Wednesday, June 21, 2017

FLIPP the Switch and SOARR

In my quest to further develop my understanding of Executive Function (EF) disorders, I picked up FLIPP the Switch: Strengthen Executive Function Skills by Sheri Wilkins and Carol Burmeister. My pervious posting was about an EF workbook for teens. Its target audience is higher functioning teen agers who can use it with little support. This book targets people with more significant challenges. Strategies include strong visual components that would be especially useful for people with ASD. They acknowledge that many people with disorders classified under the DSM and some physical medical concerns often show weaknesses in some EF skills, such as ADHD, ASD, TBI, Intellectual Disorders, SLD, and OCD. Critically, it is important that there is a range of EF skills and although there may be patterns of strength and weakness profiles, no two people have exactly the same skill set. Furthermore it is important to recognize that just because someone is weak in a skill area, it does not mean they cannot improve it or learn to effectively deal with it.

Wilkins and Burmeister group EF disorders in five categories: flexibility, leveled emotionality, impulse control, planning and problem solving. As Sarah Ward said years ago- it is not important how many categories you use, but how you address the problems.

One strategy from the Flexibility chapter that I found particularly interesting is called SOARR. Since I cannot find reference to it on Google, I believe they created it. Although they do not reference the work of Michelle Garcia Winner in this section, it pairs nicely with her social thinking framework. It also plays well with Sarah Ward's  STOP strategy:
  • Space – Where am I?
  • Time – What is happening now? Later?
  • Objects – How is the room organized?
  • People – What are the facial expressions/body language of the people?
There is a large recognition in all these approaches that expected social behaviors shift according to context. Without clearly understanding context, we cannot help people develop approaches to social success.

The text provides four concrete examples of the strategy for young people to use the strategy with vignettes describing the situation that led to the need for the strategy and a simple outcome of implementation of the strategy use. Below I have included a very slightly modified example of their template and a version of how I might have used it for my son's recent flight to visit relatives on the other coast. The book has the template in a landscape orientation that would probably work better because of the possible increase in writing space.

Specify
Observe
Analyze
Respond
Reflect
What is the situation/ specific context?
Example:
Ordering food and eating in a restaurant- what kind of restaurant
Participating in PE class
Attending a worship service
Joining a group in a general education class
What are other people doing in this situation?
How are they behaving?
What do I need to do to fit into this context?
What questions do I need to ask and answer in my head?
Example:
What is the noise level/volume?
Does the discussion/tone/mood seem fun or serious?
Is there a leader?
What is my role in this group and where do I fit in?
If I am unsure about something is there somebody I can approach with questions?
Based on my analysis, respond appropriately,
As I am responding, pay attention to how others are responding to me.
What happened?
What did I learn?
What can I do differently next time?

Blank SOARR template from Wilkins, S. and Burmeister, C. (2015) FLIPP the Switch: Strengthen Executive Function Skills, p. 49

Specify
Observe
Analyze
Respond
Reflect
What is the situation/ specific context?

What are other people doing in this situation?
How are they behaving?
What do I need to do to fit into this context?
What questions do I need to ask and answer in my head?

Based on my analysis, respond appropriately,
As I am responding, pay attention to how others are responding to me.
What happened?
What did I learn?
What can I do differently next time?
In line at the airport to go through security
People are standing in line, keeping their hands to themselves. Some are in groups that are a little closer together, but most groups are not talking to each other. People are using a quiet voice. When asked a question or given a direction by a uniformed person, people do what is asked of them.
People are waiting. I need to wait to move with the line. I should not talk to people I do not know unless they ask me a question. I need to use a quiet voice. If I need help there are people in uniforms I can ask questions.
Some people do not move along in their line as quickly as they can, but I keep my comments about that to myself. I wait patiently for my turn at the various spots before moving on through the terminal.
It was hard to wait patiently because not everyone moved as fast as I wanted them to. I need to have my paperwork and ID in an easy to access location so I do not hold up the line.




I think working within this framework, young people could learn to address social issues, but training in reflection, problem solving and forecasting human behavior would be an important part of an intervention. This book has me eager to read to learn more concrete strategies for helping young people learn to deal with their weaknesses in EF.

Monday, June 19, 2017

executive functioning workbook for teens

Sharon A. Hansen penned a wonderful book for teenagers with executive function weaknesses, The Executive Functioning Workbook for Teens. Although this book will not provide all the tools, especially the motivation, to work on improving weak skills, it is a beginning.

The book opens with a letter to teens, inviting them improve their lives by learning skills they are not strong in. It is a welcoming, non-confrontational start. Then it moves to a brief checklist. As opposed to many other checklists I have seen and used it is brief. This one has four statements in each of 10 areas and youth are asked to circle the ones that describe them, such as I need to have directions repeated and I blurt out answers in class without being called on by the teacher. Then they can target the areas in which they circled 2 or more descriptors. If you were doing this with kids, I can see where it would take some degree of trust  to get accurate responses from them. Following the self-assessment are three activities per area to focus on. Each area of focus begins with a short vignette. These would be useful for getting buy in, a critical component for change. The exercises always begin with examining something not personal to the student- think about the story at the beginning, what might be some people's responses to these things. Then they move to the personal- what about in your life.

One thing that I think the book does not do well is demonstrate how long it can take to learn new skills and make a change. Although the beginning has a line about it takes 28 days to make a habit with a new skill, and for kids with a challenge in an area, it can take three times as long (p. x), it does not revisit that idea. One thing many people with executive function issues have is a lack of persistence. Developing ways to sustain the effort for three months or more is a daunting task and will require reinforcement and reminders. It showcases why even teachers who do a good job with initially teaching and reinforcing executive function skills have students that don't learn the skills- they are not reinforced long enough.

This book is going to be a useful tool to use with students, but the time component is one that I will need to keep in mind.

