1. 1 Presented by George McCloskey, Ph.D. Philadelphia College of Osteopathic Medicine gmccloskz@aol.com or georgemcc@pcom.edu Executive Functions and Classroom Learning and Production

2. Brain/Mind Bulletin, 1988 Mentally healthy persons maintain many illusory beliefs, including: –Overly positive view of themselves –Convenient “forgetting” of negative facts about themselves –Perceptions of having greater control over events than is actually the case –“Unrealistic” optimism about themselves –“Unrealistic” optimism about the future –“Abnormal” cheerfulness

3. Newberg’s Best Ways to Exercise Your Brain –Maintain Faith (Positive Belief System) –Dialogue with Others –Engage in Aerobic Exercise –Meditate –Yawn –Consciously Relax –Stay Intellectually Active –Smile

4. 4 Task Performance is directed by Executive Functions or an Executive Functions substitute. The neural networks used to perform a task depend on perceptions about how the task should be done. Key Concept

5. 5 Most of what a teacher says to students is intended to activate specific areas of the students’ brains. Key Concept

6. 6 The more specific the language used by a teacher, the more likely it is that students will be activating the necessary brain areas. Key Concept

7. 7 What Are Executive Functions?  “Despite the frequency with which it is mentioned in the neuropsychological literature, the concept of executive functions is one that still awaits a formal definition. Research efforts aimed at exploring the different aspects of this construct have often yielded contradictory evidence, resulting in a lack of clarity and even controversy regarding the true nature of executive abilities.” Jurado & Rosselli, 2007, page 213.

8. 8 What Are Executive Functions?  Directive capacities of the mind  Multiple in nature, not a single capacity  Cue the use of other mental abilities  Direct and control perceptions, thoughts, actions, and to some degree emotions  Part of neural circuits that are routed through the frontal lobes

9. Executive Functions Are Not a Unitary Trait Frequently referred to as “the CEO of the Brain” or the “Conductor of the Orchestra These metaphors hint at the nature of EFs, but are far too general for effective understanding of the concept create the impression of a central control center or a singular control capacity

10. EF as the Conductor of the Brain’s Orchestra (i.e., EF as “g”) EF =Cognitive Ability

11.  The orchestra conductor analogy feeds into the “homunculus problem,” a paradox of infinite regress, or just a complex metaphysical maze.  For practical everyday problem-solving in a more concrete manner, it is better to use the concept of a system of interrelated “co-conductors” rather than posit a single conductor. Executive Functions Are Not a Unitary Trait

12. Appropriate Metaphors for Executive Functions: A Team of Conductors and Co-Conductors of a Mental Ability Orchestra, or The Coaching Staff of a Mental Ability Football Team Executive Functions Are Not a Unitary Trait

13. Perception Cognition Emotion Action Domains of Functioning Directed by Executive Functions Action Executive control of modes of output including behavior in the external world and storage and retrieval of internal representations Cognition Executive control of thoughts and thought processing Emotion Executive control of moods, feelings, and the processing of emotions Perception Executive control of modes of perceptual input including external sensory stimuli (visual, auditory, kinesthetic) and internal (representational) stimuli

14. EF ef Activation ef Co-Conductors in a Holarchical Model of EF

15. Tiers of Executive Function Self-Control and Executive Function Capacities within Tiers Perceive Focus Sustain Energize Initiate Inhibit Stop Interrupt Flexible Shift Modulate Plan Evaluate/Compare Decide Sense Time Pace Sequence Execute Hold Manipulate Store Retrieve Trans-Self Integration Self-Activation Self-Realization Self-Awareness Other-Awareness Self-Analysis Self-Determination Goal setting Long-range Planning & Foresight Self-Generation Monitor Correct Balance Gauge Anticipate Estimate Time Analyze Generate Associate Organize Prioritize Self-Regulation EF ef Activation EF

16. IV. Self Generation III. Self Control: Self Determination Goal Generation II. Self Control: Self Regulation Initiate Modulate Execute Sequence Focus Monitor Check Interrupt/Stop Inhibit Perceive Organize Manipulate Store Retrieve I. Self Control: Self Activation Mind-Body Integration, Sense of Spirit Awaken, Attend Anticipate Hold Balance Correct Generate Sense TimePace V. Trans-self Integration Sense of source, Cosmic consciousness Sensation/Perception Cognition Emotion Action Self Realization Self Awareness Self Analysis Long-Term Foresight/Planning Gauge Shift Associate Choose Sustain Analyze Flexible Plan Est. Time

17. 17 Self-regulation Executive Functions cue and direct in different ways at different levels. Key Concept

18. 18 Self Activation  Initiation and “ramping up” of basic executive functions related to an awakened state of mind and to overcoming sleep inertia.

