SKILLS THAT HELP THE BRAIN GET THINGS DONE: IMPROVING EXECUTIVE FUNCTIONING IN CHILDREN AND ADOLESCENTS

Transcription

1 SKILLS THAT HELP THE BRAIN GET THINGS DONE: IMPROVING EXECUTIVE FUNCTIONING IN CHILDREN AND ADOLESCENTS KAILYN JONES, M.A. MAY 10,

2 DID YOU JOIN FOR PART 1? FOR THOSE OF YOU JUST MEETING ME Bachelor of Arts in Psychology (University of Alberta, 2011) Master of Arts in School Psychology (Mount Saint Vincent University, 2014) Doctoral candidate in School and Applied Child Psychology (University of Calgary) Registered Provisional Psychologist School and executive functioning in children with chronic pain, connecting healthcare and education Work clinically with children and families to support needs within school and community Assessment and consultation services within a First Nations school board 2

3 GETTING TO KNOW YOU Caregivers to children in preschool/kindergarten? Caregivers to children in grades 1-3 Caregivers to children in grades 4-5? Caregivers to children in grades 6-8? Caregivers to children in grades 9-12? Service providers working in healthcare? Service providers working in education? Service providers working in a community organization? Other? Caregivers to adult children? LAST TIME WE LEARNED: - WHAT EXECUTIVE FUNCTIONING IS - 11 KEY EXECUTIVE SKILLS - THE DEVELOPMENTAL PROGRESSION OF THESE SKILLS - HOW THESE SKILLS DEVELOP IN THE BRAIN - WHY THESE SKILLS MATTER FOR SCHOOL AND PERSONAL SUCCESS 3

4 AIMS FOR TODAY: - HOW TO IDENTIFY EXECUTIVE FUNCTIONING WEAKNESSES - HOW TO HELP YOUR CHILD OR TEEN IMPROVE THEIR EXECUTIVE SKILLS REMINDERS FROM SESSION 1 4

5 WHAT IS EXECUTIVE FUNCTIONING? A set of brain-based skills that plan and direct thinking and behaviour Umbrella term for skills involving mental control and self-regulation 11 KEY EXECUTIVE SKILLS EXECUTIVE FUNCTIONING A set of distinct yet interrelated skills Sustained Attention Task Initiation Planning/ Prioritization Organization Time Management Emotional Control Goal-Directed Persistence Working Memory Flexibility Impulse Control Executive Skills Metacognition 5

6 EXECUTIVE SKILLS DEVELOP IN THE BRAIN Frontal and prefrontal cortex are the brain base for these skills Prefrontal systems are among the last areas of the brain to fully develop Activating these skills takes more conscious effort in children than in adults Children are less likely to apply these skills to tasks of daily living in comparison to adults FROM INFANCY TO ADOLESCENCE AND BEYOND Center on the Developing Child (2012). Executive Function (InBrief). Retrieved from 6

7 YET WE ASK FOR THEM ALL THE TIME Present various developmental tasks for which executive skills are required Page%1%of%3% Developmental%Tasks%Requiring%Executive%Skills% Skills%that%Help%the%Brain%Get%Things%Done:%Understanding%Executive%Functioning%in%Children%and%Adolescents.%Presented%by%Kailyn% Jones,%M.A.%on%April%19,%2017%in%partnership%with%the%Community%Education%Service%of%Alberta%Health%Services. % % Age$Range$ Sample$Developmental$Tasks$ Preschool % Q%Run%simple%errands,% Get%your%socks%from%your%bedroom % Q%Tidy%bedroom%or%playroom%with%assistance % Q%Perform%simple%selfQhelp%tasks%with%assistance%(e.g.,%clear%dishes,%brush%teeth,%get%dressed) % Q%Inhibit%behaviours%(e.g.,%don t%touch%hot%stove,%don t%run%into%the%street,%don t%grab%a%toy%from%a%peer,%don t%hit) % Kindergarten% Q%Run%errands%with%twoQ%to%threeQstep%directions % to%grade%1% Q%Tidy%bedroom%or%playroom% $ Q%Perform%simple%selfQhelp%tasks%with%a%reminder%(e.g.,%make%bed,%put%clothes%in%hamper) % Q%Bring%papers%to%and%from%school % Q%Complete%homework%assignments%(e.g.,%home%reading%for%20Qminutes) % Q%Decide%how%to%spend%money%or%allowance % Q%Inhibit%behaviours%(e.g.,%follow%safety%rules,%raise%hand%before%speaking,%keeps%hands%to%self) % Grades%3Q5 % Q%Run%errands%with%a%greater%time%delay%or%distance%(e.g.,%go%to%a%nearby%store,%do%something%after%school) % $ Q%Tidy%bedroom%or%playroom%may%include%vacuuming,%dusting%etc. % Q%Perform%chores%that%take%15Q30%minutes%(e.g.,%clean%up%after%dinner,%rake%leaves) % Q%Bring%books,%papers%and%belongings%to%and%from%school % Q%Keep%track%of%belongings%when%away%from%home % Q%Complete%homework%assignments%(e.g.,%1Qhour%maximum) % SAMUEL 7