Sunday, June 18, 2017

70 Play activities

Both in parenting and teaching we do many roles. We do what is right for our kids regardless of what the official job title of the "responsible" party may be. I have worked with parents who clean out trachea tubes before making dinner and teachers who stretch their students to stand. These jobs belong to a nurse or PT respectively, but we do them because we care.  Lynne Kenney and Rebecca Comizio wrote 70 Play Activities for Better Thinking, Self-Regulation, Learning & Behavior integrating the role of the OT who is focusing on sensory processing with those of the psychologist. While I picked this book up after an EdWeb after watching a webinar to see what I might be able to use to reinforce and teach executive function skills, I see that her integrative approach can be used to do that and more. Although it seems that many of her strategies really focus on elementary students, adaptations, which she encourages, could lend them a broader appeal.

A key component of her approach seems to be that movement and play can both teach and prime the brain. For example, she looks at using ball bouncing to reach self-regulation and control. While the activities can be used to alert or calm a student, with the proper preface, they can showcase how self control feels and demonstrate how it helps with completion of a task. The last section of the book talks about how movement can be used to reinforce math. We now have studies that say gesticulating during math learning and explanation increases math performance. It stores information in more places in the brain helping students develop both better encoding and recall. If we start bouncing from me to you and back again, we then add the cognitive piece of reciting math facts. For example skip count or multiplication facts can be mirror counted, alternate counted, chorally counted or only student counted.

One activity I liked from the webinar that is discussed in the section on musically rhythm goes like this. Practice a rhythmic skill that the student can do to automaticity- like marching, or clap-tapping- then add counting. One, two, three, four, one, two, three, four, ... Then ever fourth cycle add a piece of cognitive recall such as identify the type of quadrilateral, continent, chemical element, phonetic sound of a letter, math fact or color I show on a piece of paper.

One, two, three, four, one, two, three, four, one, two, three, four, one, two, three, trapezoid.
One, two, three, four, one, two, three, four, one, two, three, four, one, two, three, Africa.
One, two, three, four, one, two, three, four, one, two, three, four, one, two, three, carbon.
One, two, three, four, one, two, three, four, one, two, three, four, one, two, three, A- apple- /a/.
One, two, three, four, one, two, three, four, one, two, three, four, one, two, three, 12/4=3.
One, two, three, four, one, two, three, four, one, two, three, four, one, two, three, green.


This could also work with chanting to a beat, whether it be marched, clapped, jumped, or some other combination thereof. You could even have the definition projected on a whiteboard. This sort of practice is highly associated with recall. If you involve more of the brain, more dendrites fire and students are more likely to encode it and then recall it.

The book intersperses brief theory and explanation with pages of activities. As I mentioned, most of the activities would need some modification for older kids. Her thought is to encourage older kids to play the coach or person who will help others learn. Although she talks about the neuroscience of learning, it is on a very light scale. This book is highly readable, but if you want to teach kids the neuroscience behind the idea, you will need to do more research. She does talk about specifically labeling the executive function you are trying to develop and showing how the activity helps do it. This piece of metacognition is important in helping kids understand the science behind it working. Altogether an interesting book working on using sensory processing, physical movement and cognition to improve skills in children.

Thursday, June 15, 2017

The Smartest kids in the world

Amanda Ripley went on a year search to try and identify what makes international students perform so well in school and describes her search in her book, The Smartest Kids in the World and How they Got That Way. She identified three American foreign exchange students and one American who spent years in Korea going to countries with high math PISA (Program for International Student Assessment) scores: Poland, Finland and Korea. Math was selected because a) American students perform relatively poorly on international math tests and b) math is a better predictor of future economic success than other subject areas. The importance of this is emphasized by the fact that Americans are second only to Luxemburg in education spending (p. 24). We are not getting the bang for our buck. 

She performed extensive interviews, visited schools and conducted a survey to gather data for the book. Throughout the text she traces key moments of the experience for each student and then wraps up in an appendix with her summation.

What were the differences? First there was a high expectation that education was the key to adult success. In the foreign countries, technical jobs were highly valued. Families expected a high degree of rigor. In the countries studied there was far less testing than in the US, but students were expected to take a rigorous test at the end of their school. Unlike American exit exams which are gatekeepers to graduation, the international tests were a gatekeeper to the entrance to higher education. Good performance virtually guaranteed a good university placement and job, whereas poor performance was limiting. Students in Poland and Korea dominate their high school years with preparation for success. The 50 hour Finnish test includes one extended essay for which the students had six hours. In Korea, planes are rerouted on test day. There is no retest for a year. Students cannot plead extenuating circumstances. These tests are taken seriously.

Another difference was in the concept of self esteem. Personally I define self-esteem is a measure of someone's resiliency- how well they bounce back from challenges and persist with hard things. It is not built from doing well or Atta boys; it is constructed from striving against challenges. If your NBA player only practices against primary school basketball travel teams, he will do very well, but will not improve his skills. She points out that "during the 1980s and 1990s, American parents and teachers had been bombarded by claims that children's self-esteem needed to be protected from competition (and reality) in order for them to succeed ." (p. 109) By way of contrast, in the other countries, student test grades were read off with rankings- everyone knew who was the top performer and the worst performer on every exam. The world is a giant competition and students should try and fail when young so they can avoid it as adults, when it is more expensive. This caused stress and motivation for the students to move up in the ranks or maintain their status.

Sports constitute another major contrast between the US and the other high performing countries. In the US high school sports are nearly revered. My sister's school district built an $80 million football stadium. Parents have been known to hold students back from kindergarten access in order for them to be relatively older than their peers and consequently bigger when sports teams were constituted. If a New York school budget does not pass, the first thing put out is that the sports program will be canceled and the budget usually passes. Sports teams get lots of attention in local news but academic teams get virtually none. Teachers are hired and pressured to be coaches, or worse, hired because they would be a good coach. The list goes on. In these other countries, high school sports are virtually non-existent.  Korean students might spend an extra 8 hours a day at school, but it is studying not playing sports. Finnish teachers do not coach. Polish students play recreational sports that are unaffiliated with high schools.

