1 for rock fish river elementary 10/13/10 what, where & how & who executive function &...
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for Rock Fish River Elementary 10/13/10
What, Where & How & Who
Executive Function & Behavior Management
By Judy Ritchie, P.R.E.P.
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Executive Dysfunction often leads to Behavior
Causes of Behavior Problems Confusion Expectation (inaccurate) Stimulation (over/under) Lack of order Communication
(receptive/expressive) Driven behaviors
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Behavior Serves a Purpose
Compensates for a deficit Comforts Communicates Utilizes a strength
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Most common Referrals
Boys with ADHD (usually un-medicated)
Students with Autism Spectrum Disorders
Both likely students with Executive Dysfunction
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What are some behaviors that you are concerned with
Not completing work Not paying attention Focused on wrong stuff Overflow of body/hands/mouth Forgetting needed materials Poor organization Social issues Poor impulse control
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Discipline Issues There is growing evidence that:
Problems associated with Executive Dysfunction contribute to most disruptive behavior that result in removal from the learning environment.
There is increased demands on executive function skills.
Children are exposed to fewer activities that build executive function skills.
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Could the problem be….
Not that the person is doing the WRONG thing but that they don’t know (hidden agenda) or can’t (lack of impulse control) do the RIGHT thing
Is it related to a deficit? Is it related to unrealistic
expectations? Is it related to an antecedent or lack
of?
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Executive Function or Hard Work, Discipline and Persistence
Evidence indicates that self discipline accounts for over twice as much variance in final grades as does IQ, even in college.
Duckworth & Seligman( 2005)
EF skills are important for school readiness and are more strongly associated with school readiness than IQ or entry reading or math
(Blair, 2002, 2203, Blair & Razza, 2007; Normandeau & Guay, 1998)
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ED impact on Academics
Writing Comprehension Mental Arithmetic Completing work Turning in work Consistent performance Having necessary material
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So what is Executive Function?
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Executive Function
The way people monitor and control their thoughts and actions (Carlson & Moses, 2001)
We need EF whenever we are presented with the unexpected, need to concentrate
particularly hard, or need to adapt or change
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Function of Executive Functioning
Executive Functioning is the brain's ability to absorb information interpret information, and make decisions based upon this information. Like: Picking the correct clothes based on the
weather Allowing enough time to complete a task Understanding the unspoken expectations,
goals or rules of a situation.
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Major areas of impairment in Executive Dysfunction
Inhibitory Control
Working Memory
Cognitive Flexibility
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EXECUTIVE FUNCTION JOBS
Inhibition - The ability to stop one's own behavior at the appropriate time, including stopping actions and thoughts.
The flip side of inhibition is impulsivity;
Shift - The ability to move freely from one situation to another and to think flexibly in order to respond appropriately to the situation.
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EXECUTIVE FUNCTION JOBS cont
Emotional Control - The ability to modulate emotional responses by bringing rational thought to bear on feelings.
Initiation - The ability to begin a task or activity and to independently generate ideas, responses, or problem-solving strategies.
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EXECUTIVE FUNCTION JOBS cont
Working memory - The capacity to hold information in mind for the purpose of completing a task.
Planning/Organization - The ability to manage current and future- oriented task demands.
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EXECUTIVE FUNCTION JOBS cont
Organization of Materials - The ability to impose order on work, play, and storage spaces.
Self-Monitoring - The ability to monitor one's own performance and to measure it against some standard of what is needed or expected.
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Executive Dysfunction
Core Deficits Inhibitory control Cognitive flexibility Working memory
Contributing to the ability to Plan Organize Predict Self Monitor
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Which students have Executive Dysfunction
For many students, the executive functioning system of their brain is not working properly.
Executive Dysfunctions are intimately connected with
Asperger's Disorder High Functioning Autistic ADHD (Most common) Also been found in adults with OCD,
depression, to name but some of the conditions.
Is starting to turn up as a stand alone diagnosis
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Executive Dysfunction occurs during typical brain development twice
Around the age of two=the awful twos
Around the age of thirteen=alien invasion
It is also apparent during high levels of stress
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Inhibitory Control
Self Control (Discipline) This is the ability to resist a strong inclination to do one thing instead of doing what is most appropriate or needed.
