executive functions/ functioning resource/workbook manual …€¦ · executive functioning skills...
TRANSCRIPT
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EXECUTIVEFUNCTIONS/FUNCTIONING
RESOURCE/WORKBOOK
MANUAL
2016
ExecutiveFunctions/Functioning
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SectionI
InthissectiontheconceptofExecutiveFunctions/Functioning(EF)is
introduced.CasestudieswillbeusedinprovidingexamplesofEFweakness.
Differentiatingbehaviorsandexpectationsforage-relatedbehaviorswillalso
bediscussedinthissection.
Introduction
ExecutiveFunctioning(EF)referstomentalprocessesandskills
requiredtoorganizethebraintoactoninformationtoreachagoal.Some
peoplethinkitiseasiertounderstandexecutivefunctionswhenwethinkof
EFastheairtrafficcontrollermanagingtheplanesatanairport.EFallowsus
toretainandworkwithinformationinourbrains.EFalsohelpsustofilter
distractionsandswitchgears.
SpecificskillsofEFinclude:workingmemory,initiatingandplanning
tasks,andregulatingbehavior(impulsecontrol,emotionalcontrol).WeakEF
canoccurinchildrenwithdevelopmentaldisabilitiesaswellasthosewithout
developmentaldisabilities.EFdysfunctioncanbeviewedonaspectrum.Some
childrenmayhavemilddeficitsinexecutivefunctioningwhileothersmay
havemoresevereissues.Childrenmayalsohaveweaknessinsomeskillsand
bequiteproficientinothers.
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WhileweakEFisnotadiagnosis,itwillincreasethedifficultiesof
managingday-to-dayactivitiesandeducationalsuccess,forpersonswiththis
disorder.WearenotbornwithEFskills;theymustbelearned.Theprocess
forlearningEFskillsisslowandsomepersonsneedmoreassistancein
learningtheseskillsthanothers.
TheexactnumberofchildrenwithweakEFisnotknown,however,itis
becominganincreasinglymorecommonconcern.Specialeducationexperts
arebeginningtorecognizetheeffectthatweakEFhasonaperson’sacademic
success,andtheirabilitytobecomeindependentwithinthecommunity.
Schoolstaffandcommunitymembersmustbecomeeducatedwithissues
associatedwithweakEF,inordertoadvocateforstudents’needs.Learning
howtodevelopplanstoimprovestudents’EFwillenablethesechildrento
reachtheirfullpotentialasadults.
StaffatParentsReachingOutaredevotedtoeducating,supporting,andadvocatingforfamilieswhohavememberswithdevelopmentaldisabilities.
Thismanualwillprovideeducationalinformationandpracticalstrategiesfor
familiesandprofessionals.Whilethismanualisnotintendedtoreplace
professionaladvice,itcanprovidesomeinformationandresources.Theideas
presentedinthismanualcanbeusedintheschoolsandathometoenhance
EFfunctioningforthoseneedingextrasupport.
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Ifyouhaveanyquestionsorconcernswhilereadingthisguide,please
donothesitatetocontactParentsReachingOutformoreinformation.
CaseStudies
ToillustrateExecutiveFunctionsweakness,pleasereviewthecase
studieslistedbelow:
• Lisaisa15-year-oldin9thgrade.Sheisadecentstudentwholikes
schoolanddoesn’tminddoingherhomework.Unfortunately,she
forgetstoturnitin,sosheisfailingseveralclasses.
• Iryna,13yearsold,in8thgrade,neverstartsprojectsontime.Shewill
beginworkingthedaybeforeaprojectisdue.Shefailstoobtainallthe
neededmaterialsanddoesnotcompletethework.Whilesheenjoysthe
projects,hergradessufferfromherpoorplanning.
• Anthony,11yearsold,receivesinstructionsfromhismotherregarding
thechoresheneedstocompletebeforehegoesoutsidetoplay.Afew
minutesafterbeingtoldwhatneedstobedone,hereturnstoaskforthe
informationagain,ashecannotrememberthelistoftasks.
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• Rosa9-years-old,islatetoschoolalmosteveryday.Whilesheis
awakenedandproddedtogetreadyforschool,shecannotgetouton
time.Thiscreatesgreatfrictionbetweenherandherparents.