Technology is another division. In American teacher colleges, technology plays an important role. Teachers in training learn how to use interactive whiteboards and prepare lessons using them. "Good" schools have an interactive whiteboard in every classroom. One to one initiatives are all the rage. Flipped instruction means teachers prepare online lessons for students to view as homework and then the guided and independent practice takes at school. Rare is the international school with this level of technology. The money is not spent on gadgets. Students go home to technology not available at school.

Perhaps most telling however is the caliber of the staff. In America just 5% of Schools of education were located at highly selective institutions (p. 85). When I took my exams to be a teacher, NY required a passing rate of 79% whereas Mississippi only required a 39%. NY just eliminated the ELA part of the new praxis test because too many minority students failed the exam. Instead of working to increase their skill set, they were content to dumb down the profession. In all of the other three countries all of the schools of education were highly selective. Only the best were admitted to the programs. When I was in Denmark they talked about their special education teachers. First they had to teach for at least five years in a general education classroom. Then they had to get a recommendation from their administrator. Then they had to earn a high enough score on an entrance exam. Only a few made it through the process. While not all of the nations reserved high salaries for teachers, they were all in the upper middle class range, rather than the lower middle class range in America.

Teachers in other lands also had great input in their curriculum when compared to American teachers. In our nation, textbooks could be used for weightlifting. The average 8th grade math text is 800 pages. In other nations that number is only around 200 pages. (Interestingly I have a slim volume, a math text from 1898. It has fewer than 250 pages and covers grades 1 through 12, with examples of entrance exams from several selective universities, such as Harvard, in the back.) New York State sponsored the creation of a series of math and ELA Modules to correspond to the Common Core, available online to all schools for free. If you were to print them out there would be hundreds of pages per unit. One of my friends commented that her principal was so happy because every teacher in her building was doing the same thing on the same day. I was horrified- how does that showcase teacher skills and differentiation for students? A robot could do that. While the Common Core was touted as having slashed the standards at each grade level so that they could go a mile deep rather than a mile wide, the 5th grade math strand, which was the most reduced, only took out 10% of the standards when compared with the NY standards. In the other nations, students were expected to learn it or score poorly. Teachers were expected to reach each student, afterschool tutoring abounded, students spent an increased amount of time working on higher order problems. In Finland half of the students received specialized instructional support at some time during their academic career- no label required. Teachers were also tasked with creating programs that aligned with the standards.

In the wrap up section, Ripley highlights a couple of ways we can increase our country's educational performance. All of them require a significant cultural shift, something Americans are reluctant to propose. First increase the rigor of the program both for the students and the teachers. Increase teacher autonomy so that teachers make decisions not politicians.  Then eliminate most of the testing but maintain testing that enables access to post secondary education. Increase the requirements for teacher colleges- both in order to access the program and exit the program with certification. Understand that math is a critical skill- at least as much as reading- and students need mental math fluency and problem solving expertise. No one should say I can't do math, my parents are not good at math and so neither am I, or math is not that important. True, you might not need trigonometry to survive as an adult, but a deep understanding of probability and statistics, fractions and decimals and using algorithms to solve problems is essential. We can do better, but it requires a cultural and cognitive shift to get there.


Tuesday, June 13, 2017

The smartest kids in the world- technology

When New York passed a technology funding resolution a few years back, people were delighted. Hardware for everyone! More than half a dozen years later our state still has schools that do not have adequate bandwidth to use online assessments. Those computers that were purchased are not just obsolete but in use and in disrepair. The challenge of technology is that it requires a constant on going expense to re-license, repair and secure it.

My daughter was a firm proponent of the smart boards we installed. They were fun to play on during activity period and they showed movies- mostly without permission from the studios. I have worked at private schools that cannot afford to pay their teachers much beyond minimum wage install smart boards in each room. I have always considered our love affair with technology an ill thought out crush. It is not that technology is not ever useful or desirable, but for the expense, we need to ensure we get bang for our buck.

We have research that says kids do not learn as much from reading electronically as they do from print see here or here or here. Smart board use has mixed results on achievement. One study I read years ago said it improved scores for 1/3 of students, had no impact on 1/3 of students and reduced scores for 1/3. A study of college students says that they improve student satisfaction and perception of learning, but had no impact on actual achievement. A report of school age use suggests nominal change in performance in spite of increased engagement. A study reported that notes on a laptop were by far inferior for student support of recall than handwritten notes. Students do less well in online classes than in face to face classes (or here).

Amanda Ripley, an author who has worked for Time magazine wrote The Smartest Kids in the World. She looked at differences between education in the United States and that in the high performing countries in the world, especially in the area of math, which tends to predict adult income, divorce rates and employment. One compelling difference she identified is that international schools do not spend on technology the way we Americans do. We look at  gadgets and get all excited. It is the wave of the future... Or is it the way to distraction?

If we really want to focus on emulating what successful schools in other nations are doing, perhaps we should junk the high tech and focus closer to home- teacher quality, motivation of students to work hard, and supporting a cultural change to truly value education over sports, entertainment or free time. It is not that tech has no value and well done tech can improve performance- if it is used to increase response rate and feedback. There is no discernable value in playing Jeopardy on the interactive white board over playing in with the clues written on pieces of paper taped to the wall. There is no advantage to taking notes from powerpoint over from an overhead projector or chalk board. There is no virtue in taking attendance by having student pop "balloons" on the whiteboard as they enter the classroom versus the teacher doing it on a sheet of paper.

Instead of focusing on pretty, as we Americans are so fond of doing, we need to focus on what actually makes the trinkets valuable- teachers and how they use them. Articles here, here and here discuss this idea. Ripley would certainly concur about the technology being a tool, not an end in and of itself. We spend more money than anyone on education, in part because we are not wise spenders. I remember a principal who would not allow any teacher to use the copier without prior approval. The idea was to not print drills but things that would support higher level thinking. Yes, he was a micromanager I would not like to work under. We can, however, apply this test to our technology choices. Is my intended use of the technology going to improve learning in such a way as to justify the cost? After all, we were incensed when the $10,000 hammer the government bought, but what about the $4500 tv  or overhead projector? We need to become more selective in our spending. It starts with us, the teachers who will use it.

