Is It Really So Hard?
2/20/2018
These slides may not be copied or distributed, in part or in whole, without the written permission of the author.
Is It Really So Hard? INTERVENTIONS FOR YOUTH WHO ARE DISORGANIZED Joyce Cooper-Kahn., Ph.D.
[email protected]
PREVIEW I.
Executive functioning in a nutshell: A very brief review of the basics A. Definitions B. Development of EF
II. What can we do to help disorganized youth? A. What makes and “EF Smart Environment?” B. Specific interventions to meet the needs of most disorganized kids
III. Challenges to intervention
1
2/20/2018
Review of Basics EXECUTIVE FUNCTIONING IN A NUTSHELL
A formal definition of EF Executive functioning is an umbrella term for the mental processes that serve a supervisory role in our own thinking and behavior. The executive functions work together to direct and coordinate our efforts to achieve a goal.
From Cooper-Kahn and Foster, Boosting Executive Skills in The Classroom, 2013.
2
2/20/2018
Regulation of Emotions & Behavior
Self Monitoring • Inhibition • Emotional control • Shifting •
Gioia, G. A., Isquith, P.K., Retzlaff, P.D., and Espy, K.A., 2002.
Cool Skills: Regulation of Thinking
• Planning and Organization • Working Memory • Initiation • Task Monitoring
Gioia, G. A., Isquith, P.K., Retzlaff, P.D., and Espy, K.A., 2002.
3
2/20/2018
Advancing Development and Increasing Demands There are predictable surges in the development of executive functions, and expectations for home and school are designed to pace typical development.
Who needs help? Individuals who have delays in specific executive skills Individuals who have all the foundation skills, but run into difficulty when they have to fluidly coordinate all the components to meet higher-level demands
8
4
2/20/2018
What Can We Do? HELPING YOUTH BUILD BETTER EXECUTIVE SKILLS
9
1. Change in executive functioning occurs as a function of intervention and readiness.
Understanding the Process of Change
2. Change happens in a predictable progression. The first stage requires external structure and direct instruction then proceeds to indirect prompting. Gradually, the child takes over the task, moving from intentional and effortful selfprompting to automaticity. 3. Change does not occur at a predictable pace nor can we predict with full accuracy the ultimate outcome. 4. Along the path to better executive functioning, many missteps will happen. These should be framed as feedback, not fatal errors. 10
5
2/20/2018
Levels of Intervention and Executive Skills Deficits ~5%
1:1 ~15% ~80%
Small Group Whole-School and Whole-Class Design
From Cooper-Kahn and Foster, Boosting Executive Skills in The Classroom, 2013.
What makes an “EF Smart Environment?” 1. Repetition – to build automaticity of executive routines 2. Planning – what are the EF demands inherent in the task? How can I build in supports for those demands? 3. Deliberate focus on EF 4. Allotting time – to model, practice and review students’ EF efforts 5. Coaching mindset – positive and supportive; expectation of missteps 12
6
2/20/2018
1.
Repetition
• Repeated creates habits, building automaticity for both simple skills and complex routines. • Repetition ensures that students carry out complex assignments with some opportunities for failure and additional opportunities to reflect on those failures and then try again for success
13
Behavioral Routines: Home
14
7
2/20/2018
Behavioral Routines: Classroom
15
2. Planning
Plan assignments with the executive load in mind: The more challenging the content, the lower the executive challenge should be. If you are introducing a new task or format, the content should be familiar. Think about the EF development of the child. Think about the task demands.
16
8
2/20/2018
3.Deliberate Focus on EF
Focus on executive thinking not just executive skills; encourage kids to think about tasks and how to accomplish them. As new demands are introduced, include a discussion of the strategies and options for how to complete the task (e.g. chores, homework, book reports, multiple choice tests, essays) Celebrate successful management of tasks as a separate and explicit accomplishment.
17
At Home
1. Model self-talk for planning and organizing 2. Use non-academic tasks to teach executive skills 3. Create schedules, chore cards, procedural templates for homework 4. Praise kids for executive thinking, even if they don’t reach the goal line.
9
2/20/2018
Managing “stuff”: The early grades For younger students, planning and organization is mostly about paper flow and supplies: where to put loose papers like permission slips, handouts, and homework assignments. Create a system for storing basic supplies and for restocking the backpack.
19
Managing Papers M.O.O.S.E. Folders (Management of Organizational Skills Everyday) F.R.O.G. (Fully Responsible, Organized and Growing) B.E.E. (Bring Everything Everyday) Things to be “Left at home” pocket Things to go “Right back to school” pocket 20
10
2/20/2018
Tracking Tasks Use the planner to teach planning. Help the child to break down the task into individual steps. Focus on “do” dates, not just “due” dates.
Ch. 3
(Cooper-Kahn and Foster, 2013, p. 83.)
22
11
2/20/2018
“FLIPP the switch: Strengthen executive function skills” Wilkins, S.A., & Burmeister, C. (2015)”
.
23
Supports for Multi-Step Tasks Provide models and samples of well-done projects and papers (Reif, 2015). Consider taking a photo when a chore is completed, then offer it to the child so she can “match the photo.” (See Ward and Jacobson website: efpractice.com. Offer scoring rubrics to help students visualize the steps required to plan their work and to aid in producing work at age-level expectations. Include interim due dates in the rubric to ensure that the student stays on track. 24
12
2/20/2018
Sample: Using Software to Plan a Project
Created with MindJet Mind Manager
25
Create a framework for listening/reading Organizing Information: Cognitive Routines for Previewing
Discuss the goal of the lesson.
Offer organizational frameworks in advance to help students tag and prioritize new information.
Post a few key points to cue students about what to listen for.
26
13
2/20/2018
Teach students to take an active approach to learning:
For Long Term Success
What is the goal of this lesson? Are there comprehension questions at the end of the chapter or other guidelines to help prioritize information? Can I create an outline in advance to guide learning? Have I highlighted the most important information in the directions or chapter heading? 27
4. Allotting Time
Time to check in on students’ progress with managing tasks
Time to offer support
28
14
2/20/2018
“Doveryay no proveryay.” (Trust, but verify.) Russian proverb
29
5. Coaching Mindset Provide opportunities for safe practice and safe failure.
30
15
2/20/2018
Challenges to Understanding and Compassion Adults may be skeptical or confused because students with weak executive skills can look the same in the classroom as students who are non-compliant. To further complicate the picture, there is often a mix of executive dysfunction (skill delays) and limited or variable effort and motivation. The slow pace of change may lead us to think that our efforts are not working and so we give up rather than sticking with the process. When adults feel helpless, they tend to avoid those feelings by blaming the child. 31
Challenges to Treatment Planning Brain maturation and learning take time and life keeps
coming at us. Unknown upper limits on executive ability for a particular individual means that the ideal balance between “remediation” and accommodation is unknown for any individual.
32
16
2/20/2018
Developmentally-Based Challenges Individuals with EDF will not always see the benefit of the hard work to learn skills. The need for help with executive functions may be out of synch with peers and with the individual’s emotional needs for independence.
33
References Cannon, L., Kenworthy, L., Alexander, K., Werner, M.A., & Anthony, L. (2011) Unstuck and On Target. Baltimore: Brookes Publishing, Inc. Cooper-Kahn, J. and Dietzel, L. (2008) Late, Lost and Unprepared: A Parent’s Guide to Helping Children with Executive Functioning. Bethesda, MD: Woodbine House. Cooper-Kahn, J. and Foster, M. (2013) Boosting Executive Skills in the Classroom: A Practical Guide for Educators. San Francisco, CA: Jossey Bass. Dawson, P., & Guare, R. (2009). Smart but scattered: The revolutionary "executive skills" approach to helping kids reach their potential. New York: Guilford Press. 34
17
2/20/2018
References (continued) Gioia, G.A., Isquith, P.K., Retzlaff, P.D., and Espy, K.A. “Confirmatory Factor Analysis of the Behavior Rating Inventory of Executive Function (BRIEF) in a Clinical Sample.” Clinical Neuropsychology, 2002, 8 (4), 249-257. ., Meltzer, L.(2007). Executive function in education: From theory to practice. New York: Guilford. Ramsay, J.R. and Copper, J. “ADHD & Habits.” Attention Magazine, February 2016, p.24-25. Reif, Sandra. (2015) The ADHD Book of Lists, 2nd Edition. San Francisco, CA: Jossey-Bass. Wilkins, S. A., & Burmeister, C. (2015). FLIPP the switch: Strengthen executive function skills. Shawnee Mission, KS: AAPC Publishing. 35
18
These slides may not be copied or distributed, in part or in whole, without the written permission of the author.