• Hania,10yearsoldhasdifficultydoinghismathhomework.Many
nightshehasdifficultycompletingtheworkandoftentellshisparents
thathehasfinishedhiswork,wheninrealityhegaveup.
• Lee,asix-year-oldmale,hasdifficultymovingfromoneactivityto
another.Hehasthegreateststresswhenaplannedactivityiscancelled
orchanged.Attimeshehasevenexperiencedmildpanicattacks.
EachoftheabovescenariosshowsaweaknessinExecutive
Functioning.InTable1youwillseealistofExecutiveFunctioningskillsand
examplesofweaknessesineacharea.YoucanbegintoidentifytheEF
weakness(es)intheperson(s)inyourlife.IntheAppendixyouwillfind
questionnairesthatwillalsoassistinidentifyingareasofEFweakness.
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Table1.ExecutiveFunctioningskillsandexamplesofweaknessesintheseareas.
ExecutiveFunctioning
Skill
DefinitionofWeaknessinEFArea Example
1.WorkingMemory
Inabilitytoholdontoinformationtocompleteatask.Difficultyfollowingdirections;maynotbeabletoprocessmultisteptasks.
Maybeginatask,thenneedtohavedirectionsrepeated.Maynotrememberwhats/hewasgoingtosay.
2.Flexibility
Inabilityforchildtochangeapproachestotaskswhenaplanisnotworking.Maythinkmoreconcretelythanothers.
Iffamilychangesplansatlastminute,childmaygetveryanxiousandevenpanic.Child/adolescentmayhavedifficultymovingfromoneactivitytoanother(transitions).
3.TimeManagement
Child/adolescentdoesnothaveawarenessofhowlongtaskstaketocomplete.Maywaituntilthelastminutetoworkonaschoolprojectorperformchoresathome.
Beginsascienceprojectthenightbeforeitisdue;projectmaythenbeincompleteorcompletedsloppily.
4.EmotionalControl
Childmaynotbeabletomanagefeelings;mayhavedifficultybeingcorrectedformistakes.Closelyalignedwithimpulsecontrol.
Whenachildhasdifficultywithatask(difficulthomework),theymaygetupsetandnotcompletetheassignment(oraskforhelp).
5.ImpulseControl
Child/adolescenthasdifficultythinkingbeforeacting.Theymayengageinunsafeorriskybehaviorswithoutfullythinkingaboutconsequences.Thisissuealsoincludesdifficultywithinhibition.
Mayblurtthingsoutofturn.Mayrushthroughhomework.Mayengageinhigh-riskbehaviors.Maynotbeabletostopbehaviorsthatchild/adolescentknowsthats/heshouldnotengage.
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Adaptedfrom:Packer,L.(1998-2015).OverviewofExecutiveDysfunction
Ifweapplytheaboveinformationtoourcasestudieswecanseethat:
• Lisa,whoforgetstoturninherhomeworkhasdifficultywith
organizationalskills.Shewillneedhelpinarrangingherbackpack
6.Organization
Child/adolescenthasdifficultyrememberingwheres/heplacedthings.Mayloseormisplaceitems.
Childmayforgettoturnincompletedhomework;forgetsclothing,sportsequipment,andelectronics
7.Goal-directedpersistence
Child/adolescentneedstobeableto“stick”withahardjobuntilitiscompleted.
Child/adolescentmaynotbeabletocompleteajob/tasktoreachagoal—thismaybequitedisabling.
8.SustainedAttention
Child/adolescentfrequentlydistractedduringactivities.Mayseemtoappeardisinterestedinclass,ornothearinstructionsgiven.
Mayhavedifficultyinclassespayingattentiontoanentirelesson.
9.Planning/Prioritizing
Thisskillinvolvesbreakingdowntasks/projectsintothestepsrequiredtocompletetheproject.Child/adolescentmaynotknowhowtobeginaproject.
Maylackskillstodeterminestepstocompleteaschoolproject.Doesnotprioritizethestepsneededtogetmaterialsandotheritemsforaproject.(example:cannotstartascienceproject).Waitsuntillastminute.
10.Self-monitoring
Child/adolescentsmayhavedifficultyevaluatingtheirownperformance—lackingawareness.
Child/adolescentmaynotcheckcompletedwork(orexams).