Monday, June 5, 2017

Smart but Scattered

Peg Dawson and Richard Guare are leading researchers in the field of executive function (EF). Their website is smart but scattered kids.  They wrote Smart but Scattered for parents of children in grades K-8. This is different from their other book that I have read, Executive Skills for Children and Adolescents whose focus is more for teachers and other professional practitioners. This book is a very easy read, but at the same time chock full of information and practical ideas.

The term executive skills refers to "brain-based skills that are required for humans to execute, or perform, tasks" (p. 13). I like to think of them as the things your executive assistant might to help a CEO be successful. The authors include the following skills in their list, but other authors categorize the skills differently: response inhibition, working memory, emotional control, sustained attention, task initiation, planning/prioritization, organization, time management, goal driven persistence, flexibility, and metacognition.  They are required for independence of adults. Most people have a range of strengths in executive skills. Before designing interventions, you need to identify the areas of greatest needs.

The book contains a number of checklists for children at different ages- different aged children are expected to demonstrate different skill patterns. This helps people pin point skills to focus on. One are that they repeatedly return to is that when there is a weakness in both the adult and the child both should try to learn to improve the skill.

The authors begin with a quick overview of the ABCs of behavior.
  • Antecedents- things that occur before the behavior, the environment, people and expectations that confront the individual before a problem occurs. Cleaning the room always results in an argument. Getting ready for school is never completed on time with little drama. Long term projects never get turned in. In the beginning we modify the environment for children so that they can be safe and successful. We use outlet covers to keep toddlers safe. We hold hands in parking lots. We work with children to get homework complete. As they age we try and reduce that support. Children with EF concerns cannot handle this independence the same way their peers can.
  • Behavior- problem behaviors or skills. Children need to be taught how to not stick assorted things in outlets, look both ways before crossing the street/parking lot and determine when it is safe to go and how to go about completing long term assignments.
  • Consequences- things that reinforce the behavior. We might think that time out is a punishment, but if you get out of something you don't want to do it is not. We might think that getting a good grade is a powerful motivator in getting homework in on time, but for someone who lacks the skills required, it is not.
The authors suggest beginning with modifying the environment and then slowly making changes by teaching skills and inserting rewards to reinforce the appropriate behavior.  They have a range of strategies for teaching skills such as getting ready in the morning, studying for a test and learning to handle changes in plans.

They have a process for summarizing the program:
step 1- establish behavioral goal- use a specific objective ex. complete morning routine tasks within 20 minutes.
step 2 -design an intervention:
identify environmental supports to help reach the target goal: ex. timer, written schedule, cues from parents
specific skills to teach- ex. parents will create a schedule arranging activities in a preferred order, parents set timer, parents check and cue 2x during time, check items off list as completed, choose from prize box if goal met, if he is late to school he will be required to complete missed work during free time.

A great reference book for parents.

Sunday, June 4, 2017

Smart but scattered- flexibility

I have written about the challenge of change before, and flexibility is little more than adapting to change. Yes, that is a huge understatement. Children who learn to be flexible and adaptable quickly tend to be easier to parent and teach. Children on the autism spectrum tend to be adverse to change to the point of rigidity. Social Thinking guru Michelle Garcia Winner, speaks about flexibility as an essential social skill. Sarah Ward of Cognitive Connections, which focuses on executive function skills, includes flexibility training in her programing. The authors of Smart but Scattered, Peg Dawson and Richard Guare, include this skill in their program as well.

Dawson and Guare define flexibility as "the ability to revise plans in the face of obstacles, setbacks, new information, or mistakes" ( p. 256). The Simpsons have a segment where Bart never learns to stop grabbing the electrified cupcake, showcasing his lack of flexibility around food. Although comical in the cartoon, parents and teachers who deal with children with a lack of flexibility have a definite challenge.

For years when we had a school break I would plan out a schedule and write it down for my rigid child. Once it was recorded, it was "set in stone." God forbid a change need to be made. My son's preschool class traded places with the class across the hall on Wednesdays to try and build in some flexibility. Unfortunately, once that had been done a few times, it was part of the schedule and my son was fine with it. A weekly schedule was just as good as a schedule for the hour. A Sarah Ward workshop I attended years ago spoke about introducing a surprise card to a picture schedule. These big schedule attempts are a good place to start.

Dawson and Guare discuss two types of interventions for flexibility: environmental and skill development. With skill development they include consequences that will encourage use of the skill.
Environmental modifications:
  • reduce amount of change at one instance- Instead of changing every expectation, change just one at a time. From summer to school, do not change bedtimes and daily routines together. Even though you do not need to get up for school- get up at the same time and go to bed at the same time and change where you go for the day. Do not schedule a dentist appointment on the same day there is going to be a babysitter at night because you are going out.
  • keep schedules and routines- create picture or word schedules for the day. Develop routines around daily events- getting up, going to bed, eating meals,... This enables them to predict what is going on. It showcases that non-preferred activities do not go on forever and can highlight preferred activities.
  • provide advance warnings of change- My son's bus driver attended a training where they suggested not telling kids if she was going to be absent because they would dwell on it all day. Yes, kids might dwell on it, but they will do better if you train them what to do when there is a change. You can tell kids about vacations. The classic 25 day advent calendar or chain to count down to Christmas provides warning of the change.
  • scripts for handling the situation- this has been a great activity for my son. Bibliotherapy and social stories about what do at the dentist solved problems in handling going to the dentist. We have talked through what a phone conversation might sound like before picking up the phone. This reduces the anxiety around the event.
  • reduce complexity of task- Instead of the long term project being presented at once, present only one piece at a time. Instead of pick up your room, pick up the clothes on the floor. Instead of make a phone call, dial the number.
  • give choices- we need to drop off this material after school. Do you want to have a granola bar in the car or wait until we get to the office and have a yogurt for snack? Do you want to practice your spelling with mom or dad? Do you want to go to the zoo or the park on the vacation? You need two fruits or vegetables out of these four choices: carrots, beans, applesauce or salad. Really important here- do not offer choices you cannot live with.
Skills and strategies to encourage flexibility:
  • walk a child through the task- ordering at a restaurant: we role played it at home, now we will do it together, eventually you will be able to do it on your own.
  • Use social stories- Carol Gray designed this evidence based practice. For a month before my son's first dentist visit, every day we read stories about going to the dentist and watched a Mr. Rodgers episode about it.  When we got there we took pictures of him doing the various steps so that we could look at them before the next visit. For getting ready to fly to his uncle's wedding, we again hit the library up, but then scripted each step of the event. For a student who did not like leaving preschool, we wrote one about waiting patiently to be picked up.
  • Come up with a default strategy. Think of the most problematic situations and brainstorm with your child (when they are calm!) about how to handle the situation. When we might need to wait, we bring a book to read/look at. Teaching counting to 10 to relax. Teach ask an adult for help.
  • Use coping strategies- like above. You need to teach when calm. You need to practice. You need to reinforce when they handle the change well. The authors recommend a number of Dawn Huebner's books to introduce these ideas.

