Executive Functions. what are they how do they affect your child how can you help your child who has vulnerable EF skills. Joyce M.

Transcription

1 Executive Functions what are they how do they affect your child how can you help your child who has vulnerable EF skills Joyce M. Ball 4/29/09

2 Let s see what we know about EF. What does executive functioning mean to you? What skills are included under EF? What signs are indicative of a child with vulnerable EF skills? When are EF skills developed? Can these skills be taught? What are two broad categories of ways to help children/students with vulnerable EF skills?

3 Graphic of Brain and its Functions EF skills

4 General Definition of Executive Function EF..the brain s CEO, or the orchestra conductor of all our cognitive skills Executive skills allow us to organize our behavior over time and override immediate demands in favor of longer-term goals. Through the use of these skills, we can plan and organize activities, sustain attention, and persist to complete a task. Executive skills enable us to mange our emotions (referred to as hot EF skills vs... the other skills referred to as cool ) and monitor our thoughts in order to work more efficiently and effectively. Executive skills help us select and achieve goals or to develop solutions to problems. These skills include: planning, organizing, time management, working memory, and metacognition (selfmonitoring and self-evaluation). To reach a goal, we use skills to guide and modify our behavior as we move on the path towards reaching a goal. These skills include: response regulation, selfregulation or affect, task initiation, cognitive flexibility (this includes making transitions), and goal-directed persistence. From: Dawson and Guare, Executive Skills in Children and Adolescents

5 Developmental Tasks Requiring EF Skills Preschool - run simple errands; tidy bedroom/playroom; perform simple chores and self-help tasks; inhibit behaviors (don t touch hot stove, don t run into the street) K-2- run errands; two/three step directions; tidy bedroom/playroom; perform simple chores; do self-help tasks w reminders; bring papers to and from school; complete hw assignments (20 mins max); decide how to spend money/allowance; inhibit behaviors (raise hand to speak, keep hands to self, don t swear) & follow safety rules Gr run errands (may involve a time delay); tidy bedroom/playroom; perform tasks that take mins; bring materials to and from school; keep track of belongings when away from home; complete hw (up to 1 hour max); plan simple school project; keep track of changing daily schedule; save money for desired objects; inhibit & self regulate-behave when teacher leaves classroom, refrain from rude comments

6 Developmental Tasks Requiring EF Skills Gr 6-8- help w chores in home baby sit younger siblings use a system for organizing schoolwork (inc. planner, notebooks) follow school schedule plan and complete long-term projects plan time inc. for after-school activities, homework, family responsibilities inhibit rule-breaking when authority not visible More Specifically..Students in middle school are expected to: remember to write down assignments consistently keep track of assignments and materials (notebooks, folders, books, know which materials need to be brought home or taken to school daily plan and monitor long-term assignments, including breaking them down into subtasks and creating timelines plan how work will be organized and time will be spent, including estimating how much time is required to complete daily assignments as well as long-term assignments keep track of other responsibilities or belongings-sports equipment, lunch money, permission slips, etc - manage the complexity of changing classes, inc taking different materials to different classes and having teachers with different organizational styles and expectations

7 Developmental Tasks Requiring EF Skills High Schoolmanage schoolwork effectively on a day-to-day basis: complete & hand in assignments on time, study for tests, create & follow timelines for long-term projects make adjustments in effort & quality of work in response to feedback establish & refine a long-term goal and make plans for meeting that goal (ie college) select appropriate courses & maintain GPA for college acceptance maintain extra curricular activities inc SAT/ACT prep complete college apps make good use of leisure time (employment & recreational activities) inhibit reckless & dangerous behaviors

8 What specific skills are included in EF? Depending on whose work one reads, the skills included in EF vary. Learning Works For Kids, a website, lists 12 executive functions that may be useful in clarifying a child s executive strengths and weaknesses: Planning The ability to develop a set of strategies in order to accomplish a goal; the ability to create a roadmap to reach a goal or to complete a task; it involves being able to make decisions about what s important to focus on and what s not important to focus on. Organization The ability to use a systematic approach for achieving goals; the ability to arrange or place things according to a system. Time Management & Prioritization The ability to respond to things in a timely fashion; the capacity to estimate how much time one has, how to allocate it, and how to stay within time limits and deadlines; it also involves a sense that time is important.

9 And.. Working Memory The ability to remember something while performing an activity on this memory; the ability to hold information in mind while performing and completing a complex task; it incorporates the ability to draw on past learning or experience to apply to the situation at hand or to project problem-solving strategies into the future Metacognition The ability to self-monitor, self-evaluate, and observe oneself; the ability to stand back and take a bird s eye view of oneself in a situation; the ability to observe how one s own self problem solves Response Inhibition (self-control) The ability to stop or delay an action rather than display impulsive behavior; the ability to think before one acts; this ability (to resist the urge to say or do something) allows time to evaluate a situation and evaluate how one s behavior may impact the situation Regulation of Affect The ability to manage one s feelings effectively for decision-making, task-completion, achieve goals, or control and direct behavior

10 And still more.. Task Initiation (getting started) The ability to initiate a task without procrastination Flexibility The ability to be adaptable, improvise, and shift approaches to demands; the ability to revise plans in the face of obstacles, setbacks, new information, or mistakes; it involves adaptability to changing conditions Goal-Directed Persistence -The ability to persevere on tasks that require sustained effort; the capacity or drive to follow through to the completion of a goal and not be put off by other demands or competing interests Social Thinking The ability to respond appropriately to social conditions Sustained Attention The ability to maintain one s focus and attention in the presence of distractions From: and Dawson and Guare, Executive Skills in Children and Adolescents

11 Two dimensions of EF skills Thinking & Doing EF skills involving thinking EF skills involving doing (behavior) Working memory Planning Prioritization Organization Time management Meta-cognition Response inhibition Emotional control Sustained attention Task initiation Goal-directed persistence Flexibility

12 Behaviors Found in a Student with Executive Function Issues: Starts assignments/tasks without necessary materials Does not leave enough time to complete tasks Skips steps in multi-step tasks Has difficulty relating to a story chronologically Jumps the Gun socially Wastes time doing a small project and fails to do the big project Written work is poorly organized Has difficulty identifying what material to record in note-taking When given three or more things to do remembers only the first or the last thing to do

13 Typical Behaviors Found in a Student with Executive Function Issues: Fails to turn in completed work Loses important papers or assignments Has difficulty getting started on tasks, which may appear as oppositional behavior Appears distractible and/or impulsive Picks smaller, immediate reward over larger, delayed reward Runs out of time before completing assignments/tasks Has good ideas but doesn t get the job done Has difficulty making transitions and/or coping with the unforeseen Doesn t check to insure that each step is completed Over-estimates or under-estimates time on needed tasks

14 Typical Behaviors Found in a Student with Executive Function Issues: Doesn t check work before submitting it Exhibits inappropriate or over-reactive responses to situations Starts tasks but may not finish Cannot find clothes, shoes, toys, books, pencils, etc. Doesn t realistically evaluate performance in school From: Rush University Medical Center; Rush NeuroBehavioral Center

15 Two principles to consider when thinking about helping children with EF vulnerabilities According to Kahn & Dietzel, parents and teachers have two primary roles in helping children with EF vulnerabilities: help them be successful in their daily lives & teach the skills and strategies/ approaches that allow the children to be independent in the long run. By providing temporary supports we may reinforce overdependence and learned helplessness. 1. Start with external changes/structures and then move to internal changes 2. Children can be supported by intervening with their environment and/or intervening with them - think of ways to change the environment change the physical or social environment change the nature of the task change the way cues are given change the way adults interact with students - think of ways to change children s skills by motivating them and/or directly teaching them to develop their EF skills to perform tasks and achieve goals

16 Process to teach EF skills to children: In collaboration with your child: Identify the problem or problem behavior..be specific Set a goal; that is ONE goal Create a checklist to reflect the procedure or steps to reach the goal Supervise your child as he/she follows the procedure Evaluate the process and make necessary changes Fade the supervision We must maintain a balance between support and skill building; if we only accommodate, without attempting to strengthen EF skills, we may promote dependency and helplessness. Remember, the ultimate goal is to help children / students develop their own EF skills so they can function independently.

17 How to Change a Behavior Teach, using specific behavioral terms, what is expected of your child vs... punishing Collaborate with your child Focus on the desired outcome Raise the stakes.use a reward system Reward small steps in the right direction Maintain reasonable expectations and decide when to let your child experience natural consequences for his/her behavior Remember, change does not occur in a smooth, steady, uphill manner To change a behavior or teach a skill, it takes 6-8 weeks From: Late, Lost & Unprepared; Kahn & Dietzel

18 Matching your Child to the Task When you know your child has EF vulnerabilities, pay close attention to your child s emotional and behavioral responses to the tasks assigned. When your child avoids a task, consider the possibility that your child can t do it. Figure out what EF skills the task requires & ask yourself whether your child possesses these skills. E.g.. Cleaning one s bedroom.what EF skills are required? Task initiation.start w/out reminders Planning..plan of attack Prioritization what needs to be saved vs... thrown out Organization put everything in its place

19 Matching your Child to the Task Figure out if something in the environment is making task difficult & tweak/change the environment. If your child can do a task sometimes but not all the time, this may simply mean you have identified an EF vulnerability. If your child has successfully handled the task some of the time, figure out what made the success possible and incorporate it. If your child has the EF skills to do a task, the problem may be that your child doesn t believe he/she can succeed? If so, figure out why he/she lacks confidence. (task seems too big, tried & failed previously, previous efforts have been met with criticism, someone has always jumped in and helped) so he/she has never learned to overcome an obstacle independently.)