Is It Really So Hard? INTERVENTIONS FOR YOUTH WHO ARE DISORGANIZED Joyce Cooper-Kahn., Ph.D.
[email protected]
PREVIEW I.
Executive functioning in a nutshell: A very brief review of the basics A. Definitions B. Development of EF
II. What can we do to help disorganized youth? A. What makes and “EF Smart Environment?” B. Specific interventions to meet the needs of most disorganized kids
III. Challenges to intervention
1
2/20/2018
Review of Basics EXECUTIVE FUNCTIONING IN A NUTSHELL
A formal definition of EF Executive functioning is an umbrella term for the mental processes that serve a supervisory role in our own thinking and behavior. The executive functions work together to direct and coordinate our efforts to achieve a goal.
From Cooper-Kahn and Foster, Boosting Executive Skills in The Classroom, 2013.
2
2/20/2018
Regulation of Emotions & Behavior
Self Monitoring • Inhibition • Emotional control • Shifting •
Gioia, G. A., Isquith, P.K., Retzlaff, P.D., and Espy, K.A., 2002.
Cool Skills: Regulation of Thinking
• Planning and Organization • Working Memory • Initiation • Task Monitoring
Gioia, G. A., Isquith, P.K., Retzlaff, P.D., and Espy, K.A., 2002.
3
2/20/2018
Advancing Development and Increasing Demands There are predictable surges in the development of executive functions, and expectations for home and school are designed to pace typical development.
Who needs help? Individuals who have delays in specific executive skills Individuals who have all the foundation skills, but run into difficulty when they have to fluidly coordinate all the components to meet higher-level demands
8
4
2/20/2018
What Can We Do? HELPING YOUTH BUILD BETTER EXECUTIVE SKILLS
9
1. Change in executive functioning occurs as a function of intervention and readiness.
Understanding the Process of Change
2. Change happens in a predictable progression. The first stage requires external structure and direct instruction then proceeds to indirect prompting. Gradually, the child takes over the task, moving from intentional and effortful selfprompting to automaticity. 3. Change does not occur at a predictable pace nor can we predict with full accuracy the ultimate outcome. 4. Along the path to better executive functioning, many missteps will happen. These should be framed as feedback, not fatal errors. 10
5
2/20/2018
Levels of Intervention and Executive Skills Deficits ~5%
1:1 ~15% ~80%
Small Group Whole-School and Whole-Class Design
From Cooper-Kahn and Foster, Boosting Executive Skills in The Classroom, 2013.
What makes an “EF Smart Environment?” 1. Repetition – to build automaticity of executive routines 2. Planning – what are the EF demands inherent in the task? How can I build in supports for those demands? 3. Deliberate focus on EF 4. Allotting time – to model, practice and review students’ EF efforts 5. Coaching mindset – positive and supportive; expectation of missteps 12
6
2/20/2018
1.
Repetition
• Repeated creates habits, building automaticity for both simple skills and complex routines. • Repetition ensures that students carry out complex assignments with some opportunities for failure and additional opportunities to reflect on those failures and then try again for success
13
Behavioral Routines: Home
14
7
2/20/2018
Behavioral Routines: Classroom
15
2. Planning
Plan assignments with the executive load in mind: The more challenging the content, the lower the executive challenge should be. If you are introducing a new task or format, the content should be familiar. Think about the EF development of the child. Think about the task demands.
16
8
2/20/2018
3.Deliberate Focus on EF
Focus on executive thinking not just executive skills; encourage kids to think about tasks and how to accomplish them. As new demands are introduced, include a discussion of the strategies and options for how to complete the task (e.g. chores, homework, book reports, multiple choice tests, essays) Celebrate successful management of tasks as a separate and explicit accomplishment.
17
At Home
1. Model self-talk for planning and organizing 2. Use non-academic tasks to teach executive skills 3. Create schedules, chore cards, procedural templates for homework 4. Praise kids for executive thinking, even if they don’t reach the goal line.
9
2/20/2018
Managing “stuff”: The early grades For younger students, planning and organization is mostly about paper flow and supplies: where to put loose papers like permission slips, handouts, and homework assignments. Create a system for storing basic supplies and for restocking the backpack.