Overall the authors say you need to teach it. Flexibility does come easily for some. If you are a very flexible person and your child is not, this may be especially challenging to deal with. Routines and schedules will not be your thing, but you need to work on doing what your child needs. If you are a fly-by-your-seat teacher, these kids need more structure or you will have behavior problems. Routines can save much angst, but kids also need tools to handle when routines are set aside. Increasing flexibility is critical to adult success.

Thursday, May 25, 2017

What do you say when...

I am an introvert. I hate talking on the phone, talking to new people, and events where socializing is key. That being said, I am a teacher who calls the parents of every student I have in the beginning of the year. I was a PTA president and now have risen to the role as region director where I get to talk with new people all the time. It is intimidating and uncomfortable, but easier now than it was a dozen years ago. I also have a son on the spectrum who struggles with conversation. He's good with a monologue, but a conversation is so much more challenging. Therefore I was intrigued when I saw Florence Isaacs' book, What do You Say When... Talking to People with Confidence on any social or business occasion. This book is organized into four parts: the basics, social occasions, business and professional occasions and other times for conversations.

The basics normalizes social anxiety. We easily fall into the role of I am the only uncomfortable one here. I will embarrass myself. I know no one. Let me be a wall flower until I can leave. Getting out of that rut is hard but important. This book is more about starting a conversation than carrying it on. If your communication partner is not a great conversationalist, you will still struggle.

A few key ideas from the book.
  • If you are talking to someone you don't know: start with an open ended questions, or comment with a question.
    • I love the gardens here. What do you think? What is your favorite part?
    • What did you think of the speaker today?
    • Where are you headed? What is your favorite place to visit there? or What did you do that you would recommend to others?
    • How do you know Penelope?
  • If you are talking to someone you've met before:
    • I know I've met you but old age must be hitting because I can't remember your name. I'm Susan and you are...?
    • How are your children? Your youngest was practicing for a play (soccer tournament, recital,...), how did that go?
    • How is the house hunting/remodeling going?

The if you know ones are more challenging because you need to remember information about specific people. I liked the author's idea about keeping a rolodex (or maybe an electronic file) about the people you meet and reviewing it before you go to an event they might attend. An updated file helps keep track of things my mind at least struggles with. I suspect many a sales person, dentist and hair stylist does this to help keep track of clients.

Another idea she pitches that I've heard elsewhere is to wear or have something comment worthy on you to spark conversation. I have a rather large collection of statement shoes and earrings. They give people an opening that can help get things started. Other items might be a tie or pen that can be commented on. If you are doing it for that role, perhaps the potential conversational partner is as well. Commenting on the interesting colored stripes in someone's hair might be a great opener.

The author also points out something that I heard on Dr. Phil recently. Don't answer a thoughtful question without thinking. Give yourself a moment to process. In schools we call this wait time. We need to do it in serious conversations like job interviews and conferences as well. If you are formulating your response as the speaker is finishing a statement, you might miss a critical point.

While this book was an interesting read and there are pieces I might use with a student with extreme anxiety, it is not really meant to be read cover to cover. If I can get my son to read the first two chapters, he might have an easier time with starting to speak. This book is a soft text, not right for many, but did reiterate some good ideas that I know I will use, especially if I review pertinent sections prior to an event. That is really the ideal way to utile it.

Saturday, May 20, 2017

How did students with disabilities get to Harvard?

Thomas Hehir and Laura A. Schifter's book, How Did You Get Here? Students with Disabilities and Their Journeys to Harvard, was not what I expected. I thought I would read vignettes about the trials and tribulations of people with disabilities getting into a prestigious Ivy League school. Instead I read a book that was the analysis of a research project. The authors performed in depth interviews with 14 individuals, their families and, in some cases, service providers. Then they examined commonalities and differences between the tales. There is one narrative like I expected at the end, written by Wendy S. Harbour. The book also includes two essays by people with disabilities, one the co-author, Laura, and one a student, Nick. While these include more narrative than the rest of the book, they still both lean heavily toward meta-analysis rather than story. As a piece of research, this is a pretty readable text.

