Dr Nicole Carvill on why paediatric psychology is about the heart and head
In this episode of Moments in Mind, paediatric psychologist Dr Nicole Carvill opens up about the career highlights and life-changing moments that she’s shared with children and parents. Along the way, she offers some pointers to maximise the effectiveness of standardized assessments and explains why these tools make such a profound difference.
JUMP TO: Listen on Apple Podcasts • Listen on Spotify • View all episodes • Products • Transcript
This article contains edited excerpts from the podcast. To hear the full episode, click on the audio player above or listen via Apple Podcasts, Spotify or wherever you get your podcasts. A full written transcript of the podcast is available here.
Andy McLean: Nicole, you've had a long and eventful career working with children and families. Can you tell us about what drew you into paediatric psychology?
Dr Nicole Carvill: My path into paediatric psychology was a winding one. I briefly flirted with hotel management but soon switched to studying disability services. I’d grown up with a brother who was disabled so I suspect my childhood experiences probably drew me towards that area. After a varied role in disability services, early in my career, I then realised that working with children and families was my passion and that's when I decided to specialise in this area.
Andy: Working memory is a crucial cognitive function for children's learning and development. Can you explain what working memory is and why it's so important?
Nicole: I think of working memory as being like a post-it note. It allows us to hold onto information so long as we focus on it and remember it. Working memory is essential for tasks like following instructions, problem-solving, and retaining new information. For children, working memory is particularly vital because underpins their ability to learn and succeed in the classroom. If a child struggles with working memory, they may have difficulty keeping up with the pace of instruction, leading to gaps in their understanding and potential academic challenges. We use Pearson standardized assessments such as the Working Memory Rating Scale (WMRS) to pinpoint children’s challenges.
Andy: You've worked extensively with standardized assessments to evaluate children's cognitive abilities. How do you approach these in a way that makes the experience positive for the child?
Nicole: When conducting assessments, my goals are to help each child feel safe, comfortable, and engaged. I start by meeting with the parents first, without the child present, to understand their concerns and prepare them for the process. This helps reduce anxiety and ensures the child is well-supported. During the assessment with the child, I incorporate fun, interactive activities to keep them interested and focused. My aim is to make the experience enjoyable, rather than something the child dreads.
Andy: Explaining the results of assessments to parents requires sensitivity and skill. How do you approach that?
Nicole: Parents are often anxious to understand their child's strengths and challenges. I always start by acknowledging their concerns and trying to reduce their anxiety. I give them the option of hearing the conclusions at the very start or (my preferred method) explaining the context around the assessment results first.
Either way, we’ll then talk through the implications of the results and what it means for their child's development. I want to empower parents with knowledge, so they can then become effective advocates for their child and work collaboratively with me on a plan of action.
Andy: You're also a widely respected educator and have delivered Pearson Clinical professional development for educators, health professionals and others. Why is this work important to you?
Nicole: Because it widens the reach and multiplies the impact I can have. Educators, in particular, spend a significant amount of time with children and can be powerful agents of change. By providing them with additional knowledge and strategies, I can help them better support the children in their care. The ripple effect of professional development is powerful – it means more children and more families benefit from a deeper understanding of neurodevelopmental challenges.
Andy: Years from now, when you look back on your career, what will you remember most?
Nicole: Firstly, the most rewarding moments for me are when I see the tangible difference our work has made in a child's life. It’s very humbling when I receive positive progress updates from parents, sometimes years after we’ve worked with a child.
Secondly, I’ll always remember the mentors and role models who inspired me when I was starting out. They showed me what was required to be a psych who operates with integrity and runs a clinic I can feel proud of.
ADHD Assessments
Discover targeted assessments to create a personalised ADHD treatment strategy
Academic Achievement Assessments
Identify learning difficulties and academic potential with assessments for literacy and numeracy
Wide Range Assessment of Memory and Learning | Third Edition
Measure short- and long-term memory functioning and the ability to learn new material in children and adults
We use Pearson standardized assessments to pinpoint children’s challenges...
