Virginia Beach City Public Schools December 7, 2011

1. Bright Child/Flexible MindReducing frustration in your school-aged childEmma Cole/Shannon CrayPredoctoral Residents in Clinical Psychology Virginia Beach City Public Schools December 7, 2011

2. Agenda • Overview of Executive Functions • Development of Executive Functions • Executive Functions and Gifted/Bright Individuals • Inhibition • Set Shifting/Cognitive Flexibility • Emotion Regulation • Summary: Keeping School Achievement in Perspective • Resources • Questions

3. Introduction – Executive Function • “Those mental processes we use for sustaining problem-solving toward a goal” (Luria, 1966) • “Self-regulation so as to choose, enact, and sustain actions over time toward goals, often in the context of other [goals], usually using social and cultural means so as to maximize one’s longer-term welfare as the individual determines it to be.” (Barkley, 2011)

4. Overview of Executive Functions • Functions include: • Working memory-hold information in memory to complete a task • *Inhibition-control impulses, manage behavior • Initiation-begin a task, generate ideas • *Emotional Control – modulate emotions • Attention-pay attention to several components at once • Planning- anticipate future events, set goals, and develop steps ahead of time to complete multi-step tasks • *Shift- alter problem solving strategies and think flexibly to transition from one situation to another • Monitor- check work and assess performance during or after finishing a task to ensure attainment of a goal • (Gioia, Isquith, Kenworthy, & Barton, 2002)

5. Introduction – Executive Function • “The Conductor” or “The Regulator” • The orchestration of goal-directed, intentional problem-solving skills. • Frontal lobes (PFC) coordinating activities with other areas of the brain. • The conductor must disengage from the environment to coordinate actions. • (Gioia, Isquith, Kenworthy, & Barton, 2002) • Example: Getting dressed in the morning

6. Neuroanatomy of Executive Function

7. Development of Executive Functioning (Taken from Toplis & Neighbor) 6-12 months • Impulse control and self inhibition • Early inhibition begins to be demonstrated 1-2 years • About 1 year can inhibit a response and shift to a new response • Some self monitoring and beginning ability to identify errors 3-6 years • General increases in attention, self control, concentration and inhibition • Gradual lessening in impulsivity • Occasional perseverative behaviors • By 6 years: is able to resist distractions and increase length of attention span 7-9 years • Able to screen out irrelevant stimuli from selected target for attention

8. Development of Executive Functioning Continued……(Taken from Toplis & Neighbor) 10 years • Better able to pay attention to a selected target and screen out unwanted information • Impulse control is nearing adult levels 11-12 years • Able to monitor and regulate actions • Attention is fairly mature • Limits perseveration similar to an adult • Temporary increase in impulsive behaviors Adolescence • Perseveration is rare • Working memory increases dramatically As cited in Richard, G.J., Fahy, J.K., (2005). The source for Development of Executive Functions. East Moline, IL: Linguisystems

9. Executive Function and Gifted/Bright Adults • Most studies looking at the correlation between IQ and executive functioning have been conducted with adults • Few studies have examined how intelligence relates to executive functioning. Several of the studies that have been conducted show no correlation between IQ and executive functioning abilities. (Donders & Kirsch, 1991; Johnstone, Holland & Larimore, 2000) • Those studies that do show correlations find that:

10. Executive Functioning and Gifted/ Bright Children… • Studies with children (ages 6-12) also show inconsistent findings. • Some research has found that Full-Scale Intelligence accounts for about 9–12% of the variance in • Inhibition • Set-shifting/flexibility • Verbal and nonverbal fluency • Other research shows that executive functions improve with development throughout infancy, childhood, and adolescence and propose that IQ is a moderating variable on executive functioning skills. However, the moderating influence of intelligence on executive function performance in children remains unclear.(Arffa et al., 1998; Baron, 2003; Mahone et al., 2002 IQ Age Executive Functioning Ability

11. Inhibition – What is it? • ‘The ability to not act on impulse or appropriately stop one’s own activity at the proper time.” • (Taken from Toplis & Neighbor) • Comprises 3 Processes: • Inhibition of the dominant response (across verbal, motor, cognitive, and emotion domains) • Perseveration (interrupting ongoing behavior) • Interference control (protecting the other executive functions from distraction) • (Taken from Barkley, 2011)

