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.

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