00:32
Andy McLean
Hello and welcome to the final episode in season one of Moments in Mind – a podcast from Pearson Clinical Assessment
My name is Andy McLean, and I'm a podcast producer based in Australia. In this series, we've been sharing extraordinary stories of professionals who make a difference in people's mental wellbeing every single day. And in each episode, a special guest reveals moments that have changed not only their life, but also the lives of the people who they support …and we've saved one of our best conversations to last…
In today's episode, I chatted with Dr Nicole Carvill, a highly respected psychologist, researcher, mentor and training provider.
There was so much I wanted to ask Nicole. She's an incredible human with amazing stories to tell, so I was delighted when she invited us into her busy, warm and welcoming clinic at Think Psychologists in Geelong, Australia.
As you'll hear in our conversation, Nicole is definitely a clinician who engages both her head and her heart. She really opens up about why she chose to specialise in working with children and young people, and how her experience as a sister and a parent deepened her appreciation for the highs and lows that families go through before and during assessments and intervention programs.
And so without further ado, let's jump in and hear the discussion…
Andy McLean
Well, Nicole, welcome to Moments in Mind.
Dr Nicole Carvill
Thank you for having me. I'm excited.
Andy McLean
Yeah, I'm excited too. I've been really looking forward to this conversation. We've got a lot to get through. Before we jump into your professional life, we're asking each of our guests in this series for the first moment they can remember from childhood. So can you think back, reach back into your memory banks and tell me what you can remember?
02:24
Dr Nicole Carvill
First, it's a long time ago now, my childhood! So, what do I remember?
It's hard for me to separate out my memories from my brother – he was such a big part of my life. I don't really remember time before him, but I remember when he was born, and we used to spend a lot of time in hospital and things like that, because he was really unwell.
I think there that's probably some of my core memories are around him and that, and, you know, just watching him grow up and the way that he'd been treated by different people. So yeah, I think that that just became a fundamental part of who I am and drove me potentially to where I am now.
03:07
Andy McLean
Alright. Well, that leads us on to my next question actually, Nicole! I'm interested to sort of find out what led you into not just working in psychology – but specifically working with children. Can you tell me a bit about that?
03:18
Dr Nicole Carvill
So I ended up going into Hotel Management. That was my first degree first, but I only did one year. So I started doing that but I failed my cream caramel because it didn't set!
From there, I really started to rethink what I wanted to do, because obviously Hotel Management was not for me!
So then I went and started disability studies. I did a year there, and then from there, decided I really wanted to niche down into Psych. So that was quite a journey to get to there.
And then, when you're doing undergrad psych, you don't really specialise. So it was very broad at that time. So then my first job out was in Disability Services, and the range of kids that we worked with was from [age] six to adults, so you know, it wasn't specific.
And then from there, I just kind of fell into paediatrics, or I will just keep calling it “paeds”, because it's much easier for me. So I went to specialist children's services at Disability Services and worked with [age] zero to six kids. And that's when I decided that that's what I wanted to do, because I loved working with the kids and families. It was just great. It just felt like it happened naturally, that it wasn't a conscious decision.
But now, in hindsight, I do wonder if there is a part of me that thought that I wanted to make a difference for other people's lives so families had maybe an easier time than I remember [in my own childhood].
04:52
Andy McLean
I understand that you've worked as a memory specialist with Victorian schools, and you even wrote a guide for parents on the subject. Can you tell me a little bit about what “working memory” is – and why it's so important for children?
05:04
Dr Nicole Carvill
Your working memory is your capacity to take in and hold on to information temporarily, to do something with it, to produce a result.
So if you think about your working memory, it's kind of like a little post-it note. I know people can't see me when I'm doing this, but I'm holding that [post-it note] up to my head, so it's like a little post it note. And basically the size of that post-it note determines how much information a kid can hold on to for long enough to use it.