The book hit upon some interesting features. Of the 8 chapters (plus a hearty forward, preface and conclusion), 6 discuss aspects that helped young people make it to Harvard. They are as follows:
  1. Mom- These young people had a parent who was a powerful advocate for their child. She could have just held high expectations, but many were so invested they became active service providers for their children. In chapter 8, Tom questions how can we help more children succeed without requiring monumental efforts from their parents. His only suggestions is universal design for learning (UDL), a theme throughout the book. While I cannot imagine that being a universal panacea, it would help more students move forward.
  2. Teachers and or service providers who believed in the child. These passionate, highly talented professionals included a preschool teacher, a private speech and language pathologist, a special ed teacher and a general education teacher. These professionals provided  support, critical training, and advocacy for their students leading to positive outcomes.
  3. Asking for more. These young people wanted more than the education that was initially provided. In spite of the challenge of pulling information into their brains, they wanted more. Several students commented about being in self-contained programs and seeing them as academically undemanding. Switching to mainstream programs helped impart rigor, but often presented challenges of input. Other students saw their self contained programs as life savers. The authors caution that there is no single right placement. A spectrum of placements is essential so that the placement for every student can continually be examined to see how well it meets the child's needs. These exceptional youths requested more rigor themselves.
  4. Finding things outside of school to be successful at. If school is a challenge, having something in your life that you can be successful in with less work is important. Sports, music, and poetry are some of the interests that sustained these young people through their challenges.
  5. Drive to find a way. These students attended a mix of programs- public and private school, fully mainstreamed, separate schools for students with disabilities, self contained classes and resource room were all placements that were experienced. Students needed to figure out accommodations. Developing a bag of strategies to be successful was important to these students who were highly motivated to be successful and who were, it appears, intellectually gifted, in spite of their disability. Their disabilities were deafness, blindness, deaf-blind, anxiety, dyslexic, learning disabled and orthopedically impaired. (Interestingly, no ADHD, autistic, or emotional disturbed students were in the group interviewed.) In order to make it, these students needed work-arounds for their challenges, and many had to self-discover them. They brought with them indomitable drive to be successful, often in spite of people telling them they would not make it.
  6. Audio-texts. Since many of the students interviewed experience reading disabilities, audio books, screen readers and voice-to-text technologies were critical to their success. The last two decades have seen an explosion in technology to help students with disabilities. These tools help implement UDL in a way that was, perhaps, impossible years ago.
These students overwhelmingly came from upper middle class families where there was someone who saw through the challenges to a bright and capable young person. They received the benefits of private support, educated parents, and intact families. Interventions received mixed reviews. Being deaf or dyslexic did not mean the same intervention worked for all.

Interestingly two suggestions from the students were seen as important. If you are blind, learn braille. The notion that audiobooks replace self-reading was dismissed. Being able to independently read and write, regardless of the status of the power being up, was seen as important. Audiobooks impair the ability to fully create the story in your mind and that was seen as important. Another key takeaway from the audiobook area was the challenge of someone with dyslexia listening to an audiobook in which every picture, figure, chart and diagram is described, can be a serious waster of energy.

The other suggestion was that students learn organization. Most of these students needed to spend extra time on activities. Whether it was studying for the GEDs or writing a paper, students with disabilities needed to carefully plan their time to accomplish their goals. They needed to develop plans to keep track of materials and assignments. They needed to be good at initiating and persevering through challenge. These students did not exhibit classic executive function weaknesses that many with disabilities struggle with. In and of itself, this could be a reason for these students' success. So many students, with and without disabilities lack these skills. If we can teach students strategies to manage these challenges, many more would be successful.

Sunday, May 14, 2017

Supporting students with problem behavior- support plans

Chapter 9 in Lee Kern, Michael P. George and Mark D. Weist's book, Supporting Students with Emotional and Behavior Problems, discusses how to develop a support plan to address problem behaviors. I particularly like the format that is used to  create a plan. Many districts have formal protocols that they use. It would not be difficult to ensure that they contain all the elements of the plan that is in the authors' format.

First I want to emphasize a thought. Having a "complete understanding of the causes of problem behavior, including an appreciation that environmental events (i.e. antecedents) may trigger it and that skill deficits can limit a student from engaging in desirable alternative behavior ( p. 181)" provides a strong foundation for creating an intervention plan. I think back to reading The Curious Incident of the Dog in the Night Time by Mark Haddon. The main character, Christopher, has autism and knows what sort of day it will be based on seeing yellow cars on the ride in to school. We think this is odd, but this sort of thing can set students off and we need to understand these setting events so that we can respond in a way to facilitate appropriate behavior.

The authors describe 4 categories of intervention and then add a fifth later on in the chapter and a sixth later on in the book:
  1. After setting events- modify or ameliorate- Christopher needed to have his yellow car thing ameliorated.
  2. Modify or eliminate antecedents- modify task or mode of completion, increase relevance of task, offer choice, schedule attention, provide transitional activity, provide transitional warning.
  3. Teach alternative skills- replacement skills, general skills
  4. Respond without reinforcing- instruction, positive punishment, negative punishment, extinction
  5. Lifestyle interventions
  6. Mental health interventions
I was giving a workshop this spring on deescalating behavior where I was asked about a student who responded to adults appropriately until free time, at which point he grew too loud and used inappropriate language. Since the child had an ASD diagnosis, I speculated that he did not generalize well and needed to be taught how to interact with adults during free time. A theme during that workshop was teach don't tell. We often assume that students know how to do something- we told them, they can do it in some settings or at some times. Unfortunately that is not adequate for all students in all situations.

A note on lifestyle interventions. I really like these because they impact quality of life. Increasing the number or quality of relationships a student has dramatically impact his life. A student who finds academics very challenging or school very difficult needs to find something to have success in. Often students gravitate to sports, crafts or outdoor activities. Reinforcing these is essential for students. Lunch bunch- a strategy in which a trained adult interacts with a small group of good role models and target students during lunch time- is often used to build social skills and friendships. See here for additional information. An advantage of lunch bunch is that the intervention does not pull students out of mainstream instructional times. Peer tutoring and mentoring has also been used to develop social skills and friendships.

I slightly modified a form from the book as seen below. The chart format would be one or two pages. This format would be easy to stick in a sub folder so that people coming into the program could quickly get up to speed when dealing with challenging students. Such a summary is essential with high need students.

Support Plan
Student
Date
Team Leader
Team Members
Target Behavior                             
Behavior definition
End of Year Behavior goal
How will progress be measured?

