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PALS October 2017 - Executive Functioning


PALS Meeting Minutes

October 25, 2017 9:15 a.m.

Eat'n Park (meeting room)

849 Freeport Road Pittsburgh, PA 15238

If you are unfamiliar with the term Executive Function(ing) it is a skill set we use to achieve goals, by managing our time, self-monitoring, making plans, exerting self-control, remembering things, being flexible, focusing, and controlling impulses to name a few. When we think of Executive Functions in our children we are thinking about things like remembering to bring home and return homework and textbooks, completing classwork and projects on time, organizing work on a page, staying focused on the lesson at hand, etc.

We took a closer look at Executive Functions and Self-Regulations (EF and SR) using research compiled by the Center on the Developing Child at Harvard University (CDCHU).

CDCHU used the example of an air traffic control system and the management of aircraft in the air and on multiple runways to illustrate the job of the human brain when it comes to EF and SR. Where EF and SR "skills are the mental processes that enable us to plan, focus attention, remember instructions, and juggle multiple tasks successfully", "the brain needs this skill set to filter distractions, prioritize tasks, set and achieve goals, and control impulses."

EF and SR are dependent on "three types of brain function that operate in coordination with each other":

Working memory: "governs our ability to retain and manipulate distinct pieces of information over short periods of time."

Mental flexibility: "helps us to sustain or shift attention in response to different demands or to apply different rules in different settings."

Self control: "enables us to set priorities and resist impulsive actions or responses."

"Establishing routines, modeling social behavior, and creating and maintaining supportive, reliable relationships", are paramount in facilitating a child's EF and SR skills. The CDCHU concludes that it is "important for children to exercise their developing skills through activities like creative play and social connection, teach them how to cope with stress, involve vigorous exercise, and over time, provide opportunities for directing their own actions."

Click here for the full document including an introductory video and other links.

Executive Function & Self-Regulation Key Concepts

Next, CDCHU provides the document Enhancing and Practicing Executive Function Skills with Children from Infancy to Adolescence giving examples of the activities that researchers found supported the development of EF and SR skill sets through the various stages of youth. Click on the age for more specific information on supportive activities for that group while also considering where you're child's individual skill set currently falls.

6- to 18-month-olds: during this stage the core of EF and SR skills are activity developing. Games like Peekaboo, Pat-a-Cake, hiding games, mimicking games, simple role play like picking up toys, finger play like Itsy Bitsy Spider, and simply talking help focus attention, use working memory, and practicing basic self-control skills.

18- to 36-month-olds: during this stage language skills are growing quickly. Active games like Follow the Leader, Freeze Dance, Musical Chairs, Ring Around the Rosie, song games like The Hokey Pokey, storytelling, matching and sorting games, and imaginary play all stimulate working memory, attention, and inhibitory control.

3- to 5-year-olds: during this stage EF and SR skills are growing rapidly. Imaginary play, role play, storytelling, group storytelling, movement challenges like yoga, sing songs that have a repetitive chorus while adding to earlier sections like She'll Be Coming 'Round the Mountain, matching and sorting games like Bingo help promote cognitive flexibility, holding and manipulating information in working memory, and inhibiting impulses.

5- to 7-year-olds: during this stage children begin enjoying games with rules, those that are challenging without being too difficult. Working memory, self-regulation, attention and inhibition, strategizing, and cognitive flexibility are expanded through card and board games like Uno, Go Fish, Sorry!, Battleship, physical games like Red Light, Green Light and Duck Duck Goose, movement and song games like Boom Chicka Boom, and quiet activities like puzzles and I Spy books.

7- to 12-year-oldsduring this stage it is important to steadily increase the complexity of games and activities: . Promote mental flexibility, challenge attention and decision-making, test cognitive flexibility, practice focusing, and increase self-awareness and monitoring by playing games like Hearts, Spades, and Rummy, Chess, Minecraft, Dungeons & Dragons, play physical games like jumping rope, Double Dutch, sports like soccer, singing in groups, introducing instruments and dance, brain teasers like crossword puzzles and Rubik's Cube.

Adolescents: during this stage, teenagers' EF and SR skills are often expected to be at adult levels although they have not yet developed that far. Practicing EF and SR skills throughout daily challenges will help in their continued development. Assist adolescents in identifying specific things they want to accomplish, help them develop a plan to reach the goals, volunteering, remind them to self-monitor relating it back to their goal. Self-talk is an excellent tool for self-monitoring, writing a personal journal, monitor the motivations of others, and learning to be mindful of interruptions are important during this time. Activities like sports, yoga and meditation, playing a musical instrument, singing, dancing, acting, computer games, and strategy and logical games and puzzles all assist a teenager in increasing their ability to make quick decisions, respond flexibility, sustain attention, reduce stress, promote reflective decision-mailing and behavior, cognitive flexibility, inhibition, working memory, and selective attention, planning, and monitoring of the environment, and fast reaction times. The CDCHU also looked at Study Skills during this stage since teenagers are expected to be increasingly independent and organized. These expectations can be overwhelming to an adolescent lacking EF and SR skill sets.