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toplacehomeworkinaconsistentplacewhenfinished,soshecan
finditwhenitistimetoturnitin.
• Irynaneedshelpwithtimemanagementwhereshewillneedto
learnhowtogetaprojectcompletedbyacertainduedate.Shealso
needshelpintheEFskillofplanningandprioritizing.
• Anthonyhasdifficultywithworkingmemory.Heneedshelp
learningtoperformroutinechoresanddutieswithoutconstantly
beingremindedofthelistoftasks.
• Rosalikelyhasacombinationofdifficultiessuchastaskinitiation,
movingfromonetypeofactivitytoanother(flexibility),andtime
management.
• Hania,needshelpinreachinghisgoalwithoutdeveloping
frustration.Thisistermedasgoal-attainmentpersistence.
• Leehasissueswithflexibilityandwillneedhelpadjustingto
change.
TestYourKnowledge:1. Whenachild/adolescenthasdifficultymovingfromoneactivitytoanothertheyhavedifficultywith______________________________________.
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2. Forachildwhohasdifficultyrememberingseveralstepstoatask,thisisaweaknessin__________________________________________________________.
3. Achildwhocannotplanthestepstocompleteacomplexprojectovertimehasdifficultywith_____________________________________________________.
4. Lackingtheabilitytopredicthowmuchtimeataskwilltakeisknownasdifficultywith____________________________________________________________.
5. Achildmaynotbeabletocontinuetoworkonaprojectwhenitbecomesdifficultandmaygiveup.Thisweaknessisknownas________________________________________________________________________________.
6. Achild/adolescentwhoforgetstoturninhomeworkandhasdifficultykeepingpapersinorderintheirbackpackhasdifficultywith_____________
__________________________________________________________________________________.7. Whenachild/adolescentblurtsoutanswersinclassandhasdifficultywaitingforhis/herturn,thisisknownas___________________________________.
8. Achild/adolescentwhohasdifficultypayingattentioninclassmayhavethisparticularweakness_____________________________________________________.
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AnswerKey:
1.Flexibility 2.WorkingMemory 3.Prioritizing/Planning
4.TimeManagement 5.Goal-orientedPersistence 6.Organization
7.PoorImpulseControl 8.SustainedAttention
Fromtheabovecasestudies,wecanbegintoseethatattheagesstated
thechildrenhavedifficultymeetingexpectations.Whatishelpfulforteachers
andfamiliesistohaveabasicunderstandingofwhatage-appropriate
behaviorsinclude.Belowaresomeexamplesofbehaviorsthatcanbe
expectedforchildrenintheagegroupsdescribed.Listedbelowaresome
questionstoaskteachers,primarycareproviders,andyourself.Atwhatages
shouldchildren/adolescentsbeabletodoaspecificactivity?
• Atwhatageshouldachildbeabletodresshim/herself,andgetready
forschool(whatsupports)?,
• Atwhatageshouldachildbeabletomanagealevelof
frustration/disappointment?
• Atwhatageshouldachildbeabletofollow2-3stepinstructions?
• Atwhatageshouldachildbeabletodeterminehowmuchtime
homeworktakesandplantheireveningaccordingly?
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• Atwhatageshouldachild/adolescentbeabletoplanandcarryout
stepsforaschoolprojectwithminimalassistance?
Teachers,families,healthcareprofessionalsarefamiliarwithgrowthand
developmentinchildrenwithoutdisabilities.Belowyouwillfindalistofwhat
isconsideredage-appropriateactivities.Whilethereissomevariationinall
children,thelistbelowcanassistinidentifyingifyourchild/adolescentis
achievingcertainbehaviorsbytheageexpected.
SampleListofAge-AppropriateBehaviors
3—4YearsOld1. Completesimple,singlesteperrands:“Pleaseputclothesonyourbed”.
2. Takesomeplatesfromdinnertabletothesink.3. Easilyinhibitsunsafebehaviors:don’ttouchhotstove,don’tgrabanotherchild’stoy.
5—7YearsOld1. Cancomplete2—3steperrands:Bringthedishestothesinkandfillthesinkwithsomewater.
2. Straightenupbedroomorplayareaindependently.3. Assistwithsimplechoresinthehome(mayneedreminders).
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4. Bringschoolsuppliestoandfromschool.5. Completehomework(20-30minutesmaximumwithminimalassistance).