Functional Assessment data collected ( how and from whom)
Hypothesis
Interventions
Antecedent or setting event strategies
Alternative skill instruction
Response to problem behavior
Lifestyle interventions
Who will implement Interventions? When will it be implemented?





How will plan be evaluated

If we look at the intervention portion here is what it might look at for a student.

Hypothesis: John exhibits disruptive behavior when he is frustrated, especially with inferential reading comprehension tasks or writing assignments, or is asked to switch from a preferred to less preferred activity.
Interventions
Antecedent or setting event strategies
Alternative skill instruction
Response to problem behavior
Lifestyle interventions
Who will implement Interventions? When will it be implemented?
  • Break the task into smaller more manageable parts
  • Before the lesson identify potentially problematic tasks and ensure extra adult support during those tasks
  • Provide choice for long writing tasks- write, scribe, type or voice-to-text.
  • Provide 5 and 1 minute warnings
  • teach how to ask for a break
  • teach relaxation techniques
  • Role play transitions with positive self-talk
  • Provide additional instruction in reading comprehension strategies
  • Teach and provide practice in typing
  • Provide reminders of expected behavior
  • Have cards to remind about taking a break and use relaxation strategies
  • do not alter task upon disruption
  • Reinforce break taking to accomplish a task.
  • if he does not complete task because of disruptive behavior, assign afterschool detention in which to complete task
  •  na
  •  all staff will implement
  • Counselor will teach relaxation techniques
  • Special ed teacher will role play transitions and help identify potentially problematic tasks
Begin immediately

Saturday, May 13, 2017

supporting students with behavior problems FBAs

I am reading Lee Kern, Michael P. George and Mark D. Weist's book, Supporting Students with Emotional and Behavior Problems. The book is not an easy read because of the depth of information it contains, but it is an excellent resource for behavioral interventions. The chapter on FBAs (Functional Behavior Assessment) takes me back to my son's elementary days where there was an abundance of behavioral challenges to work with. Unfortunately his experiences highlight what not to do rather than what to do. This book offers advice, guidelines and supportive paperwork to help intervene in behavior appropriately.

The authors suggest that the first step of a tier three behavior intervention is to assemble a team. The team should include staff members with expertise in areas that the child is struggling- in my son's case, his special ed teacher, SLP, OT, PT, classroom teacher and 1:1 aide- someone with expertise in developing behavior plans, and his parents. Parents are often not consulted enough in researching behavior and developing interventions. They bring valuable insights from craziness at home (ex. divorce, late parental working hours, frequent sibling conflict) to issues around home behaviors (ex. does not sleep well, limited diet, homework difficulties) to home perspectives (ex. sees school as boring, cannot complete homework, hates the kids on the bus, is teased a lot). These things have a bearing on school behavior, just as events at school have a bearing on home behavior. Parents are in the unique situation to not have rigid school day time constraints (there is no appointed lunch half hour) and potentially have access to more positive reinforcement (ex. favorite tv/video show, ice cream cone, Friday night movie, night with grandparents). They need to be a part of the team. This may be challenging. Parents often work during the day when school staff want to meet. Not everyone can go in a hour late or participate in a phone conference when it is convenient for staff. Flexibility needs to be used to ensure participation.

In primary school my son's teachers put together a behavior plan around respect. His very caring special education teacher explained to me that what everything boiled down to was a respect issue and thus this focus was perfect for him. I expressed concern. The second step is to identify and prioritize problem behaviors. Lack of respect is not a problem behavior. Yelling at others, taking materials, physical aggression, throwing materials at people, and self-injury are examples of specific problem behaviors. When the behavior is not operationally defined, your opportunity to work as a team to eliminate the behavior is limited. Yes, there can be many problem behaviors, my son actually exhibited the entire list above and more, but you need to prioritize the most important one first. The authors identify three levels of behavior to guide prioritization:
  1. Destructive- harmful or life threatening. (My son picks at his skin. He has had open wounds for months at a time.)
  2. Disruptive- destroying materials, interfering with learning of self or others including mental health issues like depression or anxiety, causing problems with social relationships, preventing participation in events or activities or likely to escalate to destructive. (My son was known for standing up in class and loudly proclaiming that the assignment and the teacher were stupid in not so polite terms followed up by ripping the paper and throwing it or eating it.)
  3. Distracting- impeding social acceptance, affecting self-image, causing minor damage to materials, likely to escalate to disruptive behavior. (My son wrote on himself and his clothing.)  (p. 157)
As you would expect, interventions need to start with destructive behaviors and advance through disruptive ones and finally settle on distracting ones. Although the authors have not yet proposed a number, other sources I have used suggest focusing on no more than three behaviors at a time. My son's teachers picked respect because that was one behavior. Addressing each component would be mind boggling and the time frame for improvement was too long to contemplate. Perhaps, however they would have been more successful in changing behavior if they had defined the problem behavior more specifically and worked on a few aspects at a time.

After the behaviors have been targeted, the real work of the assessment begins. Start with interviews. Staff, parents and the student himself should be interviewed. Strengths and likes are identified and broad concerns are labeled: past trauma, health and physical concerns, academic problems, social problems and general quality of life issues. Attempts are made to pin point when the most undesirable behaviors occur. Suppositions are made regarding antecedents and consequences that trigger and reinforce the behavior. This guides when observations are made.

Observations. The authors recommend observing 15-20 occurrences of the behavior (p. 169). This can be less for highly consistent behaviors, such as every time the fire alarm goes off, he screams and covers his ears. The most my son was ever observed for was his last reevaluation when I specifically asked the psychologist to observe him in different settings- different classes, the hall, and around lunch. Oddly enough we got the most information from that activity than from any other, including the report from his 1:1 aide. A teacher doing teaching cannot perform an adequate observation. Someone else must be on hand to do it. This could be a trained paraprofessional, principal, guidance counselor, behavior specialist, or other staff. What the book does provide is a set of forms for the observation. One is a report form, one a checklist and one a results summary. The report form requires a narrative of events during the observation. The checklist includes a series of sections like the one below for each activity observed. I really like the checklist because it suggests areas to examine as possibilities when the behavior occurs. The summary combines information from the observations, interviews and other sources, identifies consistencies and inconsistencies, and recommends either the development of a hypothesis statement or suggests that further data collection is required. My favorite FBA done on my son said there was no known antecedents for behaviors and suggested that additional supports be put in place to meet his needs. Really??