8 SAMUEL BEFORE AND AFTER o Distracted o Off-track o Unfocused o Irresponsibl e o Unable to get things done o Lazy How can he be smart but so scattered? Goal-Directed Persistence Planning/Prioritization Flexibility Task Initiation Sustained Attention Impulse Control Working Memory Emotional Control HOW YOUR OWN EF SKILLS MATTER 8

9 DENISE AND GARRET DENISE AND GARRET Denise - Hasn t been late to work in 5 years - Gets errands done immediately - Starts unpleasant tasks right away, intuitively knows how to break them down - Can t fathom being unorganized Garret - Loves nothing more than a good surprise - Gets things done eventually, being a little late isn t a big deal - Rarely loses his cool or feels bothered Tom - Needs reminders to be on time for school - Won t start homework without threat - Puts off large-projects, doesn t know where to begin - Relies on a strong working memory Mandy - Plunges into hysteria at the slightest change - Emphasizes the importance of time - Can t calm herself easily 9

10 GOODNESS OF FIT When parents have one set of strengths and weaknesses, and their children have another they lack goodness of fit If your child s EF weaknesses drive you crazy, there s a good chance you re strong in that area If you don t notice your child s EF weaknesses, it s possible that you are also weak in that area Opposites Attract AND/OR Monkey See, Monkey Do EVALUATING YOUR OWN SKILLS To help children compensate for and even eliminate EF weaknesses, you must know where your skills align and where they do not 10

11 COMPENSATING FOR FIT THAT S NOT SO GOOD When Your Strengths Align with Their Weaknesses Offer assistance in areas of weakness (GARRET: Strategy for coping with timedelays) Be creative in using your strengths to enhance skills (GARRET: Game of guessing time-delay, gets gold sticker if correct) Identifying where you are weak (GARRET: I need to be better at time management ) When You Share the Same Weaknesses Work at it and grow together Brainstorm solutions collectively Consider a systematic approach to addressing weaknesses IDENTIFYING STRENGTHS AND WEAKNESSES 11

12 IDENTIFY STRENGTHS AND WEAKNESSES Observe your child Complete questionnaires Preschool/Kindergarten Grades 1-3 Grades 4-5 Middle School Teen EXECUTIVE FUNCTIONING Emotional Control Working Memory Sustained Attention Task Initiation Planning/ Prioritization Organization Time Management Goal-Directed Persistence Flexibility Impulse Control Executive Skills Metacognition HELPING YOUR CHILD IMPROVE THEIR SKILLS 12

13 ASK YOURSELF 1. When your child seems to be avoiding, is it possible they can t? 1. What EF skills are needed for the task? Does the child have them? 2. Is something in the environment making the task difficult? 1. If the child can sometimes, what makes them successful in the sometimes? 1. If the child has the skills, do they believe they can succeed? 1. Is an emotional or behavioural response a result of a gap between an EF demand and their skill level? EXECUTIVE FUNCTIONING Sustained Attention Task Initiation Planning/ Prioritization Organization Time Management Emotional Control Goal-Directed Persistence Working Memory Flexibility Impulse Control SUPPORT STRATEGIES Executive Skills Metacognition 13

14 IMPULSE CONTROL Resisting urges and impulses. IMPULSE CONTROL Resisting urges and impulses. Delay gratification using formal waiting periods First/Then Schedules First your spelling homework, then 20 minutes of video games Highlight natural consequences When we hit others, they don t want to play with us Structure wait times Whistle while you wait, Add Response Cost systems Prepare for situations that require impulse control and cue your child ahead of time Low attention cue = place hand on shoulder High attention cue = pass a cue card, give a verbal redirection 14

15 IMPULSE CONTROL ThethingsIdowithoutthinkinginclude: Standingreallyclosetothepersoninfrontofme Cuttinginfrontofsomeone Pushingsomeone Yellingatsomeoneelsewhocutsinfront CommonsituationswhereIactwithoutthinkingare: Longlineformyfavoriteslideatthewaterpark WhatIwilldotostaycontrolled: Takeabigbreath CounthowmanybluebathingsuitsIcanseewhileIwait Squeezeandletgoofmyfists Chatpolitelywiththepersonbehindme Resisting urges and impulses. WORKING MEMORY Holding information in memory. 15

16 WORKING MEMORY Holding information in memory. Make eye contact before providing instructions Keep external distractions to a minimum (Turn off TV, Pause game) Avoid overloading, provide 1-2 instructions at once Have child repeat instructions back to you, rehearse what you expect Brainstorm ways to remember something important (Alarms, phone reminders, text messages, An apple inside my shoe ) Use visual or written reminders with prompts ( Check your schedule, Look at your list ) Reward for remembering (Sticker chart for bringing daily agenda to and from school) WORKING MEMORY Holding information in memory. 16

17 EMOTIONAL CONTROL Controlling emotions. EMOTIONAL CONTROL Controlling emotions. Assist with identifying feelings, and their associated body cues Use feeling words regularly Assist with identifying feeling intensity Model positive coping Discuss characters, people and role models who manage their emotions well (Pause movies to discuss) Provide simple soothing strategies Help your child learn relaxation techniques 17

18 EMOTIONAL CONTROL Identifying feelings and body cues How does his/her face look? What about his/her eyes? Their mouth? What does his/her body look like? Is it tight or soft? What are they doing? EMOTIONAL CONTROL Identifying feeling intensity 18

19 EMOTIONAL CONTROL Simple soothing strategies and relaxation Colour or draw Have a drink of water or a snack Blow out 5 birthday candles Blow bubbles, deep breathing Listen to your favorite song Sticky Hands, press together firmly for 10 seconds and then slowly pull apart Have a 3-minute dance party Shake it off, Let it go Pet an animal Count to 10 Give or receive a bear hug Take a walk, open a window Hold a favorite stuffed animal or object Stretch, make the letter X and T Simple yoga poses I can statements Tense and release muscles Visualize a quiet or favorite place SUSTAINED ATTENTION Staying focused. 19

20 SUSTAINED ATTENTION Staying focused. Provide supervision, encouragement, and cuing Increasing attention using a gradual process (Establish a base rate, set a timer, increase with self-monitoring) Use a visual depiction of time ( Time Timer ) Use incentive systems (Points for completed work rewards that are powerful, frequent, varied) Alternate between preferred and non-preferred activities Offer praise for staying on-task (Avoid only negative feedback) Make the task interesting (A challenge, a game, or a contest) SUSTAINED ATTENTION Staying focused. 20

21 TASK INITIATION, PLANNING, ORGANIZATION, TIME MANAGEMENT Beginning tasks without undue procrastination. Creating a roadmap to reach a goal. Maintaining systems to keep track of things. Estimating and allocating time, and staying within limits. She struggles to carry out long-term projects at school TASK INITIATION, PLANNING, ORGANIZATION, TIME MANAGEMENT Work together to break tasks down into smaller, more manageable pieces Write or draw out the steps to complete a task (What first? What next?) Prompt prioritizing (What s most important? What s is needed soonest? What will take the most energy?) Put systems in place (Have designated spaces, label them) Estimate time together, gather evidence, and compare Use calendars and schedules individually and as a family Provide a visual or oral cue to begin 21

22 TASK INITIATION, PLANNING, ORGANIZATION, TIME MANAGEMENT 1. Chore Estimating&Time&for&Chores& Howlongdo youthinkitwill take? Whenwillyou doit? Howlongdidit take? Take a photo of the space at it s best. Check-in later. TASK INITIATION, PLANNING, ORGANIZATION, TIME MANAGEMENT Date: Assignme nt DoIhaveall thematerials? Yes No Yes No Homework&Planner & DoIneedhelp? Whowillhelp me? Yes No Yes No Howlong willit take? Whenwill Istart? Yes No Yes No Done 22

23 FLEXIBLE THINKING Adapting to change. Revising plans/approach. 23

24 FLEXIBLE THINKING Adapting to change. Revising plans/approach. Keep consistent routines whenever possible Provide advance warning for what s coming next Provide a social story for handling change, rehearse it in advance Use coping strategies and relaxation techniques in the event of something unexpected Tell silly jokes and make puns, Why are fish so smart? Because they live in schools. (Dual word meaning) Make up new rules for games Try things a different way (Spread the jelly before the peanut butter) Teach self-talk and problem solving (Take 2 deep breaths, state the problem, consider at least 3 solutions, choose one, try it out) & Problem&Solving&Through&Change & HowisthislikeanotherproblemIhavesolved? WhatcanIdosolvetheproblem? Ismystrategyworking? Isthereanotherwaytosolvethisproblem? 24

25 METACOGNITION Taking a birds-eyeview. He can only come up with one solution to a problem METACOGNITION Provide specific praise for key elements of performance ( I like the way you looked under your bed to see if there were any dirty clothes, I like the way you walked away from the referee ) Have child identify what finished looks like (No more dishes in the sink, all dishes in the cupboard) Taking a birds-eyeview. Reflect on performance with your child How do you think you did? What directions did you follow? What do you think about how it looks? What might be helpful next time? Teach your child to ask questions of themselves What is the problem I need to solve? What is my plan? Am I following the plan? How did I do? 25

26 RESOURCES RESOURCES Smart but Scattered by Peg Dawson & Richard Guare Coaching Students with Executive Skills Deficits by Peg Dawson & Richard Guare Calm, Alert, and Learning: Classroom Strategies for Self-Regulation by Stuart Shanker Boosting Executive Skills in the Classroom: A Practical Guide for Educators by Joyce Cooper-Kahn & Margaret Foster Late, Lost, and Unprepared: A Parents' Guide to Helping Children with Executive Functioning by Joyce Cooper-Kahn & Laurie Dietzel Child Mind Institute. Helping Kids Who Struggle With Executive Functions. 26

27 QUESTIONS Contact: 27