Finally, we recapped our conversation with the In Brief Executive Function: Skills for Life and Learning document. Here the CDCHU concluded three important factors in EF and SR learning:

1. When children have had opportunities to develop EF and SR skills successfully, both individuals and society experience lifelong benefits.

2. The critical factors in developing a strong foundation for these essential skills are children's relationships, the activities they have opportunities to engage in, and the places in which they live, learn, and play.

3. If children do not get what they need from their relationships with adults and the conditions in their environments - or (worse) if those influences are sources of toxic stress - their skill development can be seriously delayed or impaired.

Additional Information on EF/SR Not Addressed During the Meeting

Are you interested in learning more about the science behind this research? In collaboration with Frontiers of Innovation, Washington State Department of Early Learning developed a free 90 minute training module.

Executive Function

Now that we know how all caregivers can assist children in developing EF and SR skills, how do we address them within our child's IEP or 504 Plan? With RtII (Response to Instruction and Intervention), getting goals actually set in an IEP or 504 Plan seems illusive to many. We have found a great resource to help kickstart your conversation with your child's school based IEP team members. A Day in Our Shoes posted an article in April of 2016 addressing just this.

In the article Measurable IEP Goals that Address Executive Functioning you will find information to assist you in considering the need for these goals, addressing your concerns with your child's school based IEP Team members, gathering baseline data, and setting goals. The writer has provided questions for both parents and teachers to start the conversation. Goal ideas are separated into six categories, provided here with one example each (access all examples by clicking the link above);

Self-Awareness/Self Advocacy like; Given a specific routine for monitoring task success, such as Goal-Plan-Do-Check, student will accurately identify tasks that are easy/difficult for him.

Organizing like; Given support and visual cues, student will create a system for organizing personal items in his locker/desk/notebook.

Self-Monitoring/Self-Evaluation like; Student will self-edit his work to correct spelling, punctuation, capitalization and grammar on all typical classroom assignments in all settings to eliminate all errors from his work.

Problem Solving like; When faced with changes and/or transitions in activities or environments, student will initiate the new activity after {decreasing number of supports}.

Personal Goal Setting/Self-Correction and Improvement like; Having failed to achieve a predicted grade on a test, student will create a plan for improving performance for the next test.

Keeping Track of Time/Planning/TimeManagement like; Student will learn (after helping to develop) a self regulatory plan for carrying out any multiple step task (completing homework, writing an essay, doing a project) and given practice, visual cues and fading adult supports, will apply the plan independently to new situations.

Open Forum

Parent Ideas on Addressing EF and SR at School

Have your child write down one simple sentence describing what took place in each class that day along with any homework assignments. The teacher should sign-off. Make a graphic organizer including each class and a box for both the child and teacher to acknowledge they have review it. This can be included in your child's SDIs in their IEP.

While working toward achieving the goal of remember to bring home all homework items, ask for an extra set of textbooks to keep at home to eliminate the frustration and stress caused when your child forgets them at school.

Insurance Coverage Concerns

Before traveling or sending your child off to college, double check with your insurance provider on coverage out of the area and state. Although UPMC indicates they have a nationwide "network" of providers, some choosing UPMC under their MA coverage have found otherwise. In this family's particular case it created problems filling time sensitive prescriptions, causing the family to fill the prescription here and paying to overnight it to their child attending college out of state. This of course also creates concern for families traveling out of state whose only option will be to seek medical assistance at an emergency room.

Next Meeting: November 29, 2017, 9:15 a.m. Market District Café: Atrium 910 Freeport Road, Pittsburgh, PA 15238

Topic: RtII: Response to Instruction and Intervention

#504 #diagnosis #Pittsburgh #employability #employmentskill #IEPServices #Training #MedicalAssistance #Funding #LearningDisability #SpecialEduation #EducationalFunding #SpecialEducation #PAHealthLawProject #PEALCenter #SocialSecurityInsurance #Medicaid #ExecutiveFunction #SelfRegulation #SelfAwareness #HarvardUniversity #CenterontheDevelopingChild #OrganizationalSkills #TimeManagement #workingmemory #mentalflexibility #selfcontrol #focusattention #inhibition #RTII #ResponsetoInstructionandIntervention

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