
E-mail: admin.help@copernican.solutions