Tuesday, May 15, 2012

Executive Function part II: Sarah Ward

On May 14th I attended a workshop on executive function skills presented by Sarah Ward. Sarah is a dynamic fast talking speaker whose years of experience pepper stories throughout the workshop. She has loads of good strategies to use for kids at every age. Her website http://cognitiveconnectionstherapy.com/ details much of her work. While she personally specializes in Traumatic Brain Injuries (TBI) and their impact on executive function, she has worked directly with and consulted with students on the autism spectrum, ADHD and LD.

Students with executive function difficulties often have trouble with transitions, self regulation, organization and integration of information and higher order reasoning. To deal with these issues, Sarah proposed two overarching goals: focus on features and teach "the same but different." Focus on features means to change our perspective from the detail we are talking about to the 50,000 ft level. It is not, "Fall is during September, October and November." It is, "Seasons are during specific months." The charts below show some examples of how to indicate things are the same but different. Their features are the same but their details are different. If we teach features, it increases memory and processing speed.


Baby shower
Pink and blue balloons
Balloons, streamers
Games or activities
Guess the baby’s birth weight
Musical chairs, magician, piƱata, presents
Cake, finger sandwiches
Birthday cake, pizza
Take away
Treat bag


100 Years War
Civil War
England and France both want Normandy
State rights v federal rights
England v. France
North v. South
Major events
Joan of Arc
Introduction of the long bow
Petition of Right

Attack on Fort Sumter
Battle of Gettysburg
Gettysburg Address
Emancipation Proclamation
Surrender at Appomattox
Assassination of Lincoln
France wins control of Normandy and its monarchy becomes stronger
England’s monarchy moves toward more democracy
South must be reintroduced to nation
100’s of thousands dead
Radical reconstruction

Although there were many wonderful strategies presented, the three big take aways I gathered were STOP, visualize the end and time management.


This strategy helps with:
self regulation- provides awareness of the space, people and activities; helps initiate action and understand emotions
organization- facilitates transitions with understanding and developing plans for what to do and how it needs to be done; helps with understanding time; and facilitates memory because information must be organized to be encoded
higher order reasoning- facilitates drawing conclusions, solving problems, prediction and evaluation

This strategy is for evaluating a room, developing room awareness. It can be a real room, a location like a sports field or a literary place from a story.

Space- Where is it? What is in it? Look at it. I think setting
Time- What time is it now and what is next? How long will this activity take? What is its pace? What is the typical sequence of events?
Objects- What materials are here and what need to be gathered?
People- Who is around and who do I need? What do I know about these people?

For example, if I arrive at school, the place is school. The time is morning, I need to go to my locker put things away, get things out and go to my first class/homeroom- math. I have about 10 minutes. My backpack, homework, books, coat, lockers, etc. are around. I need to have my math homework, book, notebook, calculator and a pencil. Kids are moving about, teachers are supervising, Mrs. Smith, my math teacher, is standing at her door, across from my locker, shaking her head as things fall out on the floor.

This strategy can be used to help kids transition from one activity to the next, identify awareness of the present and future activities, and help build a script of the activity to reduce anxiety and promote a plan.


This strategy helps with:
self-regulation- if we know where we are going, we can be prepared which helps self regulate;
organization- If we can identify what it should look like, we can better evaluate if we are there yet and then label the get ready and doing it steps.
higher-order reasoning- We need to draw conclusions, predict outcomes and evaluate both the process and the product

She spoke of multiple ways to incorporate and use this idea. Teaching Before --> Now --> Next in conjunction with STOP involves identifying what is going on now and what comes next. Then the what needs to come before can kick in. Using nonverbal methods to start with this pattern is essential. If kids can visualize what the final project will look like, they can then assess how they did. This can be used to break big tasks into manageable chunks and encourage both initiation and competition of tasks.

A person can taking sequencing a step further by integrating time awareness and management. Identifying the before, now and next (end) helps with expanding thoughts in both conversation and writing.

When students receive a long term assignment with multiple parts visualize the ends can help with breaking a task down so that it is not completely overwhelming.

Task to show the example:
Is the narrator insane or not insane? Reread the Tell Tale Heart’s killer’s confession and try to find evidence that you could use to prove that the murderer is or is not insane. Be as specific as possible. Write a full paragraph (4-5 full sentences) for each piece of evidence. In each paragraph, use a quote from the story (the murderer’s own words) to prove your point. Put the quote in quotation marks – “” – and then put the page number in parentheses -(): the period at the end of the sentence comes after the parentheses.

 This is intimidating to the student. If you create a visual representation it becomes easier to think about.

 Students can learn to sketch these visuals themselves from the task. Then check the rubric or question itself to see if it needs to be modified.


This strategy helps with:
self-regulation- identify our needs and respond to them- foods, sleep, etc...; sustain attention; awareness, initiation
organization- see the big picture and the key features; identify relevant and irrelevant issues; utilize the familiar to predict the novel; facilitates memory because information must be organized to be encoded
higher-order reasoning- We need to analyze our activities and day to determine what we need to spend time on and how much time is needed; Solve problems- all problem involve time on some level; Predict the outcome and handle unexpected outcomes reason and evaluate the progress

Running throughout the presentation was the concept of time. Sarah focused on the idea that children do not understand time, the passage of time, how long it takes to do something, and what time is available. This is exasperated by the prevalence of digital clocks. Showing the passage of time is easiest accomplished with a analog clock. She even recommends a working clock at eye level with the students. It can be written on (glass face- dry erase marker; plastic face- Vis a Vis marker) and colored to represent start time and end time. Students can be prompted to identify the midpoint of the time and the midpoint of the activity to allow for a self assessment of progress.  They can be shown the time it takes to do something by drawing on the clock face. A piece of this concept was identifying time robbers. We all have them: sharpening the pencil, chatting with a friend, lost materials,... The idea is to plan an organize materials time, follow it with a doing stage, and ending with it is done. In order to get to the end, you need to visualize what the end looks like and then start working toward it.

While planners have their place, students with executive function disorder often need more than a list of what needs to be done. Literally scheduling every day with the "normal" activities. Then every day, week, whatever interval is appropriate, the schedule can be looked at, modified to address the needs of day- assembly, appointment, long term assignment work,... These items need to blocked out on an time based schedule. Identify the free time for chill out activities, the set in stone must dos, the flexible homework times,... and teach the student to try and do it on his own.

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