February 23, 2015 Resource Teacher Training Karen Horner Executive Function

Do you know anyone who is….. Disorganized? Not able to complete homework or assignments? Unmotivated except when a topic interests him or her? Rarely able to get things done? Easily angered? Having difficulty with social situations?

… Difficulties with Executive Function may be the culprit! Can’t versus won’t Is this ‘behaviour’? Is this an act? Is this student just lazy? Why can’t this bright student get assignments handed in? … Difficulties with Executive Function may be the culprit!

Executive Function is not the same as intelligence… …so then what is Executive Function?

What did your brain have to do? How different would your day have gone if your brain didn’t work in an efficient manner?

Executive Function “High level cognitive functions which enable us to manage our emotions and monitor our thoughts in order to work more efficiently and effectively….. These skills help us to regulate our behaviour” (Dawson and Guare, 2010)

Executive Function Executive Skills are built in, but are not necessarily developed at birth. Read about Brain Development pg. 2-4 (Dawson and Guare)

It Starts With the Brain and Brain Development

Prefrontal Cortex and Frontal Lobe Frontal lobes are the last of brain structures to myelinate. Young adulthood is complete around 24 years of age. This is the same time that executive functioning should be fully developed.

How do executive skills develop? Through a process called myelination. Myelin acts as insulation, increasing the speed with which nerve impulses are transmitted. The faster the impulse, the better the skill.

When is brain development complete?

A teenage brain is like a Ferrari… The teenage brain is like a Ferrari: it's sleek, shiny, sexy and fast, and it corners really well.  But it also has really crappy brakes. May look like a well developed brain but struggles a lot  

All skills, including executive skills, improve with practice… The more you practice, the better the skill. Practice also makes the task less effortful

Executive Function is Like a Conductor or….

An Air Traffic Controller

Executive Function The following information is from the Provincial Outreach Program for Autism and Related Disorders (POPARD) Handout on Executive Function Executive Function for students with Autism has been divided into two categories: Hot Executive Functions Cold Executive Functions Show POPARD handout on doc cam

Executive Function – Hot Functions “Affective, motivational processing – includes: inhibition and emotional regulation, shifting and flexibility, initiation and self monitoring Most closely associated with behaviour and emotional regulation in social situations.”

Executive Function – Cold Functions Cold Executive Functions: “Abstract, de-contextualized processing includes cognitive tasks, such as: working memory, planning organizing, and sustaining attention Most closely associated with academic performance in learning situations” – thinking about thinking

8 Elements of Executive Function Thinking About Thinking (Cold) Behaviour Regulation (Hot) Initiation Inhibition Planning Shifting Attention Organization Emotional Control Working Memory Monitoring Metacognition

Thinking About Thinking: Task Initiation The ability to begin projects without undue procrastination, in an efficient or timely fashion. getting started; paying attention; finishing work

Thinking About Thinking: Planning/Prioritization The ability to create a roadmap to reach a goal or to complete a task. It also involves being able to make decisions about what’s important to focus on and what’s not important. Taking an issue apart, analyzing the pieces, reconstituting and organizing it into new ideas (complex problem solving).

Thinking About Thinking: Organization The ability to design and maintain systems for keeping track of information or materials.

Thinking About Thinking: Working Memory The ability to hold information in mind while performing complex tasks. It incorporates the ability to draw on past learning or experience to apply to the situation at hand or to project into the future. Working memory and recall (holding facts in mind while manipulating information; accessing facts stored in long-term memory.)

Thinking About Thinking: Monitoring/ Metacognition The ability to stand back and take a bird’s eye view of oneself in a situation. It is an ability to observe how you problem solve. It also includes self- monitoring and self- evaluative skills. self-monitoring and prompting

Thinking About Thinking: Time Management The capacity to estimate how much time one has, how to allocate it, and how to stay within time limits and deadlines.  It also involves a sense that time is important

Behaviour Regulation: Flexibility The ability to revise plans in the face of obstacles, setbacks, new information or mistakes.  It relates to an adaptability to changing conditions. If there is a bad match between student and environment may look like: withdrawl, overwhelming anxiety, anger, fear. 6-9 months (coinciding when they start to get mobile). We need to be the surrogate frontal lobes! Need to design environments that operate as external frontal lobes. Flexibility – need to understand the expectations all of the time. Once they make a decision, they are full in – that is scary! Put your agenda on the table so they know! Picture schedules, pre-planning, preparing them.

