HELPING CHILDREN CHANGE SERIES:

1. HELPING CHILDREN CHANGE SERIES: My Child Is Not Worried ENOUGH!!! What Science Tells Us About Helping Children to Become Long-Term instead of a Short-Term Hedonists Presented by Dr. Caren Baruch-Feldman Scarsdale Library April 9, 2014 Dr. Caren Baruch-Feldman, Psychologist drbaruchfeldman.com drcarenfeldman@msn.com

2. Do you have a child who…? • Do you have a child who can’t switch from what he is doing to what you need him to do? • Do you have a child who does her hw, but fails to hand it in? • Do you have a child who doesn’t think before acting? • Do you have a child who just doesn’t seem motivated? • Do you have a child who constantly gravitates to what feels good in the moment and can not access future consequences? • If the ANSWER IS YES, then today’s talk is for YOU. • These children often have weaknesses in their executive functioning abilities. Dr. Caren Baruch-Feldman, Psychologist drbaruchfeldman.com drcarenfeldman@msn.com

3. Weakness in Executive Functioning (EF) = A Production Issue • What Is Executive Functioning? • Executive Functioning refers to our ability to be able to make and carry out plans, direct our attention, focus and also control our internal states: our impulses and emotions and to be able to switch from one task to another. • It is involved in processes such as planning, cognitive flexibility, abstract thinking, rule acquisition, initiating appropriate actions and inhibiting actions, and selecting relevant information. Dr. Caren Baruch-Feldman, Psychologist drbaruchfeldman.com drcarenfeldman@msn.com

4. Goals of the Talk • Review key points from Workshop 1 on helping children change. • Discuss how to help children who have executive functioning weaknesses change so that they can be more 1) long-term in their thinking 2) mindful and 3) productive.

5. A Little Bit About Me Before After

6. Review of Workshop 1: Helping Children Change • It all starts with a positive relationship. This is especially true for kids with EF difficulties. • A relationship is like a bank account. • Looking for bright spots and creating “special time”. Dr. Caren Baruch-Feldman, Psychologist drbaruchfeldman.com drcarenfeldman@msn.com

7. Review of Workshop 1: Helping Children Change • There needs to be an agreement on the goal(s). BUY IN is KEY!!! • An understanding of where your child falls on the cycle of change (pre-contemplative, contemplative, planning, action, maintenance). Dr. Caren Baruch-Feldman, Psychologist drbaruchfeldman.com drcarenfeldman@msn.com

8. Review of Workshop 1: Helping Children Change • Developmental considerations (e.g., frontal lobe, black and white thinking, poor emotional control). • This is especially true with children who have EF weaknesses. • They are often behind their peers developmentally. Dr. Caren Baruch-Feldman, Psychologist drbaruchfeldman.com drcarenfeldman@msn.com

9. Review of Workshop 1:How We All Change • Even when children want to change they are often ambivalent about change. There is often a tug of war between the rational (long-term) and emotional (impulsive) brain. For kids with EF challenges the impulsive part of the brain often wins. • To make successful change one needs to engage one’s thinking, behavior/emotions, and shape the path. Dr. Caren Baruch-Feldman, Psychologist drbaruchfeldman.com drcarenfeldman@msn.com

10. The Myth of Laziness- Kids Do Well If They Can I believe that Kids Do Well if They Can. No one wakes up in the morning and says, “let me forget my homework, let me not care about school, let me procrastinate the day away”. Behind every challenging behavior is an unsolved problem or lagging skill. Challenging behavior often occurs when the demands being placed on a kid exceed his/her capacity to respond adaptively. NOT IN THE ZONE. One needs to determine what thinking skill the child is lacking so that the thinking skill can be taught. Skills are taught from external to internal, from physical to mental, and from multi-stepped to automatic and folded. The goal is to develop a plan with the child that resolves the problem in a realistic and mutually satisfactory manner. BUY IN.

11. Children with EF Weaknesses Get a Bad Rap 1. Because internally driven production is much easier to accomplish than externally demanded production for children who have these difficulties their lack of production on demand often stands in stark contrast to their seemingly effortless production “when the spirit moves them”. 2. The on-demand deficiencies observed by others are often attributed to negative personal characteristics such as being UNMOTIVATED, WILLFULLY LAZY and DISORGANIZED, POSSESSING A BAD ATTITUDE, DOING THIS ON PURPOSE. 3. More and more however, neuroscientists are saying that these underachievers may suffer from neurological abnormalities, particularly in the FRONTAL LOBE.

12. Executive Functioning and the Brain

13. Teach EF Skills Just As You Would Any Other Skill 1. It is a skill that needs to be taught, not demanded. It is best to suggest to the child in a way that gets the child to want to do it him/herself. 2. Muscle memory. Wouldn’t teach swimming outside the water. 3. Keep it simple, concrete, and without abstraction. 4. Teach Children to become meta-cognitive learners. 5. Teach a replacement behavior.