6. Iftemperoutburstsstillexist,theyareshortandeasilydiverted.
8—11YearsOld
1. Rememberstobringhomeimportantpapersfromschool.
2. Independentlyperformschoresthatcantakeupto30minutestocomplete.
3. Keepstrackofbelongingswhenawayfromhome.
4. Cancompletehomeworkindependently(upto60minutes).
5. Cansaveearnedmoneyforawanteditem(delaygratification).
6. Canwaittobecalledinclassbeforespeaking.
7. Olderchildrenmaybegintocareforyoungersiblings.
8. Olderchildrenmaybegintobetrustedtobealoneinthehouse.
9. Avoidsgettingintophysicalaltercationswithotherchildrenatschool.
12—14YearsOld1. Mayberesponsibleforarrangingtheirschedule.
2. Canindependentlydotheirhomeworkandplantheiractivities.3. Canindependentlydochores(60—90minutes).
4. Canbabysityoungersiblingsandnon-relatedchildren.
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5. Canfollowsafetyruleswithoutrequiredsupervision.
6. Canplanandcarryoutlong-termprojects.
Usethespacebelowtoaddbehavioralexpectationsforthechild(ren)in
yourclassroom/family.
1. ______________________________________________________________________________
2. ______________________________________________________________________________
3. ______________________________________________________________________________
4. ______________________________________________________________________________
5. ______________________________________________________________________________ ChildrenarenotbornwithExecutiveFunctioningskills;theymustbelearned.Childrenare,however,bornwiththeabilitytoacquireEFskills.ThemannerofdevelopingEFskillsisaslow,progressiveprocess,beginningininfancyandcontinuingtoyoungadulthood.ChildrenbuildEFskillsthrough
activitiesandsocialinteractions.OvertimeEFcompetenciesmaybepracticed
anddeveloped.
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DevelopmentofExecutiveFunctionsSkills
ChildrenbegintobuildtheirEFskillsbyparticipatinginmeaningful
socialinteractionsandenjoyableactivities.Throughgames,play,andschool,
childrenbegintoworkontheEFskillsandbehaviorregulation.Adultsneedto
supportchildrenwhiletheylearn,andslowlyreducesupportsothatthechild
canbecomemoreindependentinEFskills.
Severalactivitieshavebeenidentifiedasage-appropriateevents,which
mayenhancethelearningofEFskills.Whiletheyarenotallresearch-based,
manyexpertshaveagreedthatcertaineventswillallowchildrentopractice
andperfecttheirEFskills.Manyoftheseactivitiesparentsroutinelydo.This
resourcebookprovidesasampleofundertakingsthatwillenhancethe
developmentofEFskillsinchildren/adolescents.Inaddition,further
resourceswillbelistedintheAppendix.
Table1.ExecutiveFunctioningSkillDevelopmentfor3-5year-olds
Introduction
Betweentheagesof3-5children’sEFskillsmatureatarapidpace.
ImaginaryPlay
Childrenlearntoplaycooperatively,andactoutexperiencesintheirownlife,suchasnurse,mommyordaddy,etc.Parentscanhelpchildrenbyprovidingdifferentprops(clothing,playtools).Assistchildrentoalsouseotheritemsaspretend,example.tapeasaband-aid.Thiswillaidchildrentolearnaboutflexibility(anduseimagination).
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Parentscanalsoassistchildrentodrawaplanonpaperbeforetheyactouttherole(s).Thishelpschildrentolearntothinkfirst,andthenact,whichassistsinlearningimpulsecontrol.
Storytelling
Youngchildrenlovetellingstories.Oneideaistohaveafewchildrenworktogethertotellastory.Onechildbeginsthetaleandeachchildinturnaddsontotheexistingnarrative.Childrendevelopworkingmemoryskills.Ifyouspeakasecondlanguagetoyourchild,ithelpsbuildfluency,andworksonmanydifferentEFskills.
Songsandgamesandotheractivities
Songs,gamesandmovingtomusicaidchildreninworkingmemoryskillsandinhibitorycontrol.Encouragechildrentoparticipateinawiderangeofactivities.Whenlearningnewandchallengingactivitieschildrenlearntofocusattentionandgoalorientedpersistence.Quietgamessuchasmatchingteachworkingmemoryandcognitiveflexibility.Puzzlesaidinworkingmemoryandplanningskills.Cookingisafunactivitywherechildrenpracticeworkingmemory,inhibitorycontrolandfocusing.
