1. Overcoming Underachievement in School: Interventions for Specific Skill Deficits Ed Link Foundation

2. Intervention for Specific Executive Skills Response inhibition - thinking before acting Kristin often blurts out answers and interrupts other children during circle time. Her teacher always remind her of the class rules to not interrupt and talk out of turn.

3. Intervention for Specific Executive Skills Response inhibition - thinking before acting Environmental Modifications: increase external controls - a child who throws should not be able to reach breakable things increase supervision - physical presence or proximity to child find ways of cuing - posting and reviewing class rules, reminders of self- control behaviors

4. Intervention for Specific Executive Skills Response inhibition - thinking before acting Teaching the Skill: 1. Explain skill being worked on - interrupting for recognition, need to raise hand. 2. Walk the child through the process by practicing. 3. Cue her right before using the skill. 4. Reinforce immediately after use of skill. 5. Ignore disinhibited response. 6. Gradually fade cuing / reinforcement.

5. Intervention for Specific Executive Skills Response inhibition - thinking before acting Kristins teacher introduced a talking stick and said that only the person holding the stick could talk. She also gave 2 chips to each child they could spend by asking questions when the speaker was done. The children would raise their hands for the teacher to call. Kristin learned to wait her turn and be conscious of spending her chips.

6. Intervention for Specific Executive Skills Working memory - ability to hold information while doing tasks Mario, 11 yrs old, would always forget the materials he needed to bring home from school, his assignments, and permission slips to be signed. His mother would have to drive him back to school to get the things he forgot. She felt this was rewarding him for forgetting, so she stopped.

7. Intervention for Specific Executive Skills Working memory - ability to hold information while doing tasks Environmental modifications: Storage devices - calendars, notebooks, electronic devices (PDAs, tape recorders,etc) Cuing devices - verbal reminders, alarms, page systems, visual cues, naturally occurring cue in the environment

8. Intervention for Specific Executive Skills Working memory - ability to hold information while doing tasks Teaching the skill: 1. Explain the problem as it shows. 2. Provide a range of options for younger children, generate options for older children. 3. Mentally rehearse association between the cue and working memory. 4. Devise a monitoring system.

9. Intervention for Specific Executive Skills Working memory - ability to hold information while doing tasks Mario, his mom and his teacher developed a list of things he may need to remember to bring home everyday. They put the list in a plastic sleeve with an erasable pen. On the last 10 minutes of the day, a school aide and Mario went through the checklist item by item. For quite some time, the aide supervised Mario. Now she just says get your checklist and he can do it.

10. Intervention for Specific Executive Skills Self-regulation of affect - the ability to manage emotions to achieve goals Recess time is always hard for Timmy. He loves to sit on the green swing but it was often being used whenever he got out to the playground. Once he got to use it, he resisted giving anyone else a turn. Timmy would get angry, shout and would lose control.

11. Intervention for Specific Executive Skills Self-regulation of affect - the ability to manage emotions to achieve goals Environmental modifications: Anticipate Teaching coping strategies Giving children scripts Break tasks to smaller steps Model practice of positive self-statements Teach child what you think = what you feel

12. Intervention for Specific Executive Skills Self-regulation of affect - the ability to manage emotions to achieve goals Environmental modifications: Anticipate Teaching coping strategies Giving children scripts Break tasks to smaller steps Model practice of positive self-statements Teach child what you think = what you feel Use literature

13. Intervention for Specific Executive Skills Self-regulation of affect - the ability to manage emotions to achieve goals Teaching the skill 1.Explain skill to the child. 2.Have child practice skill. 3.Reinforce child for practicing it well. 4.Cue the child to use skill in real life situations (classroom/home settings). 5.Reinforce the child for using the skill successfully.