12. Inhibition • Deficits in the School Setting Can Look Like: • Impulsive behavior • Responding too quickly to instructor questions • Rushing through seat work • Inappropriate verbalizations to peers or instructors (social disinhibition) • Low frustration tolerance • Fidgetiness • Difficulty Completing Assignments (Perseveration)

13. Inhibition - Activity • Experiment: • Pick a partner • Imagine we give your child a marshmallow in a room for up to 20 minutes. Your child is promised a second marshmallow if the first one is left untouched until the adult returns. Discuss with your partner what your child would likely do; estimate how long your child would wait. Imagine yourself at that age. How would your behavior have been? Similar/different? (5 minutes) • Group examples (5 minutes) • The Marshmallow Experiment • Discussion: Expectations

14. Inhibition – Activity (continued) • The “Delay of Gratification” Experiment • (Mischel, Shoda, & Rodriquez, 1989)

15. Inhibition – Activity (continued) • The “Delay of Gratification” Experiment • (Mischel, Shoda, & Rodriquez, 1989) • “Those 4-year-old children who delayed gratification longer in certain laboratory situations developed into more cognitively and socially competent adolescents, achieving higher scholastic performance and coping better with frustration and stress.” • Understanding of self-regulatory strategies also correlated with improved outcomes in adolescence. • Distraction vs. Abstraction

16. Strategies for Parents - Inhibition • Provide concise and easy to understand guidelines for completing schoolwork. • Agree upon and establish a set of expectations; consider posting visually. • Limit distractions. • Provide a consistent, structured environment. • Provide specific, realistic time-limited periods for completing homework assignments with breaks in between.

17. Strategies for Students - Inhibition • Teach response delay techniques, such as counting before responding. • Stop and Think methods. • Frequent breaks. • Peer role models, cross age tutoring. • Limit time in unstructured settings. • Request seating near the teacher. • Use of a “fidget tool” (e.g., stress ball) in the classroom. • Keep long-term goals on the radar/in focus

18. Cognitive Flexibility/Set Shifting: What is it? • Cognitive flexibility is also known as Set Shifting • The ability to alter problem solving strategies and to think flexibly. • Including: the ability to change focus, adapt to changing conditions or revise plans in the face of obstacles, new information or mistakes. Changing approach to a problem based on errors

19. Cognitive Flexibility/Set Shifting: In the Classroom • Deficits in flexibility in the classroom are often seen as: • Difficulty stopping one activity and beginning another after being instructed to do so • Tendency to stay with one plan or strategy even after it is shown to be ineffective • Rigid adherence to routines • Refusal to consider new information

20. Development of Cognitive Flexibility(Taken from Toplis & Neighbor) 2-4 years • 2 ½ years: knowledge of rules • Unable to shift or alter behavior • Rely on perseveration • 3 years: Can shift behaviors to adapt to knowledge of rules but only to one rule at a time • 4 years: Begin to shift between two simple task sets • Has difficulty when response sets increase in complexity • Greater task completion because of increased mental flexibility 5-6 years • Difficulty shifting between multiple rules with verbal prompts • 6 year olds: Have sharp increase of mental flexibility • Perseveration decreases • Increasing ability to learn from mistakes and generate new strategies for solving simple problems

21. Development of Flexibility Continued (Taken from Toplis & Neighbor) 7-9 years • Struggles with shifting behavior sets that are contingent on multiple demands • 8 years: Increased focused, sustained attention, ability to shift attention • 9 years: More success shifting from rules or sets depending on multiple or changing demands 10-12 years • Improvement in ability to shift between multiple tasks • Decline in perseveration • Greater ability to learn from mistakes • Create alternative strategies for multidimensional problems Adolescence • Cognitive flexibility is fairly mature • Perseveration is rare • Flexibility or the ability to change between performance demands and initiate deliberate behaviors is greatly improved

22. Cognitive Flexibility and Bright Students • Recent work suggests that gifted children with diagnosed executive functioning difficulties are predisposed to exhibit a state of "hyperfocus.“ • While this can be positive in terms of task persistance, it becomes a problem when the child is asked to shift from one task to another. • Some studies have shown that about 9-10% of the variance in set shifting abilities can be attributed to IQ.