But it's also highly related to your attention and concentration. So if you think about your attention like a spotlight, it's got to be focused on that post-it note. But what happens sometimes is kids will get distracted by things that are happening around them or things that they're thinking about, so that spotlight goes somewhere else, and then that information is lost, and that's referred to as catastrophic loss. So once it's gone, it's gone.
If you think about how classrooms typically work. Teachers speak a lot generally, because that's how they give out information. If you're rapidly losing that information, then you're missing opportunities. It's hard still in primary school, but in primary school, there's lots of repetition, so you get lots of opportunity to go over the same information. But once you hit secondary school, the impact is much bigger, because if you think about the rate of content delivery, it's much faster in secondary, because it's just like different teachers different subjects, you don't get the same degree of repetition.
So that's kind of why working memory is really important. Because if you can't retain the information, you're not going to learn it.
06:41
Andy McLean
And are there any particular assessment tools that you use when you are assessing memory?
06:47
Dr Nicole Carvill
Yep so we talk about it just as working memory capacity, so we would use a cognitive assessment. So these are Pearson assessments. So the WISC (and the WISC-V for younger kids). Typically, we use those because they give us a nice measure of working memory, but also attention as well, because you need to be looking at both.
07:07
Andy McLean
Now the next moment in your career I'm interested to explore is a leap of faith, so a time in your career where you really had to kind of grit your teeth and just push on through and tell me a little bit about what you learned from that experience too.
07:24
Dr Nicole Carvill
Starting the business, that was probably the biggest act of optimism!
So again, I sort of fell into that organically. We started out… So Caitlin Jolly – who is here as well – she's a speech pathologist, and so her clinic is co-located with us.
Originally, when we started out together, we worked at an agency called Gateways, doing autism assessments, and then we just started to work independently doing assessments.
We both shared a room in a clinic in Belmont in Geelong, and we would just rotate in and out, and then gradually, what happened is the NDIS was introduced into our region, and we were a trial site. So once that happened, that changed everything, because demand started to really increase, and at that time, there weren't many people to refer to, so it made sense to us to start to employ therapists.
So from there, we just got bigger and bigger slowly and just added to the team.
08:27
Andy McLean
And for anyone listening to the podcast right now, obviously you can't see what we can see, but we've entered the clinic today here in Geelong, and the place is buzzing. There are kids laughing. You can hear clinicians and other professionals working with kids. There's lots of smiles around the place. There's several rooms here. It's quite a substantial clinic, so you've grown quite a bit.
08:51
Dr Nicole Carvill
Yeah, so there's about 15 therapists here now. We're a mix of occupational therapists – OTs, speech pathologists and psychologists and social workers.
09:04
Andy McLean
And now thinking back to when you had children, how would you say that has influenced the way you practice as a psychologist?
09:15
Dr Nicole Carvill
It's influenced me in so many different ways.
Once I had kids, I started thinking about what this is actually like from a parent perspective, to navigate this kind of service, and how when you come into new places.
It's overwhelming and it's a bit scary, and you don't know what to expect, and you're worried maybe that people will be judging you and you won't have the opportunity to talk about the things that are important to you.
So, you know, when we were looking at setting up this clinic, all of those things were running through my mind, because I wanted it to be a really good experience, not just for the kids, but for the parents as well.
So [parenting] definitely influenced me in that way, but also in terms of the things that I've been interested in. Both of my kids are neurodivergent, so when we recognise that, then, you know, I started going out and learning a lot more about those particular areas, it definitely made me pivot into a certain direction that potentially I wouldn't have originally, because it becomes your passion.
10:23
Andy McLean
When you talk about that direction, what direction did it kind of steer you?
10:28
Dr Nicole Carvill
More towards working with neurodivergent kids and families. So when I say “neurodivergent”, I'm talking about ADHD, autism, etc.
10:39
Andy McLean
Now you've been talking a little bit about your business, and certainly, even when we walked through the door today, we were greeted really warmly by your colleague, Lucy. It really was quite noticeable. She introduced herself made us feel welcome. And I'm sure that's the approach that your clients receive when they arrive too, which is quite lovely. And when I look at your website, you talk about “viewing children through the lens of a psychologist, with the heart of a parent”.
You're clearly running a place that is as much about the heart as well as the head, right?
11:10
Dr Nicole Carvill
What it means to me to view kids “through the lens of a psychologist” is that's when I would be thinking about the way that we were trained to view kids, so thinking about, you know, just a very clear, cut approach that is used. And it's not designed to be a cold approach, but it almost feels like a cold approach when you're just doing things like that.
But if you start to introduce the using “the lens [heart] of a parent”, it's an entirely different experience, because then you're more sensitive, more understanding to what's going on for parents, and hopefully have greater empathy towards them when they come in here, knowing how hard it is to reach out and look for some support, but also just knowing that parents want the best for their kids. And they're often feeling really worried when they come in here and really vulnerable, and so a big part of our job is to help them to feel comfortable, safe and relaxed in this space.
12:21
Andy McLean
It’s interesting, because you will be obviously conducting assessments and things like that, right, which are, by necessity, objective and scientific in nature. In practice, though, presumably, that's where you might be applying that “heart of a parent” a little bit, because that's where you're trying to make the experience engaging [and] hopefully enjoyable for a child. So can you tell me a little bit about perhaps, how you apply those assessments and make them an experience that kids feel comfortable in?
12:52
Dr Nicole Carvill
And I think that this is where my parent perspective comes in.
The first step is we ask the parents to come in without the child. So they come in, they get the opportunity to see the space to – if it's me – meet me, ask any questions, talk about anything that's on their mind. And that in itself, is a really valuable experience from a parent perspective. They come in, hopefully they feel comfortable. We talk about what the assessment is going to look like. So they're fully prepared, so they can prepare their child for when they come in and then when they walk out, they've got some information so that they can share that with their child. So hopefully it's less stress inducing, coming in.
And I always say to parents that my first goal, really, with kids when they come in, is to help them to feel safe. So when kids come in, having that preparation makes a really big difference.
When the kids come in, we'll play some games, we'll do some fun stuff, and then I introduce the assessment in a very non-threatening way. So for most kids, it's not a bad experience for them,
13:58
Andy McLean
Yeah, which is really important, right? Because the assessment is just one early step on a path where you might be doing a quite a lengthy intervention with an individual. So you want them to feel comfortable and happy in the environment and want to come back?
14:12
Dr Nicole Carvill
Oh, 100%. Yeah, the goal is always to help kids to feel comfortable and safe so that they look forward to coming here. It shouldn't be a chore. It should be something that is fun and engaging and helpful and useful.
14:25
Andy McLean
And how about at the point where you get the assessment results back and you're imparting that information, I suppose, initially, to the family, how do you approach that and manage everybody's emotions and so on?
14:40
Dr Nicole Carvill
So in terms of feedback for assessment – that's the third step when we're doing an assessment process. And parents are always nervous when they come in. So the first thing that I try to do is help them to feel comfortable and just reduce that anxiety a little bit.
And some parents have a preference for hearing the outcome straight away, and others are happier to go through a process where we talk about all of the different things that we did and then what the outcome is. So I try and get a sense for you know what their preference is.
Generally, I'd rather not go straight into what I'm thinking is happening. I'd rather provide that kind of context around it, because then it prepares a parent to understand what a diagnosis is and why we reach that conclusion and where to from here.
So always at the end, I'm hoping that parents are walking away feeling like they know what's happening and what to do moving forward and with a new understanding of their child. Because often parents can be incredibly hard on themselves, and in the absence of having this sort of knowledge, your default is just to think that it's your “fault” that you've “done something wrong”. I hope that this process changes that, and the sense that I get is that it does.
It's really lots of “aha! Moments” for parents when they get this information.