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Inhibitory Control The ability to keep attention focused
despite visual displays noises novel information boredom initial failure interesting digressions
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Discipline (Self-Control)
The ability to resist your first impulse and give a more considered response
instead
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Attention Deficits Can affect motor, visual or auditory
activities Too short Wrong stuff Inconsistent Too late I never moved but lost it anyway Relocation experts I have no idea, no really I have no ideaOften it doesn’t affect all so the student may be
better focused if an unaffected area is required
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La Différence ADHD
Probably know the rule
Often don’t know or can’t tell why it happened
Won’t benefit from strategies to inform
There may be an ego component (failure is a poor learning tool)
Try and determine area of better focus (hands on,visual, auditory)
ASD Probably don’t know the rule Can (if language) explain sometimes Will benefit from informing strategies Probably don’t realize impact Most are have superior visual and perceptual skills
(never argue perception)
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Benefits of Inhibition
Allows a measure of control over attention and actions
Lessons control of external stimuli, emotions, old habits (of mind and behavior)
Inhibition helps make change possible
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Cognitive Flexibility
This allows us to flexibly switch our perspectives or our focus of attention as needed for task demands
It allows us to be flexible and adjust to changes in demands, priorities, schedules, expectations
It allows us to be able to think outside the box
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La Différence
ADHD Often described
as having greater ability to attend to self chosen activities
Can be resistant to change but also easily distracted
ASD Transition issues
Ending Beginning
Perspective issues Routine Issues Concrete/Rule issues Hidden Agenda Theory of Mind
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Cognitive Flexibility and Behavior
CF allows us to change the focus of our attention from what others are doing wrong to how we might be contributing to that situation or how we might make the best of what happened.
It allows us to change our focus from ourselves and our own needs to focusing on the needs of others.
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Cognitive Flexibility
It is critical to creative problem solving It allows us to think of other ways of
reacting to what is happening It allows us to think about or
conceptualize a problem in other ways It allows us to try other ways to
overcome obstacles
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Working Memory
Holding information in mind and working with it.
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Working Memory Relating one idea to another
The beginning of a story to the end Mental arithmetic Holding information in mind while working
on something else Mentally holding onto information during an
interruption or while you have to do something else first
Making judgments or analyzing info to determine where it fits into existing knowledge or categories
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Other contributors
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Gender Issues
Boys are more likely to be sensitive and at times over-reactive
Boys have 30 % more muscle mass, are stronger and inclined to action
Growth spurts for boys can result in temporary hearing loss (the ear canal stretches)
Testosterone influences the brain and makes boys more concerned with rank and competition
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Gender Issues
Boys Need structure to feel safe and answer
questions Who’s in charge What are the rules Will the rules be fairly enforced
Ambiguity may heighten their anxiety or increase their acting out or over activity
Math and perceptual skills kick in before verbal and writing
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Girls
Tend to be more eager to please It can be more about relationship
than boys Verbal and writing skills kick in at
an earlier age than math and perceptual skills
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Human Nature Issues
Why anyone may avoid or give up Type of task Frustration tolerance Hopelessness Emotional/health factors Prior experience Expectation of success
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Emotional Sense
It is not rational…it seems counterintuitive
It is self-serving emotionally It is protective in nature It is less purposeful than you think It will be repeated if it works
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So what works?
Visual Strategies External Structure Using Their Strengths Novelty for ADHD and sometimes for
ASD Routine for some ADHD and most ASD
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So what works cont.?
Preferred interests or desired topics Smaller segments, fewer numbers,
tasks broken down Frequent feedback Technology
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So what works cont.?
Breaks Switching gears before review or editing Success Protecting self-esteem Avoid using success punitively
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So what works?
Avoid tracking or measuring disability Gentle, positive self-monitoring Avoiding why questions when they know the
rules (generally not a deficit of knowledge for the ADHD student but can be a deficit for the ASD student)
Vs. Explain why to address tendency to think impulsively Meaningful frustration is easier to bare than
meaningless frustration
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More of what works Wait and think strategies (Ditty
intervention) Change color for reversals Cognitive cues (strategies that help
you remember the sequence of steps as well as the content or steps themselves) mnemonic (ROYGBIV) Can be visual (take a walk)
Positive or neutral reframing of characteristics
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More of what works
Back up plans, materials, opportunities Technology Give them 5 Second set of books Materials to use or borrow
Coach vs lecture or parent (remember they may know)
Address one dimensional problem solving Lets look at the options or result of choice brainstorm
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Addressing Executive Function Challenges
Why Use Visual Strategies Visuals are not transient and
compensate inattention, poor working memory, inability to prioritize/organize
Visuals help sort out or point out what is important
Visuals lesson demands on working memory and other executive functions
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Types of Visual supports Color Coding (like science folder, books,
notebooks etc. all blue, even what bin to place work into)
Strips that contain steps in the editing process such as checking punctuation, checking for capitalization, etc.