Table2.ExecutiveFunctioningSkillDevelopmentfor5-7yearoldsIntroduction
Childrenatthisageareveryindustriousandactive;theyliketobechallengedandlearnnewthings.
CardGamesandBoardGames
Cardgamesandboardgamesrequiringuseofmemoryskillsand/orlearningstrategiesarehelpfulforstudentstolearnEFskills.
PhysicalActivities
Physicalactivitieswillassistinthelearningofattentionandinhibition,especiallythosethatrequirestartingandstoppingduringtheactivity.Fastgamesinvolvedecision-makingandself-control.Whenchildrenparticipateinorganizedsports,martialarts,andothermindfulnessactivitiestheydevelopenhancedfocusandattention.
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Activitiesrequiringstrategyandreflection
Age-appropriatepuzzles,brainteasersandmorecomplicatedmatchinggamesexerciseattentionandproblemsolvingskills---whichenhanceworkingmemoryandcognitiveflexibility.Logicandreasoninggames—Rubik’scube,TrafficJamexerciseworkingmemory,reasoningskills,andcognitiveflexibility.
Table3.ExecutiveFunctioningSkillDevelopmentfor7-12yearoldsIntroduction
Forchildren7-12,similaractivitiesaspreviouslydescribedcontinue.Childrenwillneedtobecontinuallychallengedwithincreasinglymorecomplexactivitiesandsports.
Cardgamesandboardgames
Challengingboardgamesandcardgamesthatincludeneedingtorememberandstrategizewillexerciseworkingmemory.Cardgamessuchasginrummyandotherswillalsoprovideenhancedcognitiveflexibility,attentionanddecision-making.Gameslikechessrequirestrategies,whichenhanceworkingmemory,decision-makingandmanyotherskills(focus,attention).
Adaptedfrom:HarvardUniversity,CenterontheDevelopingChildwww.developingchild.harvard.edu
Atthispointyoushouldhavesomeideaoftypicalactivitiesachild
shouldbeabletoperformatacertainage,andwhatbehaviors/skillsmay
indicatethatyourchild/adolescentmayneedsomeassistance.Onceyouhave
identifiedthatyourchild(ren)needsupport,youcanrequestanevaluation
throughtheschoolforyourchild.
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SectionII
WewillnowlooktheliteratureonExecutiveFunctions/Functioning,
whichmaybealittlemorehelpfulinunderstandinghowEFisimportantto
learningandsocialinteractions.
InSectionIabroadoverviewofExecutiveFunctioning(EF)was
described.CasestudiesgivingexamplesofweakenedEFwerealsoprovided.
Wethenlookedattypicalexpectationsofchildrenatcertainpointsintimein
theirlife.InSectionII,amorein-depthlookofEFwilltakeplace.Theprocess
regardinghowEFweaknessisidentifiedandhowyoucanexpeditethe
processofhavingyourchild/studentevaluationisoutlined.Reviewingthe
literatureandresearchregardingEFwillalsobeincludedinthissection.
ExecutiveFunctioningSkillsreferstotheinteractionsinourbrains
requiredtoperformtasksandgetthingsdone.Saidinanotherway,Executive
Functions(EF)arecentralprocessesthatgiveorganizationandordertoour
actionsandbehaviors(Packer,2015).Sometimestheseabilitiesarecalled
mentalskills.InsectionIwetalkedabout:planning,organizing,prioritizing,
rememberingthings,regulatingbehavior,andusingbehaviorfromthepastto
solvepresentissues.ChildrenwhohaveweakEFmayhavedifficulty:a)
keepingtrackoftime,b)makingplans,c)multitasking,d)analyzingideas,e)
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timeplanningand,f)learningfrompastexperiences(Morin,2014).When
childrenhaveweakEFtheywillhavegreaterdifficultyinanalyzingtasksand
breakingthemdownintosmallersteps.
ChildrenneedEFskillstodevelopintoindependentmembersoftheir
community.EFskillsalsoenablepositivebehaviorandallowustomake
healthychoices.EFskillscanbetaughtandcurrentEFskillscanbeimproved.