14. Intervention for Specific Executive Skills Self-regulation of affect - the ability to manage emotions to achieve goals Specific strategies that can be taught: Self-statements Have the child verbalize a goal Use visual imagery Have the child incorporate practicing the skill into a routine activity (I.e. journal writing)

15. Intervention for Specific Executive Skills Self-regulation of affect - the ability to manage emotions to achieve goals Timmy learned a strategy to manage his emotions. The teachers deal with him was that he could swing the 1st 5 min of recess time and then, if he gave up the swing to another child w/o a fight, he would be given the last 3 min to swing again. She taught Timmy to say to himself, If I dont get mad, I can swing again. as he got off the swing. In time, he learned to wait his turn as well.

16. Intervention for Specific Executive Skills Sustained attention - capacity to maintain attention in spite of distractibility Sarah, a 4th grader has the hardest time getting her seatwork done. When the teacher assigns a task, she starts it right away but quickly gets distracted. She stands up to sharpen her pencil, go to the bathroom, talk to to her classmates. She may overhear a conversation and join in. Her teacher tried keeping her from recess to finish her work. Her parents objected to this solution.

17. Intervention for Specific Executive Skills Sustained attention - capacity to maintain attention in spite of distractibility Environmental modifications Using incentive systems Breaking tasks into subtasks - with breaks Setting a timer Using a self monitoring tape Providing supervision Making tasks interesting Praise and attention

18. Intervention for Specific Executive Skills Sustained attention - capacity to maintain attention in spite of distractibility Teaching the skill 1.Help then become aware of their attention levels and capacities. 2.Teach how to break tasks down. 3.Help them make a work plan - active reading (highlighting, note taking); creating a script; using timers, etc. 4.Cuing to follow plan 5.Reinforcing and transferring responsibility

19. Intervention for Specific Executive Skills Sustained attention - capacity to maintain attention in spite of distractibility Sarah worked with her mom and teacher to identify what distracted her. She used a self- monitoring tape and a checklist to keep her focused on her work. Her mom added the incentive of watching her favorite TV show when her work was done. Gradually the checklist and tapes were removed. Sarah improved her work production through better attention.

20. Intervention for Specific Executive Skills Task initiation - ability to begin working Lisa had a very hard time starting her homework after dinner (the time set by her mom as study time). After several late nights and constant arguing, her mom decided it was time to teach this as a skill.

21. Intervention for Specific Executive Skills Task initiation - ability to begin working Environmental modifications: Verbally cuing to get her started Arrange visual cues Walking her through the first portion Ask her to specify how she can be cued - alarm clock, immediately after dinner

22. Intervention for Specific Executive Skills Task initiation - ability to begin working Teaching the Skill 1.Have her make a written plan. 2.Ask her to determine what cue will be used to remind her to begin the task. 3.At the point she is supposed to begin, make sure she does so promptly. 4.Gradually fade supervision.

23. Intervention for Specific Executive Skills Task initiation - ability to begin working Lisa and her mother sat down and make a homework plan. She listed what her assignments were and when she would start each one. When it was time to start her homework, her mom would pull out the planner and asked Lisa to look at it. After her mom made sure she got off on a good start, she would leave Lisa alone to finish.

24. Intervention for Specific Executive Skills Planning - the ability to create a roadmap to reach a goal Tom, an 8th grader,had a bad habit of leaving projects until the last minute and then having no idea what he had to do to complete the assignment. This created a great deal of tension at home and experienced meltdowns as deadlines approached.

25. Intervention for Specific Executive Skills Planning - the ability to create a roadmap to reach a goal Environmental modifications: Have an adult provide a plan or schedule Use scoring rubrics when giving work Break long-term projects to assigned subtasks and attach deadlines to each Create a template

26. Intervention for Specific Executive Skills Planning - the ability to create a roadmap to reach a goal Teaching the Skill 1.Walk him through the planning process many times. 2.Gradually turn over the process by asking questions that will help them make a plan. 3.Use analogy (roadmap - plan; destination - goal)

27. Intervention for Specific Executive Skills Planning - the ability to create a roadmap to reach a goal Toms mom arranged with the school to be notified when long-term assignments were given. Together, she and Tom drew up a plan for each assignment. They would brainstorm and identify all matls needed. Then they wrote down deadlines on a calendar that he could check each day.

