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Twice-Exceptional Children: Understanding Their Unique Pattern of Strengths and Support Needs
A child explains a complex scientific idea but cannot begin a simple worksheet. Another reads years above grade level but becomes overwhelmed when plans change. A student solves advanced problems mentally, yet routinely loses assignments, forgets directions, or shuts down during written work. The patterns can seem contradictory, but they are not. Some children have significant strengths or advanced abilities while also having a disability, developmental difference, or area in
Cara Koscinski
Sep 167 min read


Executive Function Is Dynamic: Why State Matters for Both Access and Learning
A child’s ability to use executive function skills can change from moment to moment. So can their ability to learn new ones. When we talk about executive function, we often describe skills such as initiation, working memory, planning, organization, flexibility, inhibition, time management, persistence, and metacognition. This can make executive function sound straightforward: identify the weak skill, teach a strategy, practice it, and expect improvement. But executive functio
Cara Koscinski
Aug 75 min read


Executive Function Assessment: Why Traditional Approaches Miss the Bigger Picture
The EFX™ Access Profiler™ is a new participation-focused executive function assessment and clinical reasoning system designed to help professionals better understand executive function access across real-world contexts, supports, regulation states, and participation demands. Beta testing opportunities are opening soon.
Cara Koscinski
Jun 35 min read


Why School-Based OTs, PTs, and SLPs Need to Understand MTSS
When MTSS feels stuck, the issue may not be student motivation; it may be access. This body-first, access-based perspective helps school teams look beneath observable challenges to better support regulation, executive function, and meaningful participation.
Cara Koscinski
May 126 min read


Toileting Starts with Access: A Body-First Approach to Support
Toileting depends on much more than learning a routine. Interoception, regulation, sensory processing, nervous system state, and body awareness all influence how children access toileting participation. This body-first, neurodiversity-affirming approach helps caregivers and professionals better understand the systems underneath daily routines and support children through access, safety, and participation.
Cara Koscinski
May 105 min read
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