19. 19 Self Regulation  A set of control capacities that cue and direct functioning across the domains of sensation/perception, emotion, cognition, and action  The current model posits 33 self-regulation executive functions

20. 33 Self-Regulation EFs  Perceive  Focus  Sustain  Energize  Initiate  Inhibit  Stop  Interrupt  Flexible  Shift  Modulate  Balance  Monitor  Correct  Gauge  Anticipate  Estimate Time  Analyze  Generate  Associate  Plan  Organize  Analyze  Compare  Choose  Prioritize  Compare/Eval  Decide  Sense Time  Pace  Sequence  Execute  Hold  Manipulate  Store  Retrieve

21. 21 Self-regulation Executive Functions can be organized into 7 basic clusters. Key Concept

22. SREF “Clusters”  The 33 self-regulation executive functions can be grouped based on “Clusters” in which several srefs are used in an integrative manner.  There are seven primary clusters to consider.

23. SREF “Clusters”  Attention  Engagement  Optimization  Efficiency  Memory  Inquiry  Solution

24. Attention Cluster  “What’s going on out there?”  Includes: Perceive, Focus/Select, Sustain

25. Engagement Cluster  “Get to it – or not”  Includes: [Attention Cluster], Energize, Initiate, Inhibit, Stop/Interrupt, Flexible, Shift, [Optimization Cluster]

26. Optimization Cluster  “How am I doing?”  Includes: [Attention Cluster], Monitor, Modulate, Balance, Correct

27. Efficiency Cluster  “The Smooth Operator.”  Includes: Sense Time, Pace, Sequence, Execute, [Optimization Cluster]

28. Memory Cluster  “You CAN get there from here.”  Includes: [Attention Cluster], Hold, Manipulate, Store, Retrieve, [Efficiency Cluster]

29. Inquiry Cluster  “Inquiring minds need to know.”  Includes: Anticipate, Gauge, Estimate Time, Analyze, [Memory Cluster], Evaluate/Compare, [Solution Cluster]

30. Solution Cluster  “I’m the Decider.”  Includes: Generate, Associate, Prioritize, Plan, Organize, [Memory Cluster], Choose/ Decide, [Optimization Cluster]

31. 31 Self Realization  Directs cognitive processes that engage in self-awareness, self- reflection and self-analysis.  Cues cognitive processes to access accumulated information about self and apply it in specific situations to initiate, sustain, or alter behavior.

32. 32 Self Determination  Foresight/Long-Term Planning and Goal Generation  Directs the use of cognitive processes to construct visions of the future and plans for action over longer periods of time. Directs reflection on the past for purposes of improving or altering behavior and thinking in the future.

33. 33 Self Generation  Directs the posing of speculative questions related to the meaning and purpose of life and/or the ultimate source(s) of reality and physical existence, mind-body relationships, spirit, and soul; contemplates existence beyond the physical plane.  Directs the generation of a philosophy of life used to guide self-awareness, self-realization and the other levels of executive function processes; serves as a basis for an ultimate source of intentional behavior direction.

34. 34 Trans-Self Integration  Directs the engagement of mental processes that enable realization and experiencing of a trans-self state of ultimate or unity consciousness.  In most spiritual traditions, this state is considered the highest achievement of human consciousness and therefore very different from the maladaptive states characteristic of clinical diagnoses of dissociative states.