19
Managing Papers M.O.O.S.E. Folders (Management of Organizational Skills Everyday) F.R.O.G. (Fully Responsible, Organized and Growing) B.E.E. (Bring Everything Everyday) Things to be “Left at home” pocket Things to go “Right back to school” pocket 20
10
2/20/2018
Tracking Tasks Use the planner to teach planning. Help the child to break down the task into individual steps. Focus on “do” dates, not just “due” dates.
Ch. 3
(Cooper-Kahn and Foster, 2013, p. 83.)
22
11
2/20/2018
“FLIPP the switch: Strengthen executive function skills” Wilkins, S.A., & Burmeister, C. (2015)”
.
23
Supports for Multi-Step Tasks Provide models and samples of well-done projects and papers (Reif, 2015). Consider taking a photo when a chore is completed, then offer it to the child so she can “match the photo.” (See Ward and Jacobson website: efpractice.com. Offer scoring rubrics to help students visualize the steps required to plan their work and to aid in producing work at age-level expectations. Include interim due dates in the rubric to ensure that the student stays on track. 24
12
2/20/2018
Sample: Using Software to Plan a Project
Created with MindJet Mind Manager
25
Create a framework for listening/reading Organizing Information: Cognitive Routines for Previewing
Discuss the goal of the lesson.
Offer organizational frameworks in advance to help students tag and prioritize new information.
Post a few key points to cue students about what to listen for.
26
13
2/20/2018
Teach students to take an active approach to learning:
For Long Term Success
What is the goal of this lesson? Are there comprehension questions at the end of the chapter or other guidelines to help prioritize information? Can I create an outline in advance to guide learning? Have I highlighted the most important information in the directions or chapter heading? 27
4. Allotting Time
Time to check in on students’ progress with managing tasks
Time to offer support
28
14
2/20/2018
“Doveryay no proveryay.” (Trust, but verify.) Russian proverb
29
5. Coaching Mindset Provide opportunities for safe practice and safe failure.
30
15
2/20/2018
Challenges to Understanding and Compassion Adults may be skeptical or confused because students with weak executive skills can look the same in the classroom as students who are non-compliant. To further complicate the picture, there is often a mix of executive dysfunction (skill delays) and limited or variable effort and motivation. The slow pace of change may lead us to think that our efforts are not working and so we give up rather than sticking with the process. When adults feel helpless, they tend to avoid those feelings by blaming the child. 31
Challenges to Treatment Planning Brain maturation and learning take time and life keeps
coming at us. Unknown upper limits on executive ability for a particular individual means that the ideal balance between “remediation” and accommodation is unknown for any individual.
32
16
2/20/2018
Developmentally-Based Challenges Individuals with EDF will not always see the benefit of the hard work to learn skills. The need for help with executive functions may be out of synch with peers and with the individual’s emotional needs for independence.
33
References Cannon, L., Kenworthy, L., Alexander, K., Werner, M.A., & Anthony, L. (2011) Unstuck and On Target. Baltimore: Brookes Publishing, Inc. Cooper-Kahn, J. and Dietzel, L. (2008) Late, Lost and Unprepared: A Parent’s Guide to Helping Children with Executive Functioning. Bethesda, MD: Woodbine House. Cooper-Kahn, J. and Foster, M. (2013) Boosting Executive Skills in the Classroom: A Practical Guide for Educators. San Francisco, CA: Jossey Bass. Dawson, P., & Guare, R. (2009). Smart but scattered: The revolutionary "executive skills" approach to helping kids reach their potential. New York: Guilford Press. 34
17
2/20/2018
References (continued) Gioia, G.A., Isquith, P.K., Retzlaff, P.D., and Espy, K.A. “Confirmatory Factor Analysis of the Behavior Rating Inventory of Executive Function (BRIEF) in a Clinical Sample.” Clinical Neuropsychology, 2002, 8 (4), 249-257. ., Meltzer, L.(2007). Executive function in education: From theory to practice. New York: Guilford. Ramsay, J.R. and Copper, J. “ADHD & Habits.” Attention Magazine, February 2016, p.24-25. Reif, Sandra. (2015) The ADHD Book of Lists, 2nd Edition. San Francisco, CA: Jossey-Bass. Wilkins, S. A., & Burmeister, C. (2015). FLIPP the switch: Strengthen executive function skills. Shawnee Mission, KS: AAPC Publishing. 35
18
