executive functioning: the basics - school of st. mary
TRANSCRIPT
Executive Functioning: The Basics
Lisa Novak, Psy.D.
Noelle Pontarelli, Ph.D.
Illuminate Psychological Assessments, LLC
Agenda
u What is executive functioning?
u How does executive functioning develop over time?
u How do we assess executive functioning?
u What interventions can help improve executive functioning?
u Questions & Resources
Broadly, executive functions are…
u What we use to control and regulate ourselves to accomplish goal-directed tasks.
uinitiate uplan and organize uset goals uflexibly solve problems uregulate emotionsumonitor behavior
Variability in EF Development
u Frontal lobe: last area of brain development
u Fluid vs. stepwise development
u Wide range of “normal” functioning
u Adverse impact on functioning
u Social, academic, behavioral challenges
Preschool Expectations
u Follow 1-step directions
u Perform simple chores with some assistance/reminders
u Inhibit simple behaviors (hitting/biting, touching hot stove)
KindergartenExpectations
u Follow 2-3 step directions
u Inhibit more complex behaviors with reminders (e.g., look both ways before crossing a street)
1st/2nd Grade Expectations
u Tidy bedroom/playroom with minimal assistance
u Bring papers & materials to/from school
u Complete simple homework assignments with minimal assistance
u Decide how to spend money
u e.g., save allowance for future goal
u Independently inhibit specific behaviors
u e.g., raise hand before speaking in class
3rd - 5th Grade Expectations
u Complete 1h of homework with minimal assistance (and one to two breaks)
u Keep trach of changing daily schedule
u Plan how to earn money and save it for desired objects
u Keep track of belongings when away from home
u More complex behavioral inhibition: continue to behave when teacher leaves room, don’t make rude comments, inhibition of outbursts
6th – 8th Grade Expectations
u Independently use system for organizing schoolwork
u Follow more complex & flexible school schedules
u Plan & execute steps to complete long-term projects
u Minimal assistance in time management for juggling demands & activities
u e.g., homework, chores, extracurriculars
High School Expectations
u Establish long-term goal & continuously monitor plan for achieving goal
u Identify & synthesize main ideas from grade-level text
u Organize thoughts coherently in writing
u Inhibit reckless or dangerous behavior
u e.g., succumbing to peer pressure, unsafe decisions while driving
Examples of EF Challenges at different stages
u Forgetting to turn in completed homework
u Messy backpack, locker, bedroom
u Losing materials for school & extracurriculars
u Blurting out in class; interrupting others’ conversations
u Motor restlessness & excessive energy/activity level
u Conflicts with peers due to rigidity or poor self-monitoring
u Limited ability to sustain effort on non-preferred tasks
Assessment of EF
u Importance of multiple sources of data
u Review of relevant developmental history
u Teacher & parent reports
u Clinical observation
u Comprehensive evaluation
u Performance on standardized measures to directly compare to same-age peers
Assessment of EF
Assessment of EF
Why pursue an evaluation?
u Identifying underlying causes
u Other issues can masquerade as poor EF (e.g., learning disorders, anxiety)
u Determine magnitude of concern
u Is there a diagnosable disorder?
u Would medication be helpful?
u What other interventions/supports might be necessary?
EF Interventions
u Home-based strategies
u Visual schedules/family organizers
u Visual timers
u Manage expectations
u Games to encourage flexibility, working memory, inhibition
u Scaffolding of support to encourage increasing independence
EF Interventions
u Private providers
u EF coaches
u Occupational therapists
u CBT therapists
u Psychiatrists/pediatricians
u Tutors for reading comprehension/writing
EF Interventions
u School-based supports
u Interventions (RtI & IEPs)
u Accommodations (504 Plan)
u Functional Behavioral Analysis (FBA) & Behavior Intervention Plan (BIP)
Questions?
Lisa Novak, Psy.D. & Noelle Pontarelli, Ph.D.
www.illuminateneuropsych.com