Whilethismayrequirepatienceandworkonthepartofparentsandschools,
theoutcomeisabetterprepared,moreindependentyoungadult.
Currently,wedonothavedataonhowmanychildrenhaveEF
weakness.Wedoknowthatitisverycommoninchildrenbothwithand
withoutdisabilities.DisabilitiesthatcommonlyhaveEFweaknesses
associatedwiththeminclude:a)AttentionDeficitHyperactivityDisorder,b)
AutismSpectrumDisorder,c)FetalAlcoholSyndrome,d)Cancerpatientson
chemotherapeuticagents,and,d)LearningDisabilities.
AtthispointintimenooneknowsexactlywhatcausesEFweaknesses.
Expertsbelievethatthereisacombinationofinfluencesthatcreatethe
environmentforEFdysfunctiontooccur:a)genetics,b)differencesinbrain
function,particularlytheareacalledthepre-frontalcortex,andtheeffectof
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neurologicalconditions,mooddisorders,andotherdevelopmentaldisabilities
(Morin,2014).
SpecificsymptomsthatmayindicateanEFweaknessinclude(Morin,
2014)
§ Difficultyfiguringouthowtobeginamultisteptask.
§ Unabletofigureouthowmuchtimeittakestodoatask.
§ Maydothingsveryslowlyandrunoutoftimetocompletetask.
§ Maydotasksveryquicklyandsloppily.
§ Getseasilyfrustratedwhenworkingonataskthatisdifficult.
§ Hasdifficultypayingattention;losesthoughtwheninterrupted.
§ Difficultyfollowingdirections;needstobetoldseveraltimes.
§ Unabletoeasilyswitchactivities.
§ Difficultyprocessinginformation(Morin,2014).
Aschildrenmature,expectationsbecomegreater.EFweaknessmaynot
beasnoticeableinyoungerchildren,butmaybecomeparamountlaterin
childhood/adolescence.InterventionstoimproveEFfunctioningcanbeginat
anyage.
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EFweaknessescanbediagnosedthroughacomprehensiveprocess.
Parentsandteachersmaynoticecertainareasofweaknessthatastudenthas
throughobservationandrecordkeeping.Onceaconcernregardingstudents’
abilitiesisnoteditisrecommendedthatthefollowingprocesstakeplace:
1. Itisimportanttokeeptrackofyourchild(ren’s)/student’sdifficulties.If
youcankeepabrieflogthatwouldbehelpfulinformationtobringto
healthcareprovidersandschoolofficials.
2. Onceyounoticethedifficulties,itisimportanttohavethe
child/adolescentevaluatedbyaprimarycareprovider.Itishelpfulto
lookatanymedicalissuesfirst;hearingandvisualtestsamongothers
maybeordered.
3. Comprehensivetestingcanberequestedthroughtheschool.
Professionalssuchasspecialeducationteachers,socialworkers,and
psychologistsmaythendoevaluationsandtestingtonarrowdown
whatissuesmightbeoccurring.
4. Anassessmenttool,theBehaviorRatingInventoryofExecutive
Function(BRIEF)isaquestionnairespecificallyevaluatingexecutive
functioningskills.Bothparentsandteacherscompletethis
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questionnaire.Thereisalsoaself-reportforschool-age
children/adolescentstocomplete.
5. Intelligencetestingmayidentifycomprehensionissuesandprocessing
disorders.
6. Professionalsusuallyalsowanttoobservethestudentintheschool
settingtodetermineanyenvironmentconcerns.
7. Oncetheinformationiscollected,theprofessionalswillreviewthe
results.Theymayofferstrategiesthatmightbehelpfultoassistyour
child.Youwillalsobeabletousethisinformationtoobtainan
IndividualizedEducationPlan(IEP)(Morin,2014).
8. Becominginvolvedinsupportgroupsandorganizationsthatprovide
education,advocacy,andsupportarealsoveryhelpful.Parents
Reachingouthasmanyworkshopstoaidfamiliesinlearninghowto
managethemanyissuesfacedwhenlivingwithachildwithdisabilities.