35. 35  Executive control also varies depending on the Arena of Involvement  The Four Arenas of Involvement are  Intrapersonal (Control in relation to the self)  Interpersonal (Control in relation to others)  Environment (Control in relation to the natural and man-made environment)  Symbol System (Control in relation to human made symbol and communication systems) Arenas of Involvement

36. Environment Control of Self in Relation to Surroundings Intrapersonal Interpersonal Environment Symbol System Executive Functions within Arenas of Involvement Symbol System Control of Self in Relation to Culturally Determined Modes of Communication including Reading, Writing, Mathematics, and Communication Technologies Interpersonal Control of Self in Relation to Others Intrapersonal Control of Self in Relation to Self

37. 37 Effective use of Executive Functions can vary by Arena of Involvement as well as by Domain of Functioning. Key Concept

39. Executive Functions and Intelligence  The concept of executive functions is not synonymous with the traditional concepts of intelligence or “IQ”  Executive functions often are not directly assessed with standard intelligence tests

40. Directions for the Wisconsin Card Sorting Test (WCST): I can’t tell you much about how to do this task. Which of these do you think this one goes with? I’ll tell you if your answer is right or wrong. Measuring Executive Functions with a Reasoning Task

41.  The more classroom instruction resembles tests of executive functions like the Wisconsin Card Sorting Test (figure out what we’re learning, I’ll tell you whether you are right or wrong), the more executive difficulties are going to impact classroom learning and performance. Executive Functions and School

42.  Test taking can be exceptionally difficult for a student with executive function difficulties if the test format emphasizes executive function demands over content knowledge. Executive Functions and School

43. 43 Executive Functions are developing form birth; maturational delays can cause difficulties. Key Concept

44. 44 Developmental Progression with a 30% Delay EFAGEEQEFAGEEQ Chronological Age 6 8 10 15 21 30 60 90

45. 45 EF Development does not progress by continuous equal intervals

46. 46  Executive control is highly dissociable; it can vary greatly depending on the domain of functioning that is being directed: sensation/perception, emotion, cognition, or action.  Good executive control in one domain does not guarantee good executive control in the other domains; Poor control in one domain does not guarantee poor control in the other domains. Executive Function Variability

47. 47  Self-regulation executive functions are developing from the first years of life on throughout a person’s entire lifetime.  Large developmental shifts are noticeable, especially around adolescence.  Because EFs are developmental in nature, natural maturational delays and lags are observed. Executive Function Development

48. 48  Intraindividually, all EFs do not develop evenly. For any given individual, one EF can be more or less developed than any other EF at any given point in time.  Interindividually, there is also great variation relative to chronological age. At the same age, different individuals will naturally vary considerably in their level of development of various EFs. Executive Function Development

49. 49  Cultural change points (e.g., educational transitions to Preschool, Kindergarten, 1 st grade, junior h.s., senior h.s., college, graduate school, and workplace entry) can serve to highlight EF developmental delays or significant deficiencies. Executive Function Development and School

50. 50  Executive control is highly dissociable; it can vary greatly depending on the domain of functioning that is being directed: sensation/perception, emotion, cognition, or action.  Good executive control in one domain does not guarantee good executive control in the other domains; Poor control in one domain does not guarantee poor control in the other domains. Executive Functions Variability

51. 51  Self-regulation executive functions are developing from the first years of life on throughout a person’s entire lifetime.  Large developmental shifts are noticeable, especially around adolescence.  Because EFs are developmental in nature, natural maturational delays and lags are observed. Executive Function Development

52. 52  Intraindividually, all EFs do not develop evenly. For any given individual, one EF can be more or less developed than any other EF at any given point in time.  Interindividually, there is also great variation relative to chronological age. At the same age, different individuals will naturally vary considerably in their level of development of various EFs. Executive Function Development

53. 53  Cultural change points (e.g., educational transitions to Preschool, Kindergarten, 1 st grade, junior h.s., senior h.s., college, graduate school, and workplace entry) can serve to highlight EF developmental delays or significant deficiencies. Executive Function Development and School

54. 54  Some EF-based clinical syndromes, such as ADHD, demonstrate clear patterns of delayed developmental progression. Barkley (1998) estimates developmental delays of about 30% associated with various EF processes such as Inhibit, Manipulate, Shift, Sustain, Time, Monitor, Correct. Executive Function Development and School

55. 55  Some EF-based clinical syndromes, such as ADHD, demonstrate clear patterns of delayed developmental progression. Barkley (1998) estimates developmental delays of about 30% associated with various EF processes such as Inhibit, Manipulate, Shift, Sustain, Time, Monitor, Correct. Executive Function Development and School

56. 56 Virtually all individuals who struggle with psychological disorders exhibit executive function difficulties. Key Concept

57.  “Deficits in PFC [prefrontal cortex, aka frontal lobes] function are evident in every neuropsychiatric disorder (indeed, the term “psychiatric problem” seems synonymous with PFC dysfunction).” Arnsten & Robbins 2002 in Principles of Frontal Lobe Function Executive Functions and Clinical Diagnoses

58.  Most of the clinical conditions described in the DSM-IV reflect some form of Executive Dysfunction  The DSM-IV can be thought of as “A User’s Guide to All the Things That Can Go Wrong With the Frontal Lobes” Executive Functions and Clinical Diagnoses

59.  A sampling of conditions involving EF deficits:  Autism Asperger’s Syndrome  ADHD and ADD  Conduct Disorder  Oppositional Defiant Disorder  Depression and/or Anxiety  Obsessive-Compulsive Disorder  Fetal Alcohol Syndrome Executive Functions and Clinical Diagnoses

60. 60 All individuals with ADHD exhibit EF deficits but not all individuals that exhibit EF deficits are ADHD. Key Concept

61. 61 Executive Functions and ADHD?  All individuals with ADHD have executive functions deficits ADHD Executive Function Deficits  but not all individuals with executive functions deficits have ADHD.

62.  EF and ADHD are not synonymous terms; rather ADHD is a condition involving EF deficits in:  Focus/Select, Sustain, Inhibit, Modulate  Nearly all persons with ADHD also have additional self-regulation difficulties; the nature of these additional difficulties is what makes ADHD so variable from one person to the next and what causes confusion in diagnosis. Executive Functions and ADHD

63. Initiate Modulate Execute FocusSustain Monitor Interrupt Inhibit Perceive Organize Manipulate Store Retrieve Plan Hold Balance Correct Generate Gauge Shift Associate Initiate Execute Monitor Interrupt Perceive Organize Manipulate Store Retrieve Plan Hold Balance Correct Generate Est Time Pace Gauge Shift Associate Modulate Focus Sustain Inhibit Pace Sense Time Same Core Different Constellations Analyze Evaluate Energize Sequence Analyze Decide Flexible Stop Anticipate Sense Time Stop Energize Flexible Anticipate Est Time Evaluate Decide Alan Age 10 Katie Age 11

64.  Pharmacological treatment of ADHD usually only addresses the problems associated with the EFs specific to ADHD (Inhibit, Modulate, Focus/Select, Sustain)  Most persons with ADHD will require additional interventions to assist with the additional self-regulation difficulties that persist even when medication is being used effectively to treat the primary ADHD problems. Executive Functions and ADHD

65.  Although executive functions are used to guide cognitive processing involved in new learning, many new learning situations are structured in ways that reduce the need for strong executive direction.  In contrast, demonstrating what has been learned usually requires significant involvement of executive control processes. Executive Functions and School

66. 66 Executive Functions activation can be internally or externally driven; EFs can cue the use of learned strategies. Key Concept

67. 67  The neural circuits for executive function activation are routed differently depending on whether the activation is based on an internally driven desire or command versus an external demand. Internal versus External Control

68. 68  Because internally driven production is much easier to accomplish than externally demanded production for children with “producing difficulties” their lack of production on demand often stands in stark contrast to their seemingly effortless production “when the spirit moves them.” Internal versus External Control

69. 69  The on-demand deficiencies observed by others are often attributed to negative personal characteristics such as lack of responsibility, apathy, passive aggressive stance, or oppositional defiance. Internal versus External Control

70. 70 Producing difficulties are different from learning difficulties; producing difficulties reflect poor use of EFs. Key Concept

71. 71  As Martha Denckla has pointed out, Executive Function difficulties of a severe nature (especially in the Symbol System Arena) do not result in Learning Disabilities; they result in “Producing Disabilities.” Producing versus Learning Difficulties

72. 72 Learning Difficulties Only Learning Difficulties And Producing Difficulties Producing Difficulties Only Often NOT recognized as a Learning Disability, even when severe, unless an evaluation involving process assessment is done Recognized fairly quickly as a Learning Disability When severe, typically attributed to lack of motivation, character flaws, or behavior/personality problems A General Model for Conceptualizing Learning and Producing Difficulties