23. How Flexible Are You? • The Stroop Color and Word Test (Golden, 1978). • Has three trials: • First, the participant rapidly reads color words. • Second, the participant rapidly names the color of “Xs” printed in colored ink. • Third, the participant must say the color of ink words are printed in. • Measures: Inhibition and Set Shifting • Video of the Stroop Task • Now you do it! • Stop Watch

24. Flexibility/Set Shifting Brain Regions • FMRI and the Wisconsin Card Sort

25. Study Results • Overall Brain Activation: Right and left inferior frontal sulcus (Konishi, Nakajima, Uchida, Kameyama, Nakahara, Sekihara, & Miyashita, 1998) • Initial shifts: Left superior and inferior prefrontal cortex (Castellanos, X., Sonuga-Barke, E., Milham, M., &Tannock, 2006) • Following shifts: Inferior prefrontal cortex

26. Strategies For Parents - Flexibility • If your child has difficulty moving from one activity to another: • Timer • Have your child help you set a timer denoting the length of the current activity • Give them warnings at 10, 5, and 1 minutes remaining • Have a daily and weekly routine in place • Young children sometimes do better if this routine is represented visually • Even older children will do better if they know what is expected of them is the same each week • Homework schedule • Advanced warning should be given if something in routine is different (e.g. doctor’s appt.) • Moving from one task type to another (e.g. math to reading) • Make up some practice items of the next task type for your child to warm up on

27. Strategies for Parents - Flexibility • Have difficulty problem solving or finding alternate ways of doing things • Have your child think aloud, think ahead • Have the child say out loud what task, assignment, or problem they have to do • Have the child say aloud all the strategies/ways they could use to solve the problem • Have the child describe their plan as they do it • Have the child assess the outcome. If it’s not correct, have them go back and select one of their alternate strategies and work it through out loud. • Parent should model the method first and help children learn to complete it

28. Strategies for Parents - Flexibility • Have difficulty problem solving or finding alternate ways of doing things • Often bright children believe that they need to know the correct answer the first time • Praise children for using a well thought out method to arrive at an answer even if it is not correct • Sometimes HOW we get the answer is more important than the answer itself • Discuss multiple meanings of jokes, riddles, and puns • Compare current situations to past ones: compare and contrast • Ask probing questions • Probe for the correct answer after allowing a child sufficient time to work out the answer to a question. Count at least 15 seconds before giving the answer or moving onto another problem. Ask follow up questions that give children an opportunity to demonstrate what they know.

29. Strategies For Students - Flexibility • Use a planner to write down the daily activities/homework so you can prepare for what you have to do each day. • Clump homework together by similar type. It may be easier for children with flexibility difficulties to finish one type of activity before going onto another type. • Set a timer and allow yourself only that amount of time to complete an assignment or conversely take a break. • Write common problem solving strategies on notecards. When approaching a problem pick the strategy you think is most likely to work out first. If it doesn’t work, pull another. • Make or ask teachers for outlines and rubrics of assignments so it’s easier for you to know what’s expected and how you need to sequence the assignment. • Ask teachers for a time estimate for completion of the task. • If possible, obtain study questions for exams that demonstrate the format as well as the content of the test. Then try to explain what constitutes a good answer and why.

30. Emotional Control – What is it? • “Modulating / controlling one’s own emotional response appropriate to the situation or stressor.”(Taken from Toplis & Neighbor) • Video - Controlling Emotions • Discussion • Incorporate all executive functions discussed: • Which were used effectively/ineffectively? • What could Homer have done differently?

31. Emotion Control • Deficits in the School Setting Can Look Like: • Is too easily upset, small events trigger big emotional response, explosive. • Peer difficulties • Discipline problems

32. Strategies for Parents – Emotion Control – The “Frontal Lobe Prosthesis” • “Prosthetic Frontal Lobe” (Voeller, 2004) • Adults anticipating consequences and providing response guidelines • Set up Conditions rather than Teach • Facilitate the development of control: Allow student to: • Take calculated risks • Experience the outcome • Reflect on self-regulation ability, especially limits • Become more sensitive to future risk-taking opportunities and ability within themselves to manage. • (Taken from Meltzer, 2007)

33. Strategies for Parents – Emotion Control • Understand the ABCs of behavior • What are the antecedents of a meltdown? • How can antecedents be managed? • Rewards vs. Consequences • Model appropriate behavior. • If student responds with emotional outburst to school work, consider returning to mastery level or adjust academic demands. • Goal is to build tolerance and reduce reactivity to stressful situations or fluctuations in workload.

34. Strategies for Students – Emotion Control • Review inhibition options. • Provide opportunities to talk about upcoming events. • Teach concrete/simple metaphor to increase emotional monitoring such as thermometer for measuring anger.

35. Emotion Control Strategies(Wagner, 2002)

36. Wrapping Up: Keeping School Achievement in Perspective • All children have strengths and weaknesses • Praise children for effort, not for grades • Sometimes it is the process that is important, not the answer • Relax and Enjoy the Ride! Sometimes sitting back and just supporting your children as they find their way is the most important thing you can “do” as a parent… • It’s important to use the strategies we’ve suggested as supportive aids. If they are causing more stress than help ask your child’s classroom teacher for other suggestions as to how you can appropriately help your child get on track!

37. Resources/Strategies • Parent Strategies Hand-Out from Taking Charge of ADHD: The Complete Authoritative Guide for Parents by Russell Barkley, Ph.D. • Student Strategies Hand-Out from Taking Charge of ADHD: The Complete Authoritative Guide for Parents by Russell Barkley, Ph.D. • Smart but Scattered: The Revolutionary "Executive Skills" Approach to Helping Kids Reach Their Potential by Peg Dawson and Richard Guare • Promoting Executive Function in the Classroom: What Works for Special-Needs Learners by Lynn Meltzer, Ph.D. • Worried No More: Help and Hope for Anxious Children by Aureen P. Wagner, Ph.D. • Late, Lost, and Unprepared: A Parents' Guide to Helping Children with Executive Functioning by Joyce Cooper-Kahn, Ph.D. and Laurie Dietzel, Ph.D. • Test Success: Test-Taking and Study Strategies for All Students, Including Those with ADD and LDby Blythe Grossberg, Psy.D. • This book was designed to help students find efficient and effective ways of studying and test-taking geared to their learning styles. One section of the book covers how students can best prepare for math tests, which cause a great deal of anxiety among many middle and high school students.

38. Works Cited Ardila, A., Pineda, D., & Rosselli, M. (2000). Correlation between intelligence test scores and executive function measures. Archives of Clinical Neuropsychology, 15(1), 31–36. Arffa, S. (2007). The relationship of intelligence to executive function and non-executive function measures in a sample of average, above average, and gifted youth. Archives of Clinical Neuropsychology, 22, 969–978 Arffa, S., Lovell, M., Podell, K., & Goldberg, E. (1998). Wisconson Card Sorting Test performance in above average and superior school children: Relationship to intelligence and age. Archives of Clinical Neuropsychology, 13, 713–720 Barkley, R. (2011). A new look at ADHD: Treatment for multiple mental health disorders & emotional regulation. Retrieved November 21, 2011, from http://online.pesi.com/catalog/catalog.asp?UGUID=&CategoryID=&ItemID=20111005- 272095-74700. Baron, I. (2003). Neuropsychological evaluation of the child. New York, NY: Oxford University Press. Castellanos, X., Sonuga-Barke, E., Milham, M., and Tannock, R. (2006). Characterizing cognition in ADHD: Beyond executive dysfunction. TRENDS in Cognitive Sciences, 10(3), 117-123. Friedman, N. P.,Miyake, A., Corley, R. P., Young, S. E., DeFries, J. C., & Hewitt, J. K. (2006). Not all executive functions are related to intelligence. Psychological Science, 17(2), 172–179. Gioia, G., Isquith, P., Guy, S., & Kenworthy, L. (2000). Behavior Rating Inventory of Executive Function. Odessa, FL.: Psychological Assessment Resources. Konishi, S., Nakajima, K., Uchida, I., Kameyama, M., Nakahara, K., Sekihara, K., and Miyashita, Y. (1998). Transient activation of inferior prefrontal cortex during cognitive set shifting. Nature Neuroscience, 1(1), 80-84. Meltzer, L. (2007). Executive function in education. New York: Guilford Press. Mischel, Shoda, & Rodriquez. (1989). Delay of gratification in children. Science, 244, 933-938. Seidenberg, M., Giordani, B., Berent, S., & Boll, T. (1983). IQ level and performance of the Halstead–Reitan Neuropsychological Test battery for older children. Journal of Consulting and Clinical Psychology, 51(3), 406–413. Toplis, R. and Neighbor, J. Stratgies and interventions: Brain injury and executive functioning. PowerPoint Presentation: http://cokidswithbraininjury.com/resources/ Wagner, A. (2002). Worried no more: Help and hope for anxious children. North Carolina: Lighthouse Press.

39. Questions? Thank You!