ALL KINDS OF MINDS:2 EXECUTIVE FUNCTIONING:

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1 ALL KINDS OF MINDS:2 EXECUTIVE FUNCTIONING: Dr Roby Marcou

2 a student you know Maria was seen as bright/capable in Gr 1-2 though sometimes slow to complete work Gr 3- a change to IB and school move Gr 4- unable to keep up Frustrateddescribed self as just lazy Psycho-ed demonstrated high average skills no processing or language issues

3 EF: Complex cognitive processes that serve ongoing goal directed behavior Control and coordinate thoughts and behaviors Contextualize intended actions in light of past knowledge and experience, current situational cues, expectations of the future, personally relevant values and purposes Provide a sense of readiness, agency, flexibility and coherence

4 The student with good EF can: Demonstrate purposeful, goal directed activity Display an active problem-solving approach Exert self control Demonstrate maximal independence Exhibit reliable and consistent behavior and thinking Demonstrate positive self efficacy Exhibit an internal locus of control

5 MARIA: WHERE WE ARE IN TIME AND PLACE THROUGHOUT HISTORY MIGRATIONS HAVE LED TO CHALLENGES AND CHANGE Maria will research the migration to Australia of families of Greek origin. CAPSTONE EXHIBITION INDEPTH COLLABORATIVE INQUIRY INDEPENDENCE RESPONSIBILITY EXPLORING MULTIPLE PERSPECTIVES REALLY?

6 Executive Functions include : BASIC SELF MANAGEMENT: Manage the Now! STOP GO SHIFT EMOTIONAL REGULATION

7 INITIATE DEFINITION BEGINNING A TASK OR ACTIVITY in an efficient and timely manner Maria can do her daily math sheets but cannot get going with her exhibition work. DYSFUNCTION HAS TROUBLE GETTING STARTED ON HOMEWORK OR CHORES DOESN T KNOW WHERE TO START

8 INHIBIT DEFINTION NOT ACTING ON AN IMPULSE OR APPROPRIATELY STOPPING ONE S OWN ACTIVITY AT THE PROPER TIME. DYSFUNCTION HAS TROUBLE PUTTING ON THE BRAKES ON BEHAVIOR, ACTS WITHOUT THINKING If you cannot inhibit, you cannot perform any other EF.

9 SHIFT DEFINTION FREELY MOVING FROM ONE SITUATION, ACTIVITY OR ASPECT OF A PROBLEM TO ANOTHER AS A SITUATION DEMANDS; BEING FLEXIBLE AS THE TASK REQUIRES DYSFUNCTION GETS STUCK ON A TOPIC OR TENDS TO PERSEVERATE Maria is distractible and inflexible. She has wasted a lot of time on one idea that isn t working- looking at Pizza restaurants.

10 EMOTIONAL CONTROL DEFINTION MODULATING/ CONTROLLING ONE S OWN EMOTIONAL RESPONSE APPROPRIATE TO THE SITUATION OR STRESSOR DYSFUNCTION IS TOO EASILY UPSET, EXPLOSIVE; SMALL EVENTS TRIGGER BIG EMOTIONAL RESPONSES She refuses to go to school 2 days in a row. She gets upset at her best friend.

11 Some Executive Functions help us to MANAGE LATER PLAN ORGANIZE PRIORITIZE SELF MONITOR WORKING MEMORY

12 PLAN DEFINTION ANTICIPATING FUTURE EVENTS; SETTING GOALS and creating a roadmap to reach the goal. Making decisions about what is important to focus on. DYSFUNCTION STARTS ASSIGNMENTS AT THE LAST MINUTE; DOES NOT THINK ABOUT POSSIBLE PROBLEMS Maria is not willing to use a rubric. She has not started the core aspect of her work

13 ORGANIZE DEFINTION ESTABLISHING OR MAINTAINING SYSTEM TO KEEP TRACK OF INFORMATION OR MATERIALS Maria loses the information she got from her grandmother about the family home in Thessalonica. DYSFUNCTION HAS A SCATTERED, DISORGANIZED APPROACH TO SOLVING A PROBLEM, IS EASILY OVERWHELMED BY LARGE TASKS OR ASSIGNMENTS

14 SELF MONITOR DEFINTION CHECKING ONE S OWN ACTIONS DURING OR SHORTLY AFTER FINISHING THE TASK OR ACTIVITY TO ASSURE APPROPRIATE ATTAINMENT OF GOAL- revising unsuccessful approaches DYSFUNCTION DOES NOT CHECK FOR MISTAKES; IS UNAWARE OF OWN BEHAVIOR AND ITS IMPACT ON OTHERS Her classmates are angry because her part of the exhibition is not ready on time.

15 WORKING MEMORY DEFINTION HOLDING INFORMATION IN MIND FOR THE PURPOSE OF COMPLETING A SPECIFIC AND RELATED TASK She missed the oral instructions about setting up for the exhibition. DYSFUNCTION HAS TROUBLE REMEMBERING MANIPULATING INFORMATION IN MEMORY; LOSES TRACK OF IDEAS AND THINGS

16 Students with EF Issues: May or may not have other specific diagnoses (ADHD, Asperger, Dyslexia, NVLD) Increased in illness or fatigue states, Side effect of other medication, drugs or ETOH Brain injury, neurological, mental disorders, tics, genetics May be successful with tasks IF/WHEN there is sufficient support in a given setting so they may be very inconsistent

17 MOST DEVELOP EF AT EXPECTED PACE AGE 2-5: gradual development of inhibition, working memory, attention, planning Age 6: able to complete organized visual search, capable of simple planning and basic inhibition Age 8-10: rapid growth in attention capacity and and accuracy, cognitive flexibility

18 10-12 Can test hypotheses Can maintain and shift sets Close to the adult level of impulse and attention control Capable of complex planning and goal setting Flexible problem solving and self monitoring Able to impose organizational frameworks; improved fluency and efficiency Growth of mastery continues into adulthood

19 13 year old

20 Why so much talk about EF? Curricular demands reflect societal reliance on rapid communication, advanced technology, efficient media and fast access to vast sources of information Do curricular demands create EF issues in a population of students that simply is not developmentally ready for the expectations? Are we manufacturing a problem? Sleep WHAT DID YOU DO IN GRADE 4?

21 CEFI-Goldstein Barkley Reif Brown BRIEF- Goia

22 How are EF Issues Diagnosed: Bright well motivated students can perform well in an office setting but have EF issues in real life and the classroom Rating Scales- BRIEF, CEFI, Brown ADD Scales Neuropsychological testing Process approaches; observe in less structured settings A student can APPEAR to have adequate EF skills for tasks that they are otherwise fluid with

23 Stroop Part 1 Say the COLOR of the ink: GREEN YELLOW RED BLUE BLACK RED BLUE BLACK YELLOW GREEN

24 Part 2 Say the COLOR of the ink: GREEN YELLOW RED BLUE BLACK RED BLUE BLACK YELLOW GREEN

25 Until development is secure, parents and teachers act as surrogate frontal lobes for children and teens. ADOPT AN ACADEMIC MODEL: THIS IS A SKILLS SET DEFICIT; THE SKILLS NEED TO BE TAUGHT BEHAVIORAL MODELS GENERALLY DON T WORK AS SKILLS ARE NOT TAUGHT

26 EF- Support for ALL Universal level: widely directed as needed Targeted: 10-20% =may include small group instruction Intensive: 1-7% of students= requires collaboration with parents, other teachers, etc.

27 3 ways adults can help Change the environment and expectations to reduce the impact Teach the youngster executive skills Use incentives to get the youngster to use the skills that are hard for them

28 Universal Approaches Modify Environment Reduce distractions Provide organizing structures Reduce the social complexity Change the social mix Provide supervision Modify Tasks Make the task shorter or chunk the work Make the steps more explicit Create a schedule Build in variety or choice into how tasks are done Make the task closedended

29 Basic Meta-awareness: POSITIVE EVERYDAY ROUTINE GOAL: WHAT DO I WANT TO ACCOMPLISH PLAN: HOW WILL I ACCOMPLISH MY GOAL PREDICTION: HOW WELL WILL I DO, HOW MUCH WILL I GET DONE? DO: TRY MY PLAN BEHAVIORALLY REVIEW: EVALUATE ITS EFFECTIVENESS AND GENERATE POSSIBLE ALTERNATIVE SOLUTIONS

30 Change the way the teacher interacts Praise the youngster for using EF skills Increase supervision and support Balance between support and teaching skills SHOULD/CAN T/ WON T