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TestYourKnowledge
1. ListsomesymptomsofEFweakness.
a. __________________________
b. __________________________
c. __________________________
d. __________________________
e. __________________________
2. AnswerthefollowingstatementswithTforTrue,andFforFalse.
a. ExecutiveFunctionsmayalsobecalledmentalskills.______
b. GeneticsandbrainfunctionmaycontributetoEFweakness.______
c. Parentshaveanimportantroleinkeepingalogoftheirchild’sdifficultiesandhavingchildevaluatedbytheirprimarycareprovider. ______
d. Thereisasimple,singletesttodiagnoseEFweakness______
Answers:
1.a)Unabletofigureouthowmuchtimetasksrequire,b)maydotasksveryslowlyandrunoutoftime,orquickandsloppy,c)easilyfrustratedwhenataskisdifficult,d)difficultypayingattention,e)difficultyfollowingdirections,f)hasdifficultyswitchingactivities.
2)a.True b)True c)True d)False
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ResearchonExecutiveFunctioningWeaknesses
InaresearchstudyperformedbyKroesbergenVandeRittandVanLuit
(2007)theeffectsofExecutiveFunctioningWeaknessonmathematicalability
wasstudied.Atoolthatmeasuredinhibitionability,shifting(flexibility)
planning,andworkingmemorywasusedtoevaluateEFweaknesses.The
weaknessesofthestudentsEFskillswerecomparedwiththeirmathematical
ability.Thesampleincluded240Kindergartenchildren.Therewasa
correlationbetweenthemathematicalscoresandEFweaknesses,inthatthe
EFskillswerehighlyrelatedtochildren’smathcompetence.Childrenwith
weakerEFfunctioninghadpoorermathskills.Theinvestigatorsdetermined
thatthroughotherdataonthechildrenregardingtheirintelligencequotients
(IQ),thatEFskillsmaybemoreimportantthanIQ(KroesbergenVanderRitt
andVanLuit(2007).
Cantin,Gnaedinger,Gallaway,Hesson-McInnis,andHund(2015)looked
atthefollowingEFskills:workingmemory,flexibility,andinhibition.They
comparedtheseskillstomath,reading,andtheoryofmind(socialskills)
scores.Theirsampleincluded87studentsbetweentheagesof7—10.Their
studyconcludedthatEFskillsaffectsastudent’sabilitiesinmath,reading,and
socialskills.TheauthorsrecommendthatscreeningforEFfunctionsalong
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withtraditionalinstrument.willassistinobtainingappropriatesupportfor
children.TheyalsorecommendedthatEFtestingshouldbeginearlyin
elementaryschool,totoallowforearlyinterventionandsupport(Cantin,
Gnaedinger,Gallaway,Hesson-McInnis,andHund(2015).
AstudyperformedbyRomer,Betancourt,Giannetta,Brodsky,Farah,
andHurt(2009)investigatedtheeffectsofworkingmemory,cognitive
control,andrewardprocessingbyassessingrisk-takingabilityand
impulsivityamong387preadolescentsbetweentheagesof10-12yearsof
age.Theresearchersrecommendedlookingatchildrenthathaveimpulse
tendencies(poorimpulsecontrol)relatedtolowEFskillsandprovideearly
interventionforthem.Earlyinvolvementwiththeseselectedpreadolescents
mayreducethelikelihoodofhigh-riskbehaviorsthatmayoccurlaterin
adolescence(smoking,alcohol)(Romer,Betancourt,Giannetta,Brodsky,
Farah,andHurt,2009).
Take-awaysfromtheresearch:
• Math,reading,andsocialskilldevelopmentarehighlyrelatedto
EFfunctioning.
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• ExecutiveFunctionabilitymaybemoreimportantthan
intelligencequotient(IQ).
• SchoolsshouldbegintoevaluateEFskillsalongwithtraditional
testingforchildren/adolescentswhoarehavingdifficulties
academically.
• Earlyinterventionprogramsmayreduceriskybehaviorsforthose
whohaveimpulsecontrolissuesandweakEF.
ExecutiveDysfunctionisfoundinchildrenbothwithandwithout
developmentaldisabilities.CommondiagnosesinwhichweakEFisfound
include:AttentionDeficitHyperactivityDisorder,Autism,FetalAlcohol
Syndrome,IntellectualDisability,andotherLearningDisabilities.Children
withdevelopmentaldisabilitiesalreadyhavelearningchallenges.WeakEF
compoundsthoseissues.Childrenwithdifficultiesinschoolwillrequirean
IndividualizedEducationPlan(IEP).However,anystudentwithweakEFmay
likelyneedextrahelpathometolearntoenhancetheirEFskills.
