Executive Functioning

Executive Functioning November 13th, 2018 Presented by Michelle Trinchese Adapted from a previous presentation by Jamie Pollock & Erica Gerlach Information from Smart but Scattered by Peg Dawson and Richard Guare. Power-point contributor: Lauren Hough and Michelle Flemen-Tung

Do you notice your child has? • Trouble planning? • Difficulty directing activities? • Little regulation? • Difficult time organizing? • Independence Issues? • Hyper focus on details? • Rigidity?

Why are they acting this way? • They aren’t being manipulative, lazy, unmotivated, etc… • They need skills to overcome the executive functioning deficits • Kids who get “stuck” circulate between the limbic system and brainstem • They can’t access neocortex (planning, language, etc…) because the emotions/flight/fight response is overwhelming

What is Executive Functioning? • “[Executive functioning is an] umbrella term for multiple cognitive processes behind behavior that flexibly directs goal oriented behavior... In response to novel or difficult situations • Meltzer & Krisdnan • What is executive functioning? • Refers to a set of mental skills that are coordinated in the brain’s frontal lobe. • Executive functions work together to help a person achieve goals.

When Do We See Executive Functioning Difficulties? • During new or challenging situations • When situations call for flexibility • Situations requiring problem solving • Transitions • Initiating a task • When pre-occupied with preferred interest

Executive Functioning Skills Metacognition Flexibility Goal-directed Persistence Time Management Organization Planning/Prioritizing Task Initiation Sustained Attention Emotional Control Working Memory Response Inhibition

Response Inhibition • Ability to “think” before you act. • Control the impulse to automatically respond to something. • to resist the urge to say/do something allows your child the time to evaluate a situation and how his/ her behavior might impact it. • “STOP function” for both actions and thoughts.

EXAMPLES • • A young child can wait for a short period without being disruptive. • • An adolescent can accept losing without an argument.

Building Response Inhibition(strategies) • Use routines, rules, supervision and limits • Help your child learn to delay gratification with waiting periods • Discuss consequences for poor impulse control • Practice response-inhibition in role playing situations • Priming visual cues/verbal cues • TEACH- STOP, THINK, ACT

Working Memory • Capacity to hold onto information while performing complex tasks. • It incorporates the ability to draw on past learning or experiences to apply to the situation at hand or to project into the future. • Draw on both visual imagery and language • Gradually increase our expectations: • Time • Work

Examples • • A young child can hold in mind and follow 1- or 2-step directions. • • An adolescent can remember the expectations of multiple different teachers.

Building Working Memory(strategies) • Make eye contact before telling your child something • Minimize distractions • Have your child repeat what you said back to you • Reminders: pictures, written, lists, etc. • Involve the your child in planning how to help them remember

Emotional Control • Ability to regulate emotions in order to: • Achieve established goals • Complete tasks • Direct a behavior

EXAMPLES • • A young child can recover from disappointment in a short time. • • A teenager can manage the stress of a test and still perform.

Improving Emotional Control(strategies) • Regulate the environment through routines • Prepare your child for what to expect and possible solutions • Develop coping strategies • Read stories highlighting model behaviors • Countdown timers • Take breaks • Mindfulness/meditation

Sustained Attention • Capacity to sustain attention despite distractions, fatigue, or boredom. • Child may appear bored or uninterested but in fact, might just find the task too difficult.

EXAMPLES • • A young child can perform a 5-min chore with occasional supervision. • • A teenager can pay attention to HW for 1-2 hours with small breaks.

Increasing Sustained Attention(strategies) • Provide reminders and encouragement • Provide devices/strategies • Make the task interesting • Use incentive systems • Offer praise for staying on task • Implement self-monitoring strategies • “Your____will still be there.” • Park it in the parking lot

Task Initiation • Beginning a task efficiently without procrastination and in a timely manner. • Applies to tasks unpleasantor boring.

EXAMPLES • • A young child is able to start a chore/ assignment right after instructions are given. • • A teenager does not wait until the last minute to begin a project.