16:12
Andy McLean
Yeah. I mean, speaking as a parent myself, you know, we do feel an innate responsibility for our kids, and it's not just – again – we're talking about hearts and heads again, aren't we! As a parent, you operate at both levels as a parent. So there's an emotional response, but then there's also the rational response, and I think it can help enormously to have a diagnosis and to start to have a plan of action and to say these are the things that you can hopefully do as a parent.
16:37
Dr Nicole Carvill
Oh, absolutely. So parents are looking for understanding and what they can do to support their child's life. So [that] it's an easier journey.
No parent likes to see their child struggle, and I think that the other benefit of having diagnosis and information about a greater understanding of kids is that then you can share it with other people. So you can become a key advocate for your child.
Because what tends to happen is, in the absence of having a diagnosis, people will make negative attributions about kids. So they will think potentially, that they're “lazy”, that they're “not listening”, that “if they tried harder they could do it”.
But once you actually understand – say for example, if it was a working memory difficulty – once people, teachers, parents, understood that a child's optimal sort of level for information is maybe, you know, one instruction at a time, once you start to change that, then you set that child up for success, and it makes a huge difference. So having that information, I think, is critical.
17:48
Andy McLean
Yeah, absolutely. And as you say, this extends not just to the child themselves and the parents and families, but also to teachers and others who work with the children as well.
17:56
Dr Nicole Carvill
Yeah, definitely.
17:59
Andy McLean
And we'll be right back after this break
18:05
Promotional message
For more than 100 years, Pearson Clinical Assessment have tested and refined products and services that give educators and clinicians trusted tools to make a profound difference in the lives of adults and children. To find out more about the Pearson resources that Nicole and her colleagues use at Think Psychologists – covering everything from learning difficulties to working memory to attention deficit disorder and more – just Google “Pearson Clinical Assessment”, and check out the Pearson website.
18:50
Andy McLean
So we've talked a little bit about your work with parents and children, and we'll come back to that. But I'm also interested, too, in your work with other professionals, because I know that you've been a presenter for Pearson Professional Learning, which provides professional development for the education and health industry. Why is that work so important to you? And how do participants benefit from the professional learning?
19:12
Dr Nicole Carvill
That work, I think, is incredibly important, because then the scale is much bigger in terms of who you can influence. So when we're working one-on-one, that's still incredibly powerful. But once you get more people on board, then that makes a massive difference in terms of bringing about change.
And I think you know, fundamentally, what we hope to do is to bring about change at a greater environmental level, so that more people are aware of the challenges that many kids face.
So the work with Pearson around the Pearson Academy around the PD, was a terrific opportunity to connect with lots of educators, because when you think about educators, they're spending eight hours a day with kids. So they are important change makers. And once you provide them with additional information that is helpful to their role, they can affect and impact many kids trajectories.
And, you know, I think that's the power of that work, the value of that work.
20:19
Andy McLean
Yeah in a way, you're multiplying the impact that you can have, aren't you.
Also, do you have any tips that you typically give to people who are approaching standardised assessments, maybe starting out with them, using them for the first time in their career? Any advice you share with people?
20:34
Dr Nicole Carvill
That's a great question, and I'll talk about what we do here…
So when someone new starts with us, and if we've got a provisional site here on placement, what we tend to do is give them the opportunity to watch us first, so they get to sit in because it's very different practicing assessments on your own. So we'll start with that, and then we go into observing them do doing the assessments as well.
I think one of the biggest tips that I tend to give to early career therapists is to be as familiar as you can with the tests and run through practice, because it's so much information, even though you've got a book in front of you that theoretically you can read and check into it disrupts the flow of the assessment and makes it a more awkward experience for the child, really, and the therapist as well. But yeah, kids are very forgiving.
21:30
Andy McLean
Let's talk a little bit more about clients, so paediatric psychology can have a profound difference in people's lives. I just wondered if you could perhaps describe some of the breakthrough moments that you've witnessed?
21:46
Dr Nicole Carvill
I've had lots of breakthrough moments that have just been a real joy to witness, and I've been so privileged to see it.