Behaviour Regulation: Sustaining Attention The capacity to attend to a situation or task in spite of distractibility, fatigue, or boredom

Behaviour Regulation: Response Inhibition The capacity to think before you act. This ability to resist the urge to say or do something allows us the time to evaluate a situation and how our behaviour might impact it. changing activities, stopping existing activity, stopping and thinking before acting or speaking

Behaviour Regulation: Emotional Control (Also called self-regulation or affect) The ability to manage emotions in order to achieve goals, complete tasks, or control and direct behaviour. using "self-talk” to control one's behavior and direct future actions

Executive Function and the Impact on Learning, Behaviour and Socialization ADHD Learning Disabilities Autism Fetal Alcohol Spectrum Disorder Depression Head Injuries Etc…..

What Do Executive Skill Weaknesses Look Like in Students? Ask without thinking Easily over-stimulated and has trouble calming down Interrupts others Gets stuck on one topic or activity Overreacts to small problems Gets overly upset about :little things: Upset by change in plans Out of control more than peers Overwhelmed by large assignments Can’t come up with more than one way to solve a problem Talks or plays too loudly Low tolerance for frustration Doesn’t notice impact of behavior on others Acts wild or out of control Don’t see their behavior as part of the issue These have to do with behaviour regulation – response inhibition challenges

What Do Executive Skill Weaknesses Look Like in Students? Doesn’t write down assignments Forgets homework/forgets to pass it in Forgets directions Leaves long-term assignments or chores until the last minute Forgets to bring materials home Can’t break down long-term assignments Runs out of steam before finishing work Sloppy work Choose “fun stuff” over homework or chores Messy notebooks Passive study methods (or doesn’t study) Loses or misplaces things (books, papers, notebooks, mittens, keys, cell phone, etc.) Can’t find things in backpack These are metacognitive challenges

What Do Executive Skill Weaknesses Look Like in Students on ASD Spectrum? Overreacts to small problems Gets stuck on one topic or activity Upset by changes in plans Gets overly upset about ‘little things’ Overwhelmed by large assignments Out of control more than peers Resists change of routine Can’t come up with more than one way to solve a problem Doesn’t notice impact of behavior on others Low tolerance for frustration Don’t see their behavior as part of the issue  

What Do Executive Skill Weaknesses Look Like in Students on ASD Spectrum? Difficulty With: Monitoring behaviour/performance/emotions Regulating behaviour/emotions Inhibiting automatic/overlearned responses Shifting from one task/situation to another Flexible problem solving Changing expectations Adapting to change Planning/organizing an activity Applying past learning to new situations  

3 Key Strategies for Managing Executive Skill Weaknesses Intervene at the level of the environment Intervene at the level of the child by: Teach the student the weak skill Motivate the student to use the skill

3 Primary Ways Adults Can Help Students with Weak Executive Skills Change the environment both to reduce the impact of weak executive skills and encourage the use of executive skills. Help the student learn and practice executive skills. Use incentives to help students to use skills that are hard for them.

Move from External to Internal: Critical Dimensions EXTERNAL INTERNAL CHANGE CHANGE ENVIRONMENT STUDENT EXTERNAL CUE SELF-CUE

Executive Function How do you support a student with Executive Function deficits? ……Be their ‘external brain’!

Executive Function When planning to accommodate for deficits in these areas it helps to determine which executive function is being challenged and based on that, what would be the best intervention to support the need * Give out Abridged Executive Control Skills Checklist and show Dawson and Guare book

Prevent Change the Environment Adapt the Task Provide cues Provide modeling

1. Change the Environment Start here Changes depend on the area of need Impose structure E.g. messy desk due to organizational problems Text books kept on the shelf not in desk, binder system

Environmental Modifications Task domain/Executive Skills Classroom/Home Support Change the social environment - Response inhibition - Emotional control Reduce social complexity (e.g. fewer kids, more adults, supervision on playground, structured play vs. free play) Change the ‘social mix’ (seating arrangements in class, special table in cafeteria)

Environmental Modifications Task domain/Executive Skills Classroom/Home Support Change the physical environment Response inhibition Sustained attention Task initiation Organization Add barriers (gates, laws) Seating arrangements (e.g. place distractible kids near teacher, away from windows) Reduce distractions (e.g. music as white noise) Use organizing structures (e.g. clear plastic containers with labels, consistent space on blackboard for writing homework