Supporting Task Initiation(strategies) • Reinforce initiating following a prompt • Provide visual cues as reminders • Break down tasks • Doable first steps • Involve child in making a plan

Planning & Prioritizing • Creating a plan to reach goals and make decisions about what is most important to focus on. • Requires • Identifying priorities • Stick to them • Follow a set plan • Re-evaluate priorities when initial goal is met

EXAMPLES • • A young child, with coaching, can think of options to settle a peer conflict. • • A teenager can formulate a plan to get a job.

Promoting Planning & Prioritizing(strategies) • Model your planning and prioritizing • Create plans for and include your child • Work through strengths and interests • Facilitate prioritization by asking child what needs to be done first • Breakdown the tasks

Organization • Ability to establish & maintain a system for arranging/keeping track of items. • Goals • Improve efficiency • Decreases stress • Free up mental energy • Increase independence and responsibility

EXAMPLES • • A young child can, with a reminder, put materials in a designated place. • • A teenager can organize and locate various of his own materials.

Fostering Organization(strategies) • Put a system in place • Involve student in goal-setting, planning, and execution processes • Supervise • Reminders (visual, verbal) • Monitoring • Checking in & reflecting

Time Management • Ability to estimate timing • How much time the child has • How to use time effectively & efficiently • How to work within a deadline • Valuing time as something that is important

EXAMPLES • • A young child can complete a short job within a time limit set by an adult. • • A teenager can establish a schedule to meet task deadlines.

Improving Time Management(strategies) • Maintaining a predictable routine • Self talk about how long things take • Planning activities with multiple steps • Model the use of calendar and schedules • Use tools such as timers • Practice timing it/racing the clock • Reflect back on how much time things actually took

Goal-Directed Persistence • One of the most advanced EF skills. • Setting, working towards & completing a goal without being sidetracked by “competing interests.”

EXAMPLES • • A 1st grader can complete a job to get to recess. • • A teenager can earn and save to work towards something they find important.

Developing Goal-Directed Persistence(strategies) • Start early with brief, manageable things • Start with goals the child wants to work on • “Look forward approach” • Reminder about what the child is working towards • Make sure the reward is worth it

Flexibility • “Go with the flow.” • Ability to revise plans and be adaptable. • Respond effectively to new obstacles, new information or mistakes. • Make necessary and emotional adjustments.

EXAMPLES • • A young child can adjust to a change in plans without major distress. • • A teenager can accept alternatives such as a different choice when the first job is not available.

Encouraging Flexibility(strategies) • Follow schedules and consistent routines • Priming for what is coming • Offer choices • Teach and practice coping strategies • Planning changes in a plan

Metacognition • Ability to reflect on oneself in a situation & include • How you problem solve: “How did I handle that?” • Self-monitoring: “How am I doing?” • Self evaluating: “How did I do?” • Two sets of metacognition skills: • Evaluate performance & make changes • Evaluate social situations (own and others’ behaviors/reactions)

EXAMPLES • • A young child can change behavior in response to feedback from an adult. • • A teenager can monitor and critique performance to improve it by observing others who are more skilled.

Developing Metacognition(strategies) • For task performance: • Specific praise for key elements of task performance • Teach self evaluation • Identify what “finished” looks like • Teach self-questioning for problem situations • Reflect, brainstorm & develop revised plans for the future • For reading social situations • Guessing games for reading emotions • Teach identification of meaning & tone of voice • Talk about identifying feelings in people trying to hide their feelings • Discuss how actions might change someone's feelings

Executive Functioning Development • Toddlerhood-hard to resist inhibitions • Preschoolers-self-focused, poor impulse control • Elementary school-some impulse control, some skills will be effective in some situations, skills develop more • Middle school-begin to know what works for them and what doesn’t • High School-working memory and attentional control are close to adult level, but flexibility and metacognition are not yet fully developed • Adjust expectation to developmental level which may not match their grade/age

Implementation • Introduce strategy at a calm time so they can process • Demonstrate • Give it time to work • Offer praise and reinforcement • Monitor progress; is the strategy helping? • Yes-push towards independence • No-Try something different • Use skills they are strong in to develop weaker ones

Executive Functioning