Executive. Dysfunction. Tourette Syndrome Association 2014 National Conference. Adult Track, March Executive Function. Executive Function

Transcription

1 Executive Dysfunctin Margaret Edelman, M.S. E.C.-E.C.S.E. 1 Executive Functin Executive functin is a set f mental prcesses that helps cnnect past experience with present actin. Peple use it t perfrm activities such as planning, rganizing, strategizing, paying attentin t and remembering details, and managing time and space. Prblems with executive functin can be seen at any age and ften cntribute t the challenges individuals face. -Natinal Center fr Learning Disabilities 2 Executive Functin Having executive functin in the brain is like having an air traffic cntrl system at a busy airprt t manage the arrivals and departures f dzens f planes n multiple runways. Building the Brain s Air Traffic Cntrl System Harvard University 3 Adult Track, March 22 1

2 Executive Functin Skills Built ver time, frm the first year f life Skills are interrelated Each type f skill uses elements f thers Building the Brain s Air Traffic Cntrl System Harvard University 4 Wrking Memry Skills in Adulthd Can remember multiple tasks, rules, and strategies that may vary by situatin Inhibitry Cntrl Have cnsistent self-cntrl; situatinally apprpriate respnses Cgnitive Flexibility Executive Functin Revise actins and plans in respnse t changing circumstances Building the Brain s Air Traffic Cntrl System Harvard University 5 Executive Functin Disrder (EFD) Characteristics f EF weaknesses may include: Frgetfulness Difficulty planning Impaired decisin-making, errr-crrectin, trubleshting, and respnse t nvel/difficult situatins Pr time-management skills Deficits in rganizatinal skills Difficult getting started 6 Adult Track, March 22 2

3 My bed is a magical place where I suddenly remember everything I was suppsed t d. 7 EFD Challenge Executive Functin Disrder is a cgnitive prcess that may ccur as part f many simultaneus cnditins (cmrbidities) assciated with Turette Syndrme. Weaknesses in Executive Functin Skills Managed ver time with accmmdatins and cmpensatin strategies Think f it as Lifelng Learning fr a better sense f self 8 Nurturing Functin Time tempral sense Understand the reality f time cnstraints Keep it simple Opprtunity initiative and restraint Establish significant mments, with intentin, n which t fcus 9 Adult Track, March 22 3

4 Nurturing Functin Space rder and functining Cnnect specific actins with specific places that fit Materials frethught and fllw-thrugh Maintain materials with a Usefulness gauge Intrduce tls with purpseful intent 10 Create S.P.A.C.E. fr Stuff Srt Purpse Access Cntainerize Equalize Organizing Frm the Inside Out by Julie Mrgenstern 11 Ergnmic Functin 12 Adult Track, March 22 4

5 Functining in Space 13 Space The 1 st day f addressing ffice space After 7 days f repurpsing the ffice space 14 Structure vs. Stricture Changing a way f functining is a frm f separatin Denial, resentment, ppsitin t change Have a plan, and cmmunicate yur intentin Best laid plans f mice and men Rbert Burns Be pen t being flexible when necessary Lng term: Expect jagged trajectry f successes 15 Adult Track, March 22 5

6 Making Cnnectins Cnnectin vs. Separatin Initiatin happens when a cnnectin is made Fcus n the specific task Cnnect and Engage with interest and curisity Separatin will happen naturally becmes a nn-issue 16 Fundatin Strategies Organizing and Decisin Making Q Qualify respnsibility: Take it n respnsibly. Task shuld be dable Have the authrity t get it dne right Avid sabtage f yur effrts R Rutinize tasks in yur life t be added in S Supprt with visual cues where needed 17 Necessity and Inventin Wrking Memry Sme functining strategies cme frm Anticipatin f a need fr supprt Repeated supprt will cntinue t be needed Supprts help with wrking memry by freeing up r reassuring the mind that supprts are in place, whereby we can fcus n the task at hand. 18 Adult Track, March 22 6

7 Gals Making a Plan Imagine and anticipate a favrable utcme Make the gal visible. Use a picture as yur guide Use a buddy system. Cmmunicate yur intentins Pair a maintenance task with an activity that is: acceptable cmfrtable enjyable 19 Time Management Use a large, easy t read (and use) timer Underestimate the time yu will want t wrk at a task that is unpleasant t begin with. (Try 15 min. chunks.) T build mmentum, start with the easiest task 20 Time Management Assess the number f things yu can d in the time that yu have T much t d? r Can t get the first thing dne? Then cut the number f tasks in half. 21 Adult Track, March 22 7

8 Cmmunicatin Can be a surce f discmfrt with inhibitry cntrl Shy/reluctant, impulsive/talkative Rigid, bsessive, cmpulsive. A key t cnnecting with the utside wrld Outside f the self (yur wn thughts, cncerns) Are cnnectins t supprt and helpful feedback Feedback lps keep us aware f ur affect n thers It is a gd practice fr bserving and reflecting Use technlgy t cmmunicate (make cnnectins) 22 Cmmunicatin 23 Technlgy Scial Cmmunicatin Interactive and Expressive skills Persnal nte-taking/drawing, etc. Expressive skills Streaming fr news and fr music Receptive skills Adult Track, March 22 8

9 Wrkplace Challenges Inefficiency Tasks take lnger, hard t keep up with wrklad Wrry abut c-wrkers resentment, r ridicule High Errr Rate Writing, messages, reading instructins, filling ut frms Avid tasks, feel embarrassed Sequencing Tasks Difficulty with multiple-step tasks, fllwing directins, ding in a specific way r a particular rder Lk fr shrtcuts, negative impact n quality - Natinal Center fr Learning Disabilities 25 Wrkplace Challenges Time Management Managing time, planning ahead, keeping a calendar Arriving t late r t early, meeting wrk deadlines Scial Skills Challenging t scialize, knwing what t say, hw t behave Getting peple t feel gd abut wrking with yu, engaging in small talk, being discreet, sharing infrmatin abut yur abilities and limitatins, making and keeping friends - Natinal Center fr Learning Disabilities 26 Strengths What Yu Bring t the Jb Persistence Self-determinatin is ne f the mst imprtant characteristics seen in successful peple with learning disabilities Try different appraches, even after c-wrkers gave up Share yur determinatin with supervisrs and c-wrkers Sign f interest, dedicatin and lyalty - Natinal Center fr Learning Disabilities 27 Adult Track, March 22 9

10 Strengths What Yu Bring t the Jb Creativity Great prblem slving skills, extrardinarily creative and resurceful at tackling prblems. Cme up with innvative and creative slutins Valued by team members as the ne wh thinks utside the bx Cmes up with new and unusual ideas Specialized Talents Develp and rely n unique strength in special abilities Helps cmpensate fr a limitatin These might include: Drawing and design, public speaking, mechanical activities and wrk space adaptatin - Natinal Center fr Learning Disabilities 28 References Center n the Develping Child at Harvard University Building the Brain s Air Traffic Cntrl System: Hw Early Experiences Shape the Develpment f Executive Functin: Wrking Paper N Cper-Kahn, Jyce. Dietzel, Laurie Late, Lst, and Unprepared: A Parents Guide t Helping Children with Executive Functining. Wdbine Huse. Bethesda, MD. Klberg, Judith. Nadeau, Kathleen. ADD Friendly Ways t Organize Yur Life. Brunner-Rutledge Taylr & Francis Grup, New Yrk. Malley, Pam Teaching Kids Strategies t be Successful & Organized Adults. TSA 2014 Natinal Cnference Sessin. Washingtn DC. pamalley@sbcglbal.net. Mrgenstern, Julie Organizing frm the Inside Out, Secnd Editin: The Flprf System Fr Organizing Yur Hme, Yur Office and Yur Life. Henry Hlt and Cmpany, New Yrk. NCLD Adults with LD. NCLD Executive Functin Disrders Cntact Infrmatin Margaret Edelman, MS, E.C.-E.C.S.E Organizing and Educatin Specialist Educatin Advisry Bard, TSA margaretedelman@gmail.cm 30 Adult Track, March 22 10