Executive FunctioningMill Valley Middle School September 27, 2011

Barbara Easterlin, Ph.D.

Assistant Clinical Professor, UCSF Hyperactivity, Attention, and Learning Problems (HALP) Clinic and UC Berkeley Clinical Psychology Department

Licensed Clinical Psychologist

415-847-254021 Tamal Vista Blvd., Suite 101Corte Madera, California 94925

The “CEO” of the Brain The parts of the

brain that takes in information,

decides on a course of action,

issues commands via rank in a hierarchy, and

ensures that commands

are implemented

What is Executive Functioning

Generally conceptualized as the brain’s ability to

absorb or conceptualize information,

interpret this information, and

make decisions and carries through actions based on this information.

Early Development of EF New research suggests that imaginal play

behavior is integral to the development of the neural pathways that strengthen executive functioning: making things from scratch, planning out made-up games, role playing

These skills are diminished by playing videogames, using toys that are already constructed, sedentary viewing of screens

Early Development of Executive Functions

EXECUTIVE FUNCTIONS IN MIDDLE SCHOOL (starting to develop)

Regulating (sustaining) attention & effort

Task Initiation & persistence

Planning, time management & organization

Good Decision making/judgment

Understanding impact on others -- “self monitoring”

Development of idealism & dreams

EXECUTIVE FUNCTIONS IN MIDDLE SCHOOL, cont.

Dealing with Novelty

Holding information in “working memory”

Impulse control; “parking” irrelevant information, block out distractions

Mental Flexibility

Frustration tolerance & emotional control

Social awareness

Seeing the big picture

PRE-TEEN/TEEN EXECUTIVE FUNCTIONSorganization, concentration, time management & task prioritization, impulse inhibition/emotional control & motivation

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PRE-TEENEXECUTIVE FUNCTIONS

PRE-TEEN/TEEN EXECUTIVE FUNCTIONS (without adult supervision)

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ENTITLEMENT

What happens when EF is not working correctly? Impulsivity Disinhibition (behavioral or verbal) Emotional Reactivity Social inappropriateness Distractibility Making bad decisions Difficulty starting tasks; lateness Poor organization Lateness

Lazy Kid or Executive Dysfunction? Does your child seem lazy, intentionally

forgetful, unmotivated, deliberately late?

Does your child know information but can’t communicate it in a logical sequence?

Do you have a child who is constantly distracted?

Does your child seem impatient, disorganized, and constantly losing things?

Executive Dysfunction Students with executive dysfunction have

problems of a neurobiological nature that particularly affect planning, flexibility, organization, and self monitoring (Ozonoff, 1998).

These individuals may have difficulty picking a topic, planning the project, sequencing the materials for a paper, breaking the project down into manageable units with intermediate deadlines, getting started, and completing the activity

5 most important middle school skills for success Organization

Time management & Prioritization

Concentration

Flexibility & Emotional control

Motivation

1. Organization

Whether it's keeping track of research materials or remembering to bring home a lunch box, children need to be organized to succeed in school. For many students, academic challenges are related more to a lack of organization than to a lack of intellectual ability.

ORGANIZATION – SUCCESS! Make a checklist of things your child needs to bring to and

from school every day. Put a copy by the door at home and one in his backpack. Try to check with him each day to see if he remembers the items on the list.

Find out how your child keeps track of his homework and how he organizes his notebooks. Then work together to develop a system he will want to use.

Shop with your child for tools that will help him stay organized, such as binders, folders or an assignment book.

Use colored folders and in/out baskets for organizing homework

Clean out desk, backpack and notebook once a week

2a. Time Management

Learning to schedule enough time to complete an assignment may be difficult for your student. Even when students have a week to do a project, many won't start until the night before it's due. Learning to organize time into productive blocks takes practice and experience.

TIME MANAGEMENT TIPS Use a visual calendar – with overall plan for the day,

week, month for activities and assignments

Track assignments on the calendar. Work backward from the due date of larger assignments and break them into nightly tasks

Add in intermediate deadlines to show work to teacher at intervals rather than at end

Highlight due dates or test dates

TIME MANAGEMENT TIPS Help your child record how much time she spends on homework

each week so she can figure out how to divide this time into manageable chunks.

Break down assignments into steps

Plan for twice as much time as you think you need

Use a timer and reward for “chunks” of work completed

Together, designate a time for nightly homework and help your child stick to this schedule. DEVELOP A ROUTINE

If evenings aren't enough, help your child find other times for schoolwork, such as early mornings, study halls or weekends. Use weekends to track upcoming assignments

2b. Prioritization

Sometimes children fall behind in school and fail to hand in assignments because they simply don't know where to begin.