Antecedent
Behavior
Consequence
o   Told to stop or start an activity
o   Working independently
o   Given a multistep direction
o   Denial of preferred item or activity
o   other
o   Noncompliance with stopping or starting an activity
o   Attempting to gain teacher/adult attention
o   Attempting to gain peer attention
o   Noncompliance with directions
o   Minor disruptive behavior
o   Aggression
o   other
o   Redirection
o   Preferred item or activity
o   Encouragement
o   No response
o   Help
o   Time out
o   other
ABC Checklist sample section from p. 171.

Hypothesis. The authors propose the following format to frame the hypothesis:

Given the circumstance when (setting event) _________________ when (antecedent) __________ the student does (problem behavior) ________________ in order to (function) __________________.

For example:
  • "When Jim is given an assignment that takes longer than 15 minutes to complete (antecedent), he engages in disruptive behavior (problem behavior) to escape the task (function)." (p. 178)
Or
  • When Julie feels overwhelmed by her schoolwork (antecedent) she asks to leave the room and cuts herself (problem behavior) to relieve tension (function).

Then an intervention is engaged in. For Jim, at 13 minutes in we ask him to take a break and then return to the task that has been broken into 10-15 minute segments. (Slowly over time we increase the time he needs to work before a break.) For Julie, we teach her to use an anxiety rating scale and how to use a stress reduction technique to intervene without cutting, for example deep breathing paired with positive self-talk.

Then data is taken to see if the intervention is effective and when to start stretching the goal.

The process is long and extensive, requiring lots of staff resources to engage in. FBAs are not for everyone. The authors suggest that perhaps less than 5% of a school population should have an FBA done. This is consistent with the RTI concept of three tiers of intervention- the first is for everyone (good classroom management), the second for a small number who need a little more (ex. checking in paired with goal setting for success), and the third for very difficult behaviors and children who do not respond well to traditional management programs. Tier three is where FBAs fall. They should be the starting point of the intervention. Done well they should be an excellent guide to implementing an intervention and a great tool to determine if an intervention is effective.

Tuesday, April 18, 2017

Revision Decisions

I have read other Jeff Anderson books and still shoot myself for not seeing him when my boss proposed I drive the 50 miles to a workshop he was presenting. When Revision Decisions: Talking Through Sentences and Beyond rose to the top of my pile, I eagerly dug in. Once again I was captivated by the readability and practicality that Jeff and his coauthor Deborah Dean imbued throughout the work.

This book targets middle school but could certainly play up or down grade levels. The book is arranged in two sections: the basics and the lesson sets. In the basics he presents his revision mnemonic DRAFT as a way to teach students how to revise. This is not editing- making the sentences grammatically correct- although he uses grammatical instruction to help students organize their revisions. DRAFT represents the decisions writers make:
     D- Delete unnecessary and repeated words
     R- Rearrange words, phrases or clauses
     A- Add connectors
     F- Form new verb endings
     T- Talk it out
I particularly like the first two as it applies to summarizing. Teaching deletion and rearranging gives you extra bang for your buck as it were. The lesson sets demonstrate how to apply the strategy with examples and grammatically information.

The major technique that the authors propose is sentence combining and discussion. This is an evidence based practice that improves writing but largely is unused in classrooms today. Christopher Paul Curtis's book, The Watsons Go to Birmingham-- 1963, includes a sentence that can be deconstructed and rewritten as:
     He was smiling.
     He put his arms around my shoulder.
     We walked.
Students can be shown how to combine these sentences using elements of  DRAFT, talk about how their version differs from the author's, the effect of each version and then work through other sets. You might get
  • We walked together; he was smiling as he put his arm around my shoulder.
  • He smiled as he put his arm around my shoulder while we walked.
  • Putting his arm around my shoulder, he smiled as we walked.
While the author wrote:
  • He was smiling and even put his arm around my shoulder as we walked.
What is the effect of starting with smiling and ending with walking as opposed to starting with walking and moving on to body posture? Students can discuss the differences and come to conclusions about which they like best and why. Arrangement of phrases and clauses versus the main sentence stem impact emphasis and anticipation.  Discussion about the effect of the arrangement is what lets students begin to have these discussions with themselves as they carefully select how to write their sentences.  After a modeled example and small group collaboration, students are set free to search through their writer's notebook, find a place where the day's lesson can be applied and do so.

It is important to note that all the steps are not worked on at once. A particular skill is taught. You might start with reviewing how to write and punctuate a series or list and then move to how to delete words and create a new sentence with remaining material. You might have a unit on using transitions and start with how to use prepositions or FANBOYS (coordinating conjunctions- for, and, nor, but, or, yet, so).  Focusing on one element at a time is essential if students are to learn each element well.

Clearly the authors have written in the era of Common Core- text examples all come from nonfiction works of varying levels of complexity and from different content areas. These examples showcase how you can integrate the skill of combining sentences with nonfiction works. Appendixes in the text include both deconstructed sentences from these works and the author's original words. One point the authors emphasize is when comparing the key is not to replicate the author's words but to combine the sentences in a way that makes sense.

The major criticism that I have of the DRAFT revision strategy is that it omits content. Many students fail to answer a prompt and so never get the credit they deserve. Students need to be taught to dissect prompts and check to be sure they have completely responded. They need to be taught how to organize their thoughts so they make sense, how to not make logical fallacies, how to use rhetoric and how to thoroughly explain their thinking. These revision steps are essential to good writing as well. While students will become better writers if they are taught how to combine sentences in interesting ways, they need to move beyond that as well.