28. Intervention for Specific Executive Skills Organization - the ability to arrange things according to a system Joan, a 9th grader, was forever losing worksheets and assignments. She tended to write slowly and at the end of class, was still taking down notes, rushing to write down assignments and gathering her things. As a result, she tended to stuff papers into her notebooks or folded them into her books w/o paying attention where.

29. Intervention for Specific Executive Skills Organization - the ability to arrange things according to a system Environmental Modifications Provide schemes: room cleaning, backpacks with pockets and separators, color coded systems for school papers, desk organization Supervise, reinforce, gradually fade prompts

30. Intervention for Specific Executive Skills Organization - the ability to arrange things according to a system Teaching the Skill 1.Provide a checklist/template and help them over learn these schemes. 2.Cue, reinforce, practice, fade prompts. 3.Once she has internalized a scheme, help her generalize how to organize other areas of her life.

31. Intervention for Specific Executive Skills Organization - the ability to arrange things according to a system Joan now has a system involving two brightly colored folders to put assignments and finished work to be submitted in. She has learned to make it a habit to put papers in the right place and automatically check if she has to submit anything or if she has written down the homework.

32. Intervention for Specific Executive Skills Time management - estimate, allocate and execute time constraints. Fred, an 11th grader, was constantly getting work done at the last minute or asking teachers to give him an extension for the due dates. He perfected the art of believable excuses. However, his teachers were losing patience with him.

33. Intervention for Specific Executive Skills Time management - estimate, allocate and execute time constraints. Environmental modifications: Provide a schedule to follow and prompt them at each step of the way Impose time limits and provide reminders for how much time is left Use cuing devices: clocks, bells or alarms

34. Intervention for Specific Executive Skills Time management - estimate, allocate and execute time constraints. Teaching the Skill 1.Help him understand what the task involves - steps, how long it will take to do each step. 2. Make him create a plan to accomplish a task and guess how long each step will take. 3.Compare estimates with actual time required, discuss factors that affected mismatch.

35. Intervention for Specific Executive Skills Time management - estimate, allocate and execute time constraints. Fred learned by comparing his estimated time of completion to the actual time it took for him to finish his tasks that he was off an average of 25%. With this knowledge he can now make more accurate estimates.

36. Intervention for Specific Executive Skills Metacognition - ability to take a birds eye view of oneself in a situation. Joe, in 2nd grade, often failed to note the operation that he was supposed to perform in math. He would add when he needed to subtract. Sam, in 5th grade, would stop after the 1st step of a multistep math problem and give that as the answer.

37. Intervention for Specific Executive Skills Metacognition - ability to take a birds eye view of oneself in a situation. Environmental Modifications: Embedding questions that elicit metacognition (how did you solve that?) Build error monitoring into tasks (showing that they have checked math computations) Encourage children to evaluate themselves - give themselves a grade Use scoring rubrics to show expected quality of work

38. Intervention for Specific Executive Skills Metacognition - ability to take a birds eye view of oneself in a situation. Teaching the Skill 1.Develop error-monitoring checklists. 2.Teach child a set of questions to self ask when confronted with a problem (what is my problem?, what is my solution?, am I following my plan?, how did I do?) 3.Tailor sets of question to specific problem situations (personal space) 4.Define, steps, practice, cue, reinforce, fade

39. Intervention for Specific Executive Skills Metacognition - ability to take a birds eye view of oneself in a situation. Joes teacher taught him to say to himself before he began answering math problems Am I adding or subtracting? With practice, he made fewer mistakes. Sams therapist taught him to write down a notation after reading each step of a multi-operational math problem as a reminder. As he completes each step, he crosses out the notation.

40. References Dawson P. and Guare R., (2004) Executive Skills in Children and Adolescents, A Practical Guide to Assessment and Intervention, The Guilford Press, New York, NY