14. Teaching EF Skills: Scaffolding and Motor are Key 1 3 2 5 4 When learning a skill one goes from unconscious incompetence to conscious incompetence to conscious competence and finally to conscious competence- P.Dawson

15. Children with Executive Functioning Weaknesses Have Difficulties In: • Inhibiting Behavior • Working Memory • Using Visual Imagery • Talking to Themselves • Controlling Emotions • Planning and Problem Solving

16. Helping Children Inhibit Behavior

17. Turtle Technique • Model remaining calm • Teach the child the steps of how to control feelings and calm down • Step 1: Recognize your feeling(s) • Step 2: Think “stop” • Step 3: Go inside your “shell” and take 3 deep breaths • Step 4: Come out when calm and think of a “solution” • Practice steps frequently • Prepare for and help the child handle possible disappointment or change • Recognize and comment when the child stays calm • Involve families: teach the “Turtle Technique” Webster-Stratton, C. (1991). The teachers and children videotape series: Dina dinosaur school. Seattle, WA: The Incredible Years.

18. Step 1

19. STOP Step 2

20. Step 3

21. Step 4

22. Lentini, R., Vaughn, B. J., & Fox, L. (2005). Teaching Tools for Young Children with Challenging Behavior. Tampa, Florida: University of South Florida, Early Intervention Positive Behavior Support. Help the Child Think of a Possible Solution: • Get a teacher • Ask nicely • Ignore • Play • Say, “Please stop.” • Say, “Please.” • Share • Trade toys/item • Wait and take turns • Etc.

23. Helping Children to Increase Working Memory

24. Making A Visual Compensates for Poor Working Memory Dr. Caren Baruch-Feldman, Psychologist drbaruchfeldman.com drcarenfeldman@msn.com

25. Example of Visuals

26. Example of a Visual

27. Helping Children Increase Self Directed Talk

28. Examples of Visuals that Encourages Self Directed Talk

29. Student’s Self Monitoring Chart

30. Helping Children to Control Emotions Amygdala Hijack Social Story

31. Helping Children to Problem Solve More Effectively

32. Intervening at the Level of the Environment Children with underdeveloped executive skills can be supported in one of two ways: the Person or the Environment Intervening at the Level of the Person

33. Intervening at the Level of the Person • The goal of this strategy is to change the child’s capacity for using his/her own executive skills. • 1. Teaching him ways to develop or fine tune executive skills that he needs. • 2. Motivating her to use the executive skills that she has but isreluctant to employ.

34. Can’t Vs Won’t We are encouraging people to become involved in their own rescue.” Remember ,rewards will not work if the child does not have the skill. Reward programs imply that a child can do it if he/she wants to or is motivated enough to. This often leads away from the realization that many children who do want to change their behavior don’t know what to do to change it.

35. Intervening at the Level of the Person: Scaffolding • Initially the grownup becomes the frontal lobes for the child. • After having walked the child through the process many times the parent can then begin to reduce the level of supervision and support. • The next step might be to begin to transfer the responsibility to the child by asking a more general question (e.g. “What do you need to do?). • The transfer is complete when the child reaches the point when he asks himself” What do I need to do”? and either refers to the list independently without prompting from the parent or remembers the steps on the list and can perform the task without referring to the list itself.

36. Intervening at the Level of the Environment • Changing the Physical or Social Environmentto Reduce Problems • Changing the Nature of the Task • Changing the Way Cues are ProvidedTo Prompt the Child to Perform Tasks or Behave inCertain Ways

37. Intervening at the Level of the Environment: Changing the Physical or Social Environment to Reduce Problems Are there impediments to smooth executive functioning that can be removed or added to the environment? Front versus back of the class. Moving them away from a window or near their friends or talkative Children. Placing a student with weak skills with a very structured teacher. For impulsive children, placing them in smaller settings or under more adult supervision.

38. Intervening at the Level of the Environment: Changing the Nature of the Task Make the steps explicit Make the task shorter Make the task closed ended instead of open ended (e.g., fill in the blanks, T/F, rather than essays, providing word banks) Build in variety or choice with respect to the tasks to be done or the order in which the tasks are to be done. Offer bonus points for handing in homework and assignments on time instead of taking points away Offer feedback and opportunities to revise writing assignments before grading them Offer Children choices for ways to demonstrate content knowledge Offer credit for all efforts to correct work Offer opportunities to retake failed tests Deduct no more than 5-10% of total points for minor detail errors Teach note-taking, memory strategies, and study skills when necessary

39. Changing the Way the Grownups Interact with Children With Executive Skills Deficits • Remembering that you are the biggest vehicle of change and a model of good executive functioning. Don’t lose your emotional EF Skills in the process. • “Probably the greatest value in recognizing the neurodevelopmental neurocognitive domain called executive functioning is to protect a sizeable minority of children from being traumatized by what amounts to adult name-calling.” Martha Denckla

40. Last Thoughts Your children are not lazy. Get away from the “myth of laziness.” Executive functioning skills need to be taught just like any other skill. Make it explicit. Teach Children to think about their thinking. Timing is key. Don’t have discussions in the middle of an amygdala hijack. Children and EF skill development are both “works-in-progress.” As much as possible try to align external demands with internal desires to maximize motivation. Get buy in. The devil is in the details. Don’t forget scaffolding. Don’t give up too soon, but revise the plan if needed. It takes at least 3 weeks for new habits to form. Your child and you didn’t fail, the strategy failed. Remember, “the greatest injustice is the equal treatment of unequals.” -Oliver Wendell Holmes