1. Executive Functioning Stephanie Nelson, Ph.D., ABPdN, ABPP Pediatric Neuropsychologist Child Development Network Lexington, MA (781) 861-6655, www.cdnkids.com

2. How Students Succeed Self-Regulation Organization “Motivated” & “Resourceful” Family/Friends Community “Connected” & “valued” People Smarts Character “Resilient” & “compassionate” Book Smarts Quality Education “Curious” & “Able to learn” IQEQ EF You

3. What Is Executive Functioning?

4. One Name, Many Functions InitiationAttentionOrganization Working Memory InhibitionFluency Time Management Multitasking Self- Monitoring Cognitive Flexibility Emotional Control Perseverance

5. Testing Executive Function Instructions: Start with the center number (7). Follow the lines to collect 4 additional numbers, adding all 5 numbers together Goal: Lowest total possible Requires: Attention, Motivation/perseverance Working memory Processing speed Cognitive flexibility Self-monitoring Emotional control

6. Basic Neuroanatomy: A User’s Guide to the Brain

7. Where Are EFs Located?  Prefrontal Cortex  Last Part of the Brain to Fully Develop  Continues Developing into early/mid 20s  Fragile to Disruption

8. Prefrontal Lobe Connects to Brain Regions that Control:  Habits  Timing  Arousal/Awareness  Emotions  Memory  Language  Motor Planning  Eye Movements

9. How Do EFs Develop?  “He gets there, but in his own, unique way”  “She did it yesterday, why can’t she do it today?”  “Why can you remember your iPod, but not your school books?”

10. A Period of “Refinement”  Scientists talk about the “development” of the prefrontal cortex  However, these regions are not growing, they are refining

11. A Period of “Refinement” Cue1233 Goal 41  Some pathways are dead ends  Some pathways are inefficient  Pathways that work are strengthened during maturation

12.  Age 5: Lots of potential brain connections. Potential is unlimited, but pathways are inefficient.  Ages 5-20: Pathways that are used regularly are becoming strengthened. Pathways that are not used are pruned away.  Age 20: Brain pathways are more compact, more efficient.

13. How EFs Develop IdealWhat We Expect

14. How EFs really Develop Ideal What Actually Happens

15. Roles and Responsibilities Age/Time EarlyIncreasing AgeTeen??Adult Parent/Family Provides CareManagesSupervisorConsultant Child Receives careParticipatesManagesSupervisor/CEO

16. EF Resources Pros: Tons of specific suggestions Great overview of EF What is “Normal”? Caveats: Too Much Too Time-Consuming Not Teen’s Idea What if I have EF weaknesses too?

17. Start With A Healthy Foundation  Sleep  Exercise  Nutrition  Stress Management A House Built On Sand…

18. Game Plan: Shine A Spotlight  Spotlight the neuronal connections you want to develop  Brains learn what you teach them

19. Spotlighting: 5 Key Techniques  Start with Strengths  Make It Manageable  Make It Personal  Build a Scaffold  Take Advantage of Habits and Routines

20. Start With Strengths Unrealized Strengths Perform Well Energizing Maximize Use Realized Strengths Perform Well Energizing Marshal Use Weaknesses Perform Poorly De-energizing Minimize Use Learned Behaviors Perform Well De-energizing Moderate Use

21. Make It Personal  Invite her into the problem-solving process  Adolescence involves intensive levels of self- awareness  How does this relate to my life and interests?

22. Make It Manageable  Pick one thing  Be a scientist “I Can Do Anything, But Not Everything.” – David Allen

23. Allocation of Precious Resources How Adult Brains Respond to Stress How Teen Brains Respond to Stress

24. Be A Scientist Scientific Question: What is the Problem? Hypothesis: What causes it? Possible Solutions? Pros and Cons of Each Solution The Experiment: Try it!!! The Scientific Report: Did it work? My teen complains that I nag her about studying for upcoming exams, but she is not studying!!! Stop reminding Nonverbal reminding Remind more! Stop Reminding + No nagging! - Studying not done Nonverbal Reminding + Quiet - Don’t know if it will work Remind More! + Studying gets done - More shouting Nonverbal Cues Calendar Reminder (by text message) if teen fails to check off that day on the calendar Had to remind teen only 1 day out of 7 Got B on test

25. Scaffolds and Safety Nets  Start where he’s at  Create a recipe  Expect “Extinction Bursts”

26. Start Where He’s At  Zone of “Proximal Development”

27. Creating the Recipe

28. “Extinction Bursts” Frequency of Unwanted Behavior

29. Habits and Routines Reminder Trigger or Cue That Starts the Habit Routine The Behavior You Do Reward Consequence. If the Reward Is Positive, More Likely to Do the Routine Again Next Time The Reminder Pops Up The 3 R’s of Habit Formation

30. Planner Resources: www.cognitiveconnections.com www.cognitiveconnections.com http://premier.us/tools- planning/products-students

31. Think Forwards, Plan Backwards  Visualize the Goal  What Does It Look Like Right Before the Goal is Met?  What About Right Before That?  Repeat Until All Steps Between Beginning and End are in Place

32. Spotlighting: Review  Start with Strengths  Make It Manageable  Make It Personal  Build a Scaffold  Take Advantage of Habits and Routines

33. Slide 2 Notes and Resources Slides 4 - 14 Slide 29 Slide 17 Slide 20 Slide 23 Slides 4 - 14

34. Executive Functions Defined  Initiation  Getting started on a task  Avoiding procrastination  Initiating social interactions and asking for help  Organization  Planning how to work through tasks most effectively  Breaking complex tasks down into steps  Organizing materials, keeping a room clean, finding objects  Attention  Sustained Attention: Concentrating over time  Selective Attention: Focusing on the right thing (and ignoring distractions!)  Working Memory  Keeping information in mind while using that information  Following multistep directions; remembering a phone number  Inhibition  Thinking before acting and considering all options before choosing  Regulating activity level as needed; not invading personal space or interrupting  Fluency  Coming up with ideas over time  Coming up with a new idea if the first idea does not work

35. Executive Functions Defined  Time Management  Estimating how long a project will take  Balancing speed with accuracy  Multitasking  Switching between two approaches to complete a task  Considering two ideas at once  Getting back on track after an interruption  Self-Monitoring  Noticing errors and going back to correct them  Self-awareness and self-regulation (“Am I paying attention?” “Do I need to do more on this project?”)  Cognitive Flexibility  Adapting to new information or new situations  Transitioning between activities or ideas  Changing one’s mind and accepting “no”  Emotional Control  Getting “just the right amount” upset over frustrations and setbacks  Using “self talk” to calm down or reframe a situation  Perseverance  Sticking with a task as long as it takes  Effectively managing frustration, boredom, fatigue