20 What can teachers do to help students with vulnerable EF skills? Use checklists Use rubrics for assignments Create and use how to lists or tool kits for procedures Use calendars Break up long-term assignments Check that students use their assignment book Teach study skills Teach highlighting/taking margin notes Inform students how long assignments should take Teach 2-column note-taking

21 What can teachers do to help students with vulnerable EF skills? Establish daily routines for : handing in homework, gathering necessary work materials, planning to accomplish the day s tasks, writing down homework, gathering necessary materials for homework, reviewing directions for assignments (at first use a checklist each student or pair completes, then fade by cuing students to use checklist independently) Make class rules, teach the rules explicitly, practice the rules, cue students, then fade As a problem arises during year, discuss with class, identify it, & come up with a process to solve it. Having students help develop a plan incorporates EF skills.

22 What can teachers do to help students with vulnerable EF skills? Incorporate EF skills strategies into daily instruction--ask questions that require EF skills e.g.. how can you remember to.. ; since this is a big assignment, please write down the steps you need to follow ; how will you study for this quiz/test Set goals each student sets a goal (academic or behavioral) and teacher and student meet routinely to check how student is progressing towards meeting goal. If a group goal is established, use advisory to have each student report progress (e.g.. how to study for quiz/test, time management) In order for class-wide strategies to be effective. the strategy/process must be taught explicitly the strategy/process must be monitored daily for a LONG time before fading begins the strategy/process must be designed, described, and taught carefully *if the strategy/process fails, redesign the strategy/process for those students

23 What can parents do to help their child who has vulnerable EF skills? Directly teach the deficient skills rather than expecting that your child acquires the skills through observation or osmosis Consider your child s developmental level and make sure your expectations are developmentally appropriate Move from the external to the internal use cues instead of expecting your child to remember to do ; keep tasks brief instead of expecting your child to work for an extended time period External changes include: changes you make to the environment, changes to the task, or changing the way you interact with your child (rehearse what will happen, use verbal prompts) Use your child s innate drive for mastery & control create routines & schedules; build in choices; practice difficult tasks in small steps & gradually increase the demands; use negotiation the child must do the have to in order to do what s/he wants to do

24 What can parents do to help their child who has vulnerable EF skills? * Modify tasks to match your child s capacity to exert effort remember, our students have a long, challenging day, with lots of transitions (EF), so they may be tired at the end of the day * Use incentives bribery works, but you must be consistent * Provide JUST ENOUGH support for your child to be successful * Keep supports and supervision in place until your child achieves mastery or success * When you do stop the supports, supervision, and incentives, FADE them gradually, never abruptly

25 Consider hiring a coach.so, what is coaching? Coaching is the process in which an adult works with a student to set important schoolrelated goals, to ensure that the student s behaviors and actions on a daily basis are consistent with those goals, and brings the student closer to achieving those goals. 1. Set a goal, identify possible obstacles, write a plan to reach goal 2. Hold daily sessions (5-10 mins) - review/evaluate the plan for previous day - make a plan for that day

26 Through coaching and teaching children to improve their executive function skills, the children will gain knowledge of: * efficient time-management * improved organizational proficiency *sustained motivation * effective planning and scheduling practices * development of proactive behaviors * goal setting and clarification activities * academic and social balance * increased self knowledge of learning styles * development of self-discipline * reduction of fear of failure * skills for coping with ADD/ADHD and other learning differences * personal and academic growth * renewed excitement and curiosity for learning From: Rush University Medical Center; Rush NeuroBehavioral Center

27 Wrap Up Do you better understand what executive functions are? Do you have some idea of how to help your child who has vulnerable EF skills? Please seek out various resources at school to help you help your child. Remember, the ultimate goal is to help children develop their own EF skills so they can function independently Bibliography: Cooper-Kahn, Joyce & Dietzel, Laurie; Late, Lost, and Unprepared; Woodbine House; 2008 Dawson, Peg & Guare, Richard; Smart But Scattered; Guilford Press, 2009 Dawson, Peg & Guare, Richard; Executive Skills in Children and Adolescents; Guilford Pr Meltzer, Lynn; Executive Functions in Education; Guilford Press, 2007