Prioritizing tasks is a skill your child will need throughout life, so it's never too soon to get started. The ability to create a roadmap to reach a goal or to complete a task.

Especially important for Long Term Projects and Written Expression

PRIORITIZATION – SUCCESS! Ask your child to write down all the things he needs to

do, including non-school-related activities. Ask him to label each task from 1 to 3, with 1 being

most important. Ask about each task, so that you understand your

child's priorities. If he labels all his social activities as 1, then you know where his attention is focused.

Help your child change some of the labels to better prioritize for academic success. Then suggest he rewrite the list so all the 1s are at the top.

Make checklists for getting through assignments

3. Concentration

Whether your child is practicing his sixth grade spelling words or studying for an advanced algebra test, it's important that she works on schoolwork in an area with limited distractions and interruptions.

TIPS FOR IMPROVED CONCENTRATION Turn off access to email and games when your child

works on the computer. Declare the phone and TV off-limits during homework

time. Find space that fits the assignment. If your child is

working on a science project, she may need lots of space; if she's studying for a Spanish test, she will need a well-lit desk.

Help your child concentrate during homework time by separating her from her siblings.

DO WHATEVER WORKS FOR YOUR CHILD

4. Flexibility & Emotional Control

Ability to revise plans in the face of obstacles, setbacks, new information or mistakes.

Shift directions in the course of a thought or action

The capacity to think before you act

The ability to keep your cool in the face of provocation, fear, & worry

Flexibility & Emotion Strategies

Teach and model coping strategies Relaxation strategies, thought stopping, or attention diversion

strategies It’s ok to make mistakes (self and others)

Practice Multi-tasking – work with 2 or 3 familiar tasks and rotate them at regular intervals

2 minute warnings to alert student that an activity is ending or beginning

Notify student of changes in routines ahead of time.

Coach student to make mid-course corrections while thinking, reading, and writing

Martial arts – or other disciplines which emphasize self control

5. Motivation

Most children say they want to do well in school, yet many still fail to complete the level of work necessary to succeed academically. The reason is often motivation. Tapping into your child's interests is a great way to get him geared to do well in school.

TIPS TO HELP MOTIVATE YOUR MIDDLE SCHOOLER Ask your child what his/her goals are and link

everything else to their personal goals.

Link school lessons to your child's life. If he's learning percentages, ask him to figure out the price of a discounted item next time you shop.

Link your child's interests to academics. If he's passionate about music, give him books about musicians and show how music and foreign languages are connected.

TIPS TO HELP MOTIVATE YOUR MIDDLE SCHOOLER

Give your child control and choices. With guidance, let him determine his study hours, organizing system or school project topics.

Encourage your child to share his expertise. Regularly ask him about what he's learning in school.

Congratulate your child, encourage him and celebrate all his successes.

Give student something they can look forward to as soon as the task is over (i.m.’ing, Facebook, screens, etc.)

PARENTING TIPS

PARENTING TIPS Teaching skills is a long term project. BE PATIENT – keep

your cool

Try not to make your child be like you – respect your differences

Be available to help your child solve problems

Communicate optimism “We can solve this problem”

Praise your child for getting started and working on homework

MORE PARENTING TIPS Don’t do the homework, write the essay, draw the

picture, etc. for them

Check on student occasionally, but not constantly

Do a complementary activity in the same room while they are studying

Assist them in understanding directions

Communicate discreetly with teachers

WHEN TO HAVE YOUR CHILD EVALUATED: Inconsistent performance

Overly “stubborn” or rigid stance

Difficulties switching between activities & thoughts

Problems with sustaining attention

Problems with task initiation

WHEN TO HAVE YOUR CHILD EVALUATED:

Excessively impulsive; not thinking ahead or thinking about consequences

Social skill problems (appear “delayed” or out of step)

Homework grades significantly lower than test grades

Exhibits difficulty with each new grade and struggles to make transition each year to next grade level

Doesn’t seem to “learn from mistakes” or generalize from one task or situation to another

Written work is of poor quality, incomplete or disorganized (because it involves keeping track of directions, the physical act of writing, using correct mechanics, creating complete sentences, transferring ideas into written form, deciding on main ideas, details, flow, etc.)

How are EF’s measured

In addition to psychometric tests: Clinical interview Behavioral observations Rule out problems in basic sensory,

motor, and cognitive functioning are ruled out (e.g. vision, hearing, memory & learning, basic attention, & visual spatial skills)

Resources & Strategies Agenda books, electronic PDA’s, calendars

for writing down assignments or appointments

Work with an Educational Therapist

Other alerting/alarm devices – adhdwarehouse.com

Checklists for routines (i.e. what to do before leaving the house, leaving school, etc.)

Develop routines (put away wallet, keys, c-phone in same place EVERY day)