1. How Executive Dysfunction affects the transition of students with high-functioning ASD across educational settings Dr Mariam Aljunied Chartered Educational Psychologist (British Psychological Society) Principal Educational Psychologist, Ministry of Education (Singapore) Melbourne, 5 May 2016 Like a Ferrari stuck in a traffic jam…

3. Many children with ASD, despite good cognitive abilities and good skills in memory, vocabulary and attention, are significantly impaired in the ability to manage the use of (or execute) these abilities in the context of learning tasks. Difficulties in Executive Function or ‘Executive Dysfunction’ ‘Like a Ferrari stuck in a traffic jam …’

4. Overview What is Executive Function (EF)? How impairments in executive function affect children with autism? –Transition across educational settings What we know helps? What more can be done?

5. What is Executive Function? An umbrella term for complex set of processes that underlie flexible, goal-directed responses to novel or new situations. NOT a single cognitive process, e.g.: –Planning and decision making; –Error correction or troubleshooting; –Initation of novel sequences of actions; –Inhibition & attention control –Working memory (Shallice & Burgess, 1991; Shallice, 1982) Sally Ozonoff (1995) – Autism & Executive Dysfunction

6. Executive Function Skills Example… From : Behavioural Assessment for Dys-executive Syndrome for Children, Emslie et al., 2003.

7. Executive Function Skills Example… From : Behavioural Assessment for Dys-executive Syndrome for Children, Emslie et al., 2003.

8. Key search results… Many possible solutions…

9. Key search results… Systematic, pre-planned search

10. Key Search … What were the skills and knowledge that you used to do the task effectively?

11. Ben’s response (12 yrs) Key search results…

12. How executive dysfunction affects children with autism? Poor response to ‘novel’ or new info Difficulties in planning Shifting attention Difficulties in problem solving skills Rigidity & repetitive behaviour Poor generalisability Sally Ozonoff (1995) -Compared with normally developing peers of the same age and ability levels, children with autism are severely impaired in executive function skills

13. Comparison of Scale Scores for Children with High-Functioning Autism (FSIQ 98 to 132; mean = 109)(males)(aged 12-14yrs) Children with autism significantly impaired in all subtests, compared with peers with same IQ.

14. Difficulties in Transition Anxiety often attributed as main causes for difficulties in transition –Perceived barrier is Emotional “He’s scared of new environment” “He does not like change” –How can we reduce the anxiety? How can we help him regulate the emotions? Executive Dysfunction : the barrier is Cognitive –“He lacks specific executive function skills” –How can we train his better in these specific skills?

15. Overcoming barriers in Executive Function at Transition The genius of the “AND”? Preparing the environment for the child & the preparing child for the environment using autism good-practice practice strategies Training in specific executive function skills –Working memory training, e.g. COGMED –Attention training, e.g. Brain-Computer- Interface (BCI)

16. Brain-Computer Interface (BCI) The system uses a technology which analyzes brain waves captured through quantitative electroencephalography (qEEG) to determine the child’s state of attention or attention level which is then used to drive the training programme, which involves playing a computer game. Neuro-feedback therapy Technology developed and patented by A*STAR Singapore’s lead public sector agency spearheading economic oriented research to advance scientific discovery and innovative technology

17. CEREBRO – Interface Headgear BCI-CEREBRO TM Attention Driven Game Attention Driven Game Computer A*STAR Technology A*STAR Technology BCI Signal Processing Software BCI Signal Processing Software CEREBRO – Signal Management System (Wired OR Wireless) 17

19. Study on Efficacy of BCI* Following the 8-week training program, behavioural symptoms of attention difficulties showed significant improvement. Those with more severe symptoms were also the ones who showed greater improvement. When these children received monthly training sessions subsequently, the behavioural improvements were sustained but did not further improve. *Lim CG, Lee TS, Guan C, Fung DSS, Chao Y, Teng SSW, Zhang H, Ranga K (2010) Effectiveness of a Brain-Computer Interface Based Program : a Pilot Study in Psychopharmachology BullitenL Vol 43. No 1

20. Overcoming Executive Dysfunction “How can we unleash the capacity of the Ferrari in the child”