31 3 ways adults can help Change the environment and expectations to reduce the impact Teach executive skills Use incentives to get the youngster to use the skills that are hard for them

32 TARGETED Care with the social mix Task modification Homework clubs Weekly progress reports Small group coaching Peer tutoring More explicit routines Home-school incentives Measure progress and growth INTENSIVE Everybody has to work harder Target behavior is well defined as are criteria for success Skill is explicitly taught, modeled, rehearsed regularly Daily check ins at least Visual reminders of expectations Independent use of the skill is monitored. Support plans involving teacher, student, parent coach

33 Maria and The Greeks- I-DROPS Problem: poor organization and shifting Goals: schemes for organizing information and knowing when things are not going right Steps: I: identify content needed- main idea, depth, amount D: do the basic research as per rubric R: relax and revise as needed O: order the information as it comes in. mind map color code P: put the information into.. color folders S: solve the?- do I have what I need, if not what can I do differently

34 Learn While She Does Create a checklist for each aspect Have Maria tally how often she uses each step Have Maria review the checklist at every step with the teacher Teacher to observe, prompt, provide feedback Periodically revisit the strategy Use the same approach for the NEXT several multistep tasked projects in class and for all tasks where organization is key

35 Classroom Cultures Of Strategy Usage Explicit instruction and modeling in strategy Students develop own strategy notebooks Strategy Share discussions Strategy books to be shared among the class Grade on strategy use and reflection Motivate by tracking strategy usage Access previous memories of success What did you do the last time? Have you learned a strategy to help you solve this problem? Why not try that strategy again? Wasn t it much easier when you used the strategy?

36 3 ways adults can help Change the environment and expectations to reduce the impact Teach the youngster executive skills Use incentives to get the youngster to use the skills that are hard for them

37 Use incentives to augment instruction. Incentives make both the effort of learning a skill and the effort of performing a task less aversive. Furthermore, putting an incentive after a task teaches delayed gratification. Incentives

38 Simple: Reward Task order Short breaks Specific praise Immediate Speaks of value of task Acknowledge effort Help to reflect on skills learned Motivation/Incentives Complex: Start with current level Use innate drive for control Modify task demands to match capacity- decrease task demands so incentive is visible or increase the incentive! Provide minimum support needed for the child to be successful Supervise long enough to achieve success Gradually fade support

39 Teenagers Pick your battles. Use natural or logical consequences. Make access to privileges contingent on performance Be willing to negotiate If something s nonnegotiable, ask this question: What will it take for you to go along? Involve others when you can Build in verification. Understand that everybody has to work harder at something Work on positive communication skills. Set goals that are realistic--sometimes the best you can do is keep them in the game until their frontal lobes mature enough for them to take over

40 When all else fails? It s not what you know; It s what you show.

41 Additional Thoughts Children almost never choose to be nonproductive. Children with EF difficulties very often have parents with EF difficulties. Address issues of fairness early on.

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43 Difficulties in working memory underlie a wide range of learning disorders. MEMORY, PARTICULARLY WORKING MEMORY

44 What did she just say? The plight of the memory impaired child Memory over time Episodic memory versus semantic memory Baseball statistics and other realities Thinking about remembering

45 STEP- BY- STEP Entering info into short term memory (STM) Temporarily maintaining info in working memory (WM) Consolidating new knowledge in long term memory (LTM) Retrieving information from LTM with accuracy and speed

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47 Short Term Memory: A small amount of information is held for a period of seconds and then: Used immediately Held in WM and manipulated Allowed to decay Consolidated into LTM

48 Information to be stored in STM must be: Information must be registered with sufficient intensity or depth of processing to be remembered. Registration must be highly selective and ultimately involve condensing as the capacity of the STM is very limited Attention issues significantly impact the depth of processing step.

49 When there are problems with STM: Inconsistency in direction following Trouble with immediate factual recall Difficulty with initial mastery; know things well once they have it Often little use of strategies Coexisting attention issues Anxiety and memory issues: vicious cycle Fragmented skills for summarizing or paraphrasing Marked confusion with multistep input Very clear modality (visual/auditory/ motor/ sequential) specificitycan remember one modality only- you cannot remember what you do not understand

50 Strategies for support: Teaching saliency determination- what is important enough to try to remember? (increase selectivity) Teaching rehearsal strategiessubvocalization, visualization, association, mnemonic devices, chunking, (increase depth of processing) Teaching paraphrasing (selectivity and depth of processing)

51 Working Memory is. The aspect of memory which allows us to mentally suspend information while using it or manipulating it The memory needed to carry out the current task: a mental workspace, jotting pad or juggler

52 Keeping track.. 7 R 1 C Y 6 T

53 Working Memory is.. Impacted by Overload: Number of units: chunking or meaning enhance recall Recency and Primacy Background noise Rehearsal for some bits Distraction/attention shifts Anxiety.. Not recoverable Once you have lost the information, unlike stored memory, the information is gone and cannot be retrieved>> you can t think back on what you did..missed learning opportunities Andrew, tell me what it was I just told you to do.

54 Childhood and WM Capacity changes with time: range in a given class group Efficacy depends on memory stores and processing speed ( ) Attention demanding: inhibition, shifting After age 7/8 most use verbal to intake visual Capacity is a predictor of learning throughout life: more so than ST memory

55 Children and WM: Gathercole WM overload in structured learning causes the child to forget crucial information> they cannot proceed with the learning task> they learn less

56 Development of working memory in ADHD Visuospatial Working Memory Capacity Test performance

57 What about WM and ADHD? When your WM lets you down Can you attend to the information? Can you reflect on the information? Can you tune in to the details of the information? How do you respond to the information Working memory as the core cognitive deficit in ADHD Daydreaming Impulsivity Poor attention to detail Distracted Teachers often describe the patterns in terms of attention, not memory

58 What tasks are hard and why? Any task requiring mental manipulation with storage/ retrieval of information Tasks which require keeping track of progress Fluid Reasoning Idea maintenance Task component maintenance Proximal/distal planning Short term to long term memory linkage Limited Mental Energy

59 Reading: Decoding; Accumulating/ comprehending information read leaky Writing: Poor monitoring Poor sequencing Impoverished ideation Maths: Slow acquiring basic skills Poor mental maths Applications of problem solving algorhythms Speaking: Raise hand/forgetting Reserved in group settings

60 Listening: Poor instruction following: general elements and details On the wrong page Organizing: Repetition/skipping as place is lost Might start out fine, then lose focus Items lost Socializing: Shy in larger groups Losing place in conversations, jumps in Cumulative loss of chance to practice skills Zoning out when info is lost Poor driving!

61 A teacher will hear: I just forgot what I was going to say I can t remember what you told us to do I forget what to do next Can you repeat that? Can you show me again I had a really great idea of what to write, but then I forgot it I don t remember what I read

62 Classroom Support: to avoid WM overloading Recognize working memory failure Monitor the child Evaluate working memory demands Reduce WM load when necessary Repeat important information Encourage use of memory aids Develop the child s own strategies

63 strategies Math problem solving Being Step Wise Writing Automatize basic facts; until this done use calculator or do not rely on mental maths>> write it down; write out all the steps in problem solving Written and other work done in steps requires a plan; provide the plan initially and gradually help the child learn to craft it; use the list to check off with completion; use rough drafts in writing with clear input that spelling or punctuation are a later step Jot down or record ideas and topic before beginning; word processor

64 Basic Reading Ensure fluent decoding of multisyllabic materials Active Reading Underline or take notes during reading, then reread these; write comments or asterisk key ideas; many ways to mark what is salient (sticky notes) rather than highlighting; Modify complexity Preteach key ideas and vocabulary; keep tasks more meaningful; visually reinforce; simplify instructions

65 Rehearsing Information Note Taking Modify volume and rate Asking for help Ectopic Memories Repeat information to keep it in WM while activating other thinking or LTM; teach meaningful chunking techniques Teach visual as well as sequential strategies in staged manner Use of tape recorder; allow extended time on examinations; reduce the volume of work expected; keep volume heard reasonable and repeat Make it a given and help the child learn to identify what they need repeated or re:explained Close-by memory aids for spelling, math facts,

66 Klingberg et al. (2005) JAACAP

67 WORKING MEMORY CAN BE TRAINED.. EVIDENCED BASED INTENSIVE HOME BASED FOR AGES PRESCHOOL THROUGH ADULTHOOD!

68 Long Term Memory-Consolidation The process by which information is filed in the LTM can take hours or days. Most successful when the entry of information is organized to allow for easier recall later. This is accomplished by systematic entry. The best consolidating takes place when information which has been condensed into the STM is elaborated upon for placement in the LTM. Avoid interruption! Sleeping and other enhancers!

69 When consolidation is not complete: There are likely to be patches of full consolidationtypically episodic in nature, in areas of affinity and interest- this does not mean that consolidation is adequate.. I knew it last night - the information made it to STM and AWM, but was not consolidated Over-reliance on rote recall Paired associations may be sketchy-particularly grapheme-phoneme Impoverished recollections- due to insufficient elaboration

70 FURTHER EVIDENCE OF DECREASED CONSOLIDATION Steps are left out of processes and procedures Failure to internalize insights or to acquire taught rules Ideas are not interesting, impoverished recall - poor oral participation Slow speed of recall

71 LONG TERM MEMORY: GAINING ACCESS Through association: presented with one half of the pair you recall the other Pattern recognition: a familiar stimuli is recognized as correct and there is a sense of how to use this information- in word problems, in avoiding life problems

72 RETRIEVAL = TOTAL RECALL Demands for speed and precision are highest in HS Retrieval versus recognition- how do you get to the mall? Convergent Simultaneous Rapid Cumulative Content or format specific Automatic? Divergent??

73 Key Variables in Quality of Recall Automaticity- information is retrieved essentially without effort Divergence- overactivation- creativitycognitive profiles

74 When there is poor retrieval: Results on recognition based tasks are far superior Lack of application of learned patterns to avoid repeated unsuccessful efforts Paucity of complexity or content Fishing and stalling Weak recall of paired associations..what is your name again?

75 To Improve Consolidation and Access: Ensure depth of understanding Model elaboration and make elaboration a goal Rote drill for associated pairs Translate serial chains into diagrams and diagrams into chains as needed- find/use the best modality Multisensory instruction Apply rules in the context of games to enhance appreciation of when to apply them

76 Sleep and Memory Using sleep to improve memory Vulnerability in situations of not enough sleep Does catch up work? Who has sleep issues and why they have memory issues as well.

77 FURTHER STRATEGIES Read, practice and review just before sleep Mnemonic devices Selectivity in what needs to be remembered! Alternative assessments- tasks other than tests to encourage long term learning and sustain motivation Test taking modifications Open book, open ended, recognition, cloze, take home- Develop memory meta-awareness Memory plans

78 Modern Challenges: Ex-preemies Very mobile lifestyles Technology Speed Enrichment Expectations- an OVER commitment to well roundedness

79 A mind at a time: Nicola age 3 Key History/Variations Petite ex-preemie (27 weeks) Sensitive to environmental change Precise, focused but with slight fine motor impairment Slow to warm to new things Careful socially Key Interventions Be slow to judge, give her time Great caution in parental discussions! Mastery learning approaches Expect erratic patterns of performance Break tasks down to components, expose to small changes with positive reinforcement Be mindful of what can and cannot change and who can and cannot change

80 COMMON PROBLEMS: EFFECTIVE METHODS 1. HOW DOES ENQUIRY BASED LEARNING LIBERATE OR CHALLENGE THE UNIQUE LEARNER? 2. WHAT IF ANY ARE THE DEVELOPMENTAL PATTERNS THAT AN IB TYPE MODEL OF LEARNING IS NOT SUITED FOR 3. WHO DECIDES

81 HOW CAN THESE CHILDREN THRIVE? TOPICAL INTEREST TARGET SPECIFIC SKILLS IN SPECIFIC TASKS PRIORITIZE SUPPORT AT KEY JUNCTIONS ENSURE THAT CORE SKILLS ARE AUTOMATIC RECOGNITION OF STRENGTHS ABANDON THE WORD SHOULD

82 Adopting an Attuned Approach Read More Consider the developmental profiles in your class management planning Try to split a lump variations are not absolute

83 Final Thought: No child chooses to be bad at their own development. If they could, they would.

84 To Learn More Books by Dr. Melvin Levine Thanks to Dr. Nitin Gogtay, NIMH We must not see any person as an abstraction. Instead, we must see in every person a universe with its own secrets, with its own treasures, with it s own sources of anguish, and with some measure of triumph. Elie Wiesel