So I'm thinking about a girl who I saw – this was a long time ago now, but she would have been in probably Year 10, Year 11 at the time, and she was someone who had lots of challenges with her working memory [it] wasn't identified until later.
And she came to me, and we did the working memory assessment, worked out what was going on for her, gave her some strategies, and she also did the Cogmed Working Memory program.
So she did that, and she did really well, like she was fantastic. So we reassessed her working memory after that, and there was some improvements.
And then two years later, I got an email from her dad saying that she'd finished Year 12. Her ATAR [result] was much better than what they had originally expected for her, and she could get into the [university] course that she wanted.
And so he sent me an email just to say, “thank you so much, and that that changed her life”.
Which I think is like, I don't take the credit for that – that [achievement] was all about her [effort] – but it was just lovely to get that feedback. And I think when you can make a difference on someone's life so that two years later, someone will contact you, that feels pretty powerful.
23:08
Andy McLean
I’ll bet. I'll bet. Now I could talk all day with you, Nicole, I could listen to you all day. It's been such a great conversation. Before we go, I did just want to ask you one final question, which was, I guess, when you're looking back many years from now in your old age, and you're thinking back over your career, what do you think are the moments that you'll remember most?
23:30
Dr Nicole Carvill
I'll remember the people and the relationships and the connections.
If I think about early in my career, I was really lucky to start working at a time when there were good support networks around me, and I had fantastic role models for what it was to be “a psych with integrity”.
Having that role model set me up with a foundation for not only being a psych with integrity, but a clinic director, and you know how to set up a clinic that I felt proud of.
So, you know, I think I'll remember the people. I'll remember the therapists that I've helped to train and move them forward in their career. And I think they're probably the things that I will remember the most.
But also, I suppose I hope that I look back and think that I was proud of what I did, and that I in some way made a difference in someone's life and made their life a little bit easier. If I can look back and think that [then] I'd be thrilled.
24:38
Andy McLean
Yeah, that's lovely. And I must say, Nicole, it's interesting. You've talked about your role models, and I know that you're a role model yourself for many professionals, too. So it's just been such a privilege to have this conversation and have this time with you. So thank you for taking time out to do so.
24:53
Dr Nicole Carvill
Thank you for having me. I've really enjoyed it.
25:01
Andy McLean
Thank you for listening to this, the final episode in season one of Moments In Mind, a podcast by Pearson Clinical Assessment.
To find out more about the Pearson Professional Learning that Nicole referred to, and also the Pearson resources that Nicole and her colleagues use at Think Psychologists – covering everything from learning difficulties to working memory to attention deficit disorder and so much more – just Google “Pearson Clinical Assessment” and check out the Pearson website.
And to find out more about Nicole's work, visit thinkpsychologists.com.au
And so we've reached the end of season one of moments in mind! If you've missed any of our episodes and you want to listen back, or if you want to subscribe to make sure you don't miss season two – which will be coming later in the year – you can find us on Spotify, Apple Podcasts, YouTube… pretty much wherever you listen to your podcasts. And while you're there, do feel free to leave us a rating or review. We'd be so grateful if you did.
In the meantime, until season two comes around later in the year, thanks again for listening, and goodbye for now you.
Disclaimer
Client details and narratives presented in this podcast have been altered or omitted to protect confidentiality and privacy. Any similarities to actual individuals, events, or circumstances are entirely coincidental. Each client interaction is unique, and the outcomes or breakthroughs described are specific to the individuals involved. These examples are provided for illustrative purposes only and should not be interpreted as guarantees or promises of similar results for others.
Disclaimer: Client details and narratives presented in this podcast have been altered or omitted to protect confidentiality and privacy. Any similarities to actual individuals, events, or circumstances are entirely coincidental. Each client interaction is unique, and the outcomes or breakthroughs described are specific to the individuals involved. These examples are provided for illustrative purposes only and should not be interpreted as guarantees or promises of similar results for others.
Moments in Mind is also available to listen on your favourite streaming platforms: Amazon Music / Audible, Youtube, iHeartRadio, Deezer