AssessingEFWeaknessinAdultsandChildren
SeveralbooksonthemarketaddressingEFissuesofferassessment
toolstoidentifyEFweaknesses.Thesetoolsmaybehelpful.However,theyare
notconsidereddiagnostic.InAppendix,youwillfindassessmenttoolsfor
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childrenseparatedintodifferentagegroups.Youwillneedtofillinthe
informationforyoungerchildren;forolderchildrenyoucanassist.Youwill
alsofindanassessmenttoolforadults.ManyadulthaveEFweaknesses,too.
Youmightfindtheassessmenttoolshelpfulinidentifyingareasofconcernin
yourchild(ren)andinyourself.
WhenbothparentsandchildrenhaveEFweaknesses,thereareseveral
issuesthatcanarise:
a) IfyouarestronginoneEFareaandyourchildisnot,youmayhavea
hardtimeunderstandingyourchild’sdifficulty.Youarealsointhe
bestpositiontohelpyourchildinthoseareas.
b) Whenchildrenandparentshavedifferentareasofstrengthsand
weaknesses,theycanlearntosupporteachother.
a. Trytogetchildtoacceptparent’shelp
b. Askchildtoassistincreatingstrategiesthatarehelpful
c) IfparentsandchildrenhavethesameEFweaknessestheycanhave
empathyforeachother.
a. Tryandfindhumoraboutsharedweaknesses,
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b. Sinceneitherissuperior,brainstormtogetherabout
resolutions,
c. Reduceyourownfrustrationbyrememberinghowitfeltto
havethesamechallengesasyoumatured,
d. UseasystematicapproachtoaddressingyourownweakEF;
youmaywanttoaddresssomeofyourownissuesalongwith
yourchild’s.
e. Seekoutsidehelp,ifneeded.
EFweaknessisonaspectrum;somechildren/adolescentshavemild
weaknesses,othersmoresevere.Achildmayalsohaveaweaknessinone
areaandstrengthsinanother.Familiesneedtoidentifytheareasofweakness
thatneedinterventions/supporttohelpbuildthedeficientEFskill.
Atthispointwewilllookatsomegeneraltipstohelpchildrenwith
differenttypesofEFweaknesses:
1. Developasmanyroutinesforchildren/adolescentsaspossible.
2. Placesignsthroughoutthehomeasreminderse.g.
a. Rememberbackpack,sportsequipmentsignnearthefrontdoor,
asareminderbeforeleavingthehouse.
b. Brushteeth,washfacesignonthebathroom(pictures).
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c. Takemedicationsign,inthekitchen(foryoungerchildrenor
thosewithlowreadingcomprehensionmayusepictures).
d. Haveasetofbooksatschoolandathome(notalwayspossible).
e. Sendteacherpencilstokeepincaseyourchildforgetsone.
f. Cleanoutchild’s/adolescent’sbackpackonceaweek.
g. Askteachertocheckchild’splannerdaily.
h. Reduceclutterinthehome;makesurethatthereisaplacefor
everythingandasoftenaspossible,everythinginit’splace.
i. Useoftechnology(olderchildren)toorganizeinformation,set
alarms,orsendchildtextsasreminders.
j. Forolderchildrenwhoforgettoturninhomework,askteacher
ifitcouldbeemailed.Providechild/adolescentwithhardcopy
tolearntoremembertoturnitin(workonkeepingfolderor
specificlocationinbackpackwherehomeworkwillbeplaced).
Formanystudentstheabovemaybeenoughforthemtointernalize
routines,andexpectations;forothersmoreexplicitinstructionsarerequired.
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SectionIII
InSectionIIIwearegoingtolookatmorespecificstrategiestohelp
children/adolescencesimprovetheirEFskills.Thesestrategieswillrangein
complexity.Thismanualisattemptingtoprovidearangeofoptionstomeet
individualfamilyneeds.
Mostofthestrategiesincludedinthemanualwillinvolvethe
developmentofchecklists,ActionPlans,andevaluationtools.Thepurposeof
thesetoolsistohelpthestudenttointernalizeroutinesandprocