1. Executive Functioning
November 13th, 2018
Presented by Michelle Trinchese
Adapted from a previous presentation by Jamie Pollock & Erica Gerlach
Information from Smart but Scattered by Peg Dawson and Richard Guare.
Power-point contributor: Lauren Hough and Michelle Flemen-Tung

2. Do you notice your child has?
Trouble planning?
Difficulty directing activities?
Little regulation?
Difficult time organizing?
Independence Issues?
Hyper focus on details?
Rigidity?

3. Why are they acting this way?
They aren’t being manipulative, lazy, unmotivated, etc…
They need skills to overcome the executive functioning deficits
Kids who get “stuck” circulate between the limbic system and brainstem
They can’t access neocortex (planning, language, etc…) because the emotions/flight/fight response is overwhelming

4. What is Executive Functioning?
“[Executive functioning is an] umbrella term for multiple cognitive processes behind behavior that flexibly directs goal oriented behavior... In response to novel or difficult situations
Meltzer & Krisdnan
What is executive functioning?
Refers to a set of mental skills that are coordinated in the brain’s frontal lobe.
Executive functions work together to help a person achieve goals.

5. When Do We See Executive Functioning Difficulties?
During new or challenging situations
When situations call for flexibility
Situations requiring problem solving
Transitions
Initiating a task
When pre-occupied with preferred interest

6. Executive Functioning Skills
Metacognition
Flexibility
Goal-directed Persistence
Time Management
Organization
Planning/Prioritizing
Task Initiation
Sustained Attention
Emotional Control
Working Memory
Response Inhibition

7. Response Inhibition Ability to “think” before you act.
Control the impulse to automatically respond to something.
to resist the urge to say/do something allows your child the time to evaluate a situation and how his/ her behavior might impact it.
“STOP function” for both actions and thoughts.

8. EXAMPLES
• A young child can wait for a short period without being disruptive.
• An adolescent can accept losing without an argument.

9. Building Response Inhibition (strategies)
Use routines, rules, supervision and limits
Help your child learn to delay gratification with waiting periods
Discuss consequences for poor impulse control
Practice response-inhibition in role playing situations
Priming visual cues/verbal cues
TEACH- STOP, THINK, ACT

10. Working Memory
Capacity to hold onto information while performing complex tasks.
It incorporates the ability to draw on past learning or experiences to apply to the situation at hand or to project into the future.
Draw on both visual imagery and language
Gradually increase our expectations:
Time
Work

11. Examples
• A young child can hold in mind and follow 1- or 2-step directions.
• An adolescent can remember the expectations of multiple different teachers.

12. Building Working Memory (strategies)
Make eye contact before telling your child something
Minimize distractions
Have your child repeat what you said back to you
Reminders: pictures, written, lists, etc.
Involve the your child in planning how to help them remember

13. Emotional Control Ability to regulate emotions in order to:
Achieve established goals
Complete tasks
Direct a behavior

14. EXAMPLES
• A young child can recover from disappointment in a short time.
• A teenager can manage the stress of a test and still perform.

15. Improving Emotional Control (strategies)
Regulate the environment through routines
Prepare your child for what to expect and possible solutions
Develop coping strategies
Read stories highlighting model behaviors
Countdown timers
Take breaks
Mindfulness/meditation

16. Sustained Attention
Capacity to sustain attention despite distractions, fatigue, or boredom.
Child may appear bored or uninterested but in fact, might just find the task too difficult.

17. EXAMPLES
• A young child can perform a 5-min chore with occasional supervision.
• A teenager can pay attention to HW for 1-2 hours with small breaks.

18. Increasing Sustained Attention (strategies)
Provide reminders and encouragement
Provide devices/strategies
Make the task interesting
Use incentive systems
Offer praise for staying on task
Implement self-monitoring strategies
“Your____will still be there.”
Park it in the parking lot

19. Task Initiation
Beginning a task efficiently without procrastination and in a timely manner.
Applies to tasks unpleasant or boring.

20. EXAMPLES
• A young child is able to start a chore/ assignment right after instructions are given.
• A teenager does not wait until the last minute to begin a project.

21. Supporting Task Initiation (strategies)
Reinforce initiating following a prompt
Provide visual cues as reminders
Break down tasks
Doable first steps
Involve child in making a plan

22. Planning & Prioritizing
Creating a plan to reach goals and make decisions about what is most important to focus on.
Requires
Identifying priorities
Stick to them
Follow a set plan
Re-evaluate priorities when initial goal is met

23. EXAMPLES
• A young child, with coaching, can think of options to settle a peer conflict.
• A teenager can formulate a plan to get a job.

24. Promoting Planning & Prioritizing (strategies)
Model your planning and prioritizing
Create plans for and include your child
Work through strengths and interests
Facilitate prioritization by asking child what needs to be done first
Breakdown the tasks

25. Organization
Ability to establish & maintain a system for arranging/keeping track of items.
Goals
Improve efficiency
Decreases stress
Free up mental energy
Increase independence and responsibility

26. EXAMPLES
• A young child can, with a reminder, put materials in a designated place.
• A teenager can organize and locate various of his own materials.

27. Fostering Organization (strategies)
Put a system in place
Involve student in goal-setting, planning, and execution processes
Supervise
Reminders (visual, verbal)
Monitoring
Checking in & reflecting

28. Time Management Ability to estimate timing How much time the child has
How to use time effectively & efficiently
How to work within a deadline
Valuing time as something that is important

29. EXAMPLES
• A young child can complete a short job within a time limit set by an adult.
• A teenager can establish a schedule to meet task deadlines.

30. Improving Time Management (strategies)
Maintaining a predictable routine
Self talk about how long things take
Planning activities with multiple steps
Model the use of calendar and schedules
Use tools such as timers
Practice timing it/racing the clock
Reflect back on how much time things actually took

31. Goal-Directed Persistence
One of the most advanced EF skills.
Setting, working towards & completing a goal without being sidetracked by “competing interests.”

32. EXAMPLES • A 1st grader can complete a job to get to recess.
• A teenager can earn and save to work towards something they find important.

33. Developing Goal-Directed Persistence (strategies)
Start early with brief, manageable things
Start with goals the child wants to work on
“Look forward approach”
Reminder about what the child is working towards
Make sure the reward is worth it

34. Flexibility “Go with the flow.”
Ability to revise plans and be adaptable.
Respond effectively to new obstacles, new information or mistakes.
Make necessary and emotional adjustments.

35. EXAMPLES
• A young child can adjust to a change in plans without major distress.
• A teenager can accept alternatives such as a different choice when the first job is not available.

36. Encouraging Flexibility (strategies)
Follow schedules and consistent routines
Priming for what is coming
Offer choices
Teach and practice coping strategies
Planning changes in a plan

37. Metacognition Ability to reflect on oneself in a situation & include
How you problem solve: “How did I handle that?”
Self-monitoring: “How am I doing?”
Self evaluating: “How did I do?”
Two sets of metacognition skills:
Evaluate performance & make changes
Evaluate social situations (own and others’ behaviors/reactions)

38. EXAMPLES
• A young child can change behavior in response to feedback from an adult.
• A teenager can monitor and critique performance to improve it by observing others who are more skilled.

39. Developing Metacognition (strategies)
For task performance:
Specific praise for key elements of task performance
Teach self evaluation
Identify what “finished” looks like
Teach self-questioning for problem situations
Reflect, brainstorm & develop revised plans for the future
For reading social situations
Guessing games for reading emotions
Teach identification of meaning & tone of voice
Talk about identifying feelings in people trying to hide their feelings
Discuss how actions might change someone's feelings

40. Executive Functioning Development
Toddlerhood-hard to resist inhibitions
Preschoolers-self-focused, poor impulse control
Elementary school-some impulse control, some skills will be effective in some situations, skills develop more
Middle school-begin to know what works for them and what doesn’t
High School-working memory and attentional control are close to adult level, but flexibility and metacognition are not yet fully developed
Adjust expectation to developmental level which may not match their grade/age

41. Implementation Introduce strategy at a calm time so they can process
Demonstrate
Give it time to work
Offer praise and reinforcement
Monitor progress; is the strategy helping?
Yes-push towards independence
No-Try something different
Use skills they are strong in to develop weaker ones