Executive function is.. Executive dysfunction is.. Executive function is.. EXECUTIVE FUNCTION

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1 Executive function is.. EXECUTIVE FUNCTION What s Your Function? Set of neurologically-based skills involving mental control and selfregulation. Planning/completing tasks and managing oneself and one's resources. Connecting experience with present action. Kevin Anderson, PhD, OTR April 2014 Executive function is.. Controlling and regulating cognition and behavior. Necessary for goal-directed behavior. Necessary to develop independent, purposeful, goal-directed behaviors. Executive dysfunction is.. Disruption in ability to regulate, control, and manage cognition, emotion, and behavior. Deficiency in planning, abstract thinking, flexibility and behavioral control. A major factor in every day living and problem solving. Taken from Executive Function After Brain Injury Headway - The Brain Injury Association

2 initiation The Conductor of the Brain planning self-monitoring organization Lobes of the Brain self-regulation cognitive flexibility problem-solving goal-setting Taken from Executive Function After Brain Injury Headway - The Brain Injury Association What s Your Function? Impulse Control Impulse control Emotional control Planning/prioritization Flexibility Working memory Self-monitoring Task initiation Organization Skill: The ability to stop and think before acting. Dysfunction: Student is unable to maintain focus or attention in the classroom and requires structural supports to engage in the classroom.

3 Impulse Control Strategies: Brain training Classroom response system Emotional Control Skill: The ability to manage feelings by thinking about goals. Dysfunction: Student becomes upset easily when unable to complete a classroom task and is unable to use strategies to gain emotional control. Emotional Control Planning/Prioritizing Strategies: Mood apps Self-regulation and sensory tools Skill: The ability to create steps to reach a goal and to make decisions about what to focus on. Dysfunction: Student is unaware of completed versus missing work and does not plan for upcoming assignments.

4 Planning/Prioritizing Flexibility Strategies: Complete a coursework audit School work apps Skill: The ability to change strategies or revise plans when conditions change. Dysfunction: Child is unable to tolerate change of routine at home. Flexibility Working Memory Strategies: Perspective taking Digital reminders Skill: The ability to hold information in mind and use it to complete a task. Dysfunction: Student is unable to recall information from the classroom and misses important deadlines.

5 Working Memory Strategies: Electronic pen Tracking devices Self-Monitoring Skill: The ability to monitor and evaluate your own performance. Dysfunction: Student is unable to monitor volume level in the classroom and does not maintain a sufficient amount of physical activity. Self-Monitoring Task Initiation Strategies: Classroom monitoring apps Self tracking tools Skill: The ability to recognize when it is time to get started on something and begin without procrastinating. Dysfunction: Student doesn t know how to begin a classroom assignment and is unable to find relevant research material.

6 Task Initiation Strategy: Create a positive learning environment Graphic organizers and templates QR codes Organization Skill: The ability to create and maintain systems to keep track of information or materials. Dysfunction: Student is unable to locate classroom materials and often loses completed work. Organization General EF Coping Strategies Strategies: Structured and organized classroom environment Electronic management tools

7 General EF Coping Strategies Develop strategies for planning and organization. Consider impact of mood and emotional status and provide necessary supports. Provide instruction regarding appropriate social behavior, and daily interactions. Planning and Organization Needs Allow time to plan/prepare for activities. Break tasks into manageable chunks. Mentally rehearse plans. Use checklists. Develop routines. Taken from Executive Function After Brain Injury Headway - The Brain Injury Association Emotional Needs Consider counseling options. Consult physician regarding health status. Discuss feelings/frustrations with family and friends. Plan enjoyable activities after completing required tasks. Create positive environments. Social Behavior Provide opportunities to interact with positive role models. Discuss anticipated social behaviors. Role model appropriate social skills. Use video modeling tools. Create opportunities to practice social skills.

8 Assessment Assessment Informal assessment tools: Systematic interviews - feedback from parents, teachers, caregivers Systematic observations - observations in classroom, throughout school setting, at home, in community Assessment Formal assessment tools: Behavior Rating Inventory of Executive Function (BRIEF) Continuous Performance Test (CPT) D-KEFS (Delis Kaplan Executive Function System) Test of Memory and Learning (TOMAL) Wisconsin Card Sorting Test (WCST) Academic Impact for Students

9 Academic Impact for Students Reading Unable to attend while reading Difficulty decoding words Lack of reading/language fluency Difficulty comprehending information from reading material Academic Impact for Students Writing Poor fine motor control and lack of automaticity for handwriting Difficulty formulating ideas and getting on paper Difficulty organizing written material Inability to multi-task skills such as holding, manipulating, retrieving, generating, and executing Academic Impact for Students Math Difficulty self-monitoring during calculation routines Difficulty organizing, manipulating, and retrieving information for calculations or math problems Difficulty applying learned skills and rote knowledge Unable to understand meaning in word problems. Interventions Environmental supports Task modification Compensatory strategies Direct instruction Extension activities

10 Environmental Supports Increased supervision Preferential seating/ placement Daily rules & routines Visual & verbal cues Incentive systems Task Modification Breaking tasks into pieces, with breaks. Using close-ended tasks. Building in variety and choice in tasks. Compensatory Strategies Compensatory Strategies Talk through steps of an assignment, make sure you understand expectations. Use planners/schedules and reminder checklists to provide reference point when recalling tasks. Develop rehearsal strategies for memory, such as chunking information or mnemonics. Learning cool down procedures to provide mental break.

11 Direct Instruction Identify and describe target behavior. Set a goal and procedure for reaching the goal. Observe procedure and provide feedback. Evaluate procedure and modify as necessary. Gradually fade supports. Extension Activities Thinking/educational games Play-based activities Music or art therapy Social skills groups Ongoing Supports for Executive Functioning Ongoing Supports for Executive Functioning Structure learning opportunities in day-today activities to address real life problems. Use modeling and supported practice to gain skills. Develop a mindset to implement strategies and develop structured routines. Provide opportunities to practice skills across settings.