Visual thought or idea organization (inspiration.com)
Highlighting tape
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VDOE T/TAC at VCU
Socialization Toolbox• Social Stories™, Gray,
Carol• Comic Strip
Conversations, Gray, Carol
• Video Modeling• Power Cards, E. Gagnon • Role Playing• Peer partners• Clubs • Drama• The Incredible Five Point
Scale, Dunn Buron, K., Curtis,M.
• Incidental Teaching
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Tools of the Mind
An early childhood education curriculum based on the work of Vygotsky. A curriculum taught in regular classrooms
with regular teachers shown to improve cognitive control (executive function) in preschool-age through kindergarten age children from disadvantaged backgrounds.
(Adele Diamond, W. Steven Barnett, Jessica Thomas, Sarah Munro November 30, 2007, Science, vol. 317 )
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Play
Imaginative play, involving some adult participation and direction Research shows that when imaginative
play is facilitated by a skilled teacher, it helps build executive function (EF), a critical cognitive skill that helps children learn to self-regulate.
In turn, self-regulation helps children learn how to self-discipline and control impulses
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Children performed better in academics, after exercising with improvement in accuracy as well as attention. Reading comprehension, sometimes
by as much as a full grade level Math and spelling also improved,
however, the margins were not as great
Recess is an Important Part of School Day
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The study monitored twenty 9-year old children and measured their attention and academic achievement after 20 minutes of exercise and compared to their responses from the previous day when they were tested after a resting period.
(University of Illinois at Urbana-Champaign (2009, April 1). Physical Activity May Strengthen Children's Ability To Pay Attention. ScienceDaily. Retrieved April 2, 2009, from http://www.sciencedaily.com
releases/2009/03/090331183800.htm)
Recess is an Important Part of School Day
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Other Interventions Address Executive Dysfunction
challenges Provide external structure by
Organize or reorganize the child's environment
Set clear goals (e.g., "Get dressed by 8:00 a.m.).
Help the child keep his or her belongings (e.g., school books, toys, clothing) in the same place
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Addressing deficits in EF Give clear instructions (avoid multiple and
complex) Use lists or check off opportunities to help
them keep track Allow for movement when needed Teach self-monitoring strategies
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Some specifics to ASD
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Characteristics of Autism & Structured Teaching Approach
Wiring Differences Focus on details vs.
difficulty with whole
Difficulty knowing how things fit together
Difficulty extracting meaning
Difficulty knowing which are relevant details
Structured Teaching Intervention
Highlights beginning and endings
Establish routines and ways to approach tasks and materials
Highlights relevant details
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Characteristics of Autism & Structured Teaching
ApproachLearning style: Strong visual
learner Difficulty with
language
Sensory Sensitive to
sensory input and modulating stimulation
Support for learning Visual supports Visual schedules Visual routines Modifications Environment is
modified to reduce stimulation
(beware of loud confusing spaces)
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Characteristics of Autism & Structured Teaching
ApproachASD
characteristics Difficulty with
transitions Difficulty with
generalizing Can be
compulsive
ST intervention Transitions routines
are taught visually Need to disengage
and reengage is analyzed and addressed
Flexibility is taught through visual manipulation of routines and clear expectations.
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Structured Teaching Antecedent based Uses competence motivation rather
than consequence motivation Levels of Structured Teaching:
Physical Structure Schedules Work Systems Routines and Strategies Task
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Swiss Cheese
While students share characteristics Each child is unique Some need a distraction free
environment Some need background noise Some need to stand
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Get support for yourself
Un-medicated ADHD students are challenging Need for novelty Low self esteem Poor impulse control Inconsistency Co-morbid complications
Some of most common are Oppositional Defiant Anxiety
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Get support for yourself
The best laid plans may work once The fix is a process, try to make a positive
contribution and know that they are likely equally discouraged but may be using cover-up strategies
Use their motivations and interests whenever possible
Design behavior plans to track what you are looking or hoping for not what they are doing wrong
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Other Treatment Medications
Stimulants usually are the first-line medications prescribed. If two or three stimulants are tried and found to be ineffective, antidepressants may be used.
Stimulants do not cure ADHD, but they can help control symptoms.
Studies have shown that these medications can improve symptoms in 70–90% of children who have ADHD. We often note dramatic improvements in writing
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Medication Issues If parents disagree
When parents don’t see benefit
Complications of cost, pick up etc.
Forgotten morning pill
Lack of accurate information
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Meds diets and other treatments for ASD
Some remarkable case studies Research has not sorted out who
will benefit from what Usually focused on improving
focus, behavior, sleep issues