Environmental Modifications Task domain/Executive Skills Classroom/Home Support Modify tasks Sustained attention Task initiation Working memory Flexibility metacognition Make tasks shorter or build in breaks along the way Make steps more explicit Help kids track time

Environmental Modification Response Inhibition Environmental Modification Teaching Strategy Increase external controls Cue the child (external to internal) Restrict access Teach wait/stop Post home or classroom rules and review regularly Teach delayed gratification

The Marshmallow Experiment The Zimbardo Experiment

Environmental Modification Working Memory Environmental Modification Teaching Strategy Use orthotic memory devices Principle of ‘off-loading’ Directions/Past experience (prompt them to access it) Agenda books/calendars Generate options and have them choose (or elicit options from student) Notebooks (to do lists) Mentally rehearse association between cue and working memory Electronic devices & apps (iPad, iPhone) Choiceworks app

Environmental Modification Emotional Control Environmental Modification Teaching Strategy Reduce or eliminate triggers Teach kids to recognize situations or early signs Give child a script to follow Graded exposure/guided mastery Remove student from problem situation Teach coping strategy Rehearse the strategy repeatedly until it is internalized

Environmental Modification Flexibility Environmental Modification Teaching Strategy Limit flexibility demand Increase support - reduce novelty - highlight similarities - provide a template - put in place a default strategy - turn open-ended tasks into closed-ended tasks - make steps more explicit - normalize errors - present expectations - walk them through the task - give plans or rules for managing situations - think aloud

Environmental Modification Sustained Attention Environmental Modification Teaching Strategy Reduce distractions Teach self-monitoring/peer coaching Prompt to attend (look, listen, respond) Have the student identify something to look forward to Modify/limit task length or demand (end in sight) Build in variety/choice Choose best time of day Immediately reinforce

Environmental Modification Task Initiation Environmental Modification Teaching Strategy Provide cues/prompts Have the student select cueing system Reduce perceived effort/task demand Help the student limit initial demand Walk through first step – build behavioural momentum Help the child select reinforcer Make help readily available Help the child make a plan for doing the task Establish set time to do non-preferred tasks

Planning/Prioritization Environmental Modification Teaching Strategy Demonstrate what a plan is Walk through the planning process Help student design a plan/template Have them apply plan to a simple task and gradually prompt kids to do more of the planning themselves Provide planning tools (calendar, agenda, apps) Ask questions to get kids to prioritize (What do you need?, What should you do first?)

Environmental Modification Organization Environmental Modification Teaching Strategy Demonstrate principle of off-loading the example from their lives Help them walk through the process. Have them motorically practice it (a long-term process, requiring that they put a system in place that’s monitored, initially on a daily basis) Work with them to create scheme, template or picture Ask students to evaluate current systems and challenge them to improve them Show organizational tools and have them try them out

Environmental Modification Time Management Environmental Modification Teaching Strategy Make schedules and time limits explicit Help kids learn what time means (time gaps in behavioral contingency) Work with kids to make a schedule to follow and prompt each step of the way Picture schedules Clocks, alarms Tablet/phone apps Timers Show them ways to mark time and let them practice Practice how to estimate how long it takes to do something Help them to follow schedules (daily events to homework plans)

Goal-Directed Persistence Environmental Modification Teaching Strategy Establish goals with kids Point out to kids how they already set goals but they may not know what they are. Define goals as something that people want to get better at or to change Reward kids for persistence (sticking with difficult tasks) Ask kids to set small, achievable goals, or a goal for something they want to do outside of school or set class goals Make sure the goal or benchmark is in sight

Environmental Modification Metacognition Environmental Modification Teaching Strategy Specify what is to be evaluated and how (goal or objective) Help student on how performance will be evaluated Evaluate performance for the student Have the student evaluate her performance Provide sample to match or error-monitoring checklist Compare evaluations Teach students to ask questions - What’s my problem? - What’s my plan? - Am I following my plan? - How did I do?

After the Fact… Label what the student did well Talk about the situation (s) Ask for feedback from others

More Strategies Break complex tasks down into manageable tasks with deadlines Goal Estimated Time Needed: Start Date __/__/__ Deadline Date Done 1. 2.

Resources… See Resources Handout for more ideas First Class – Special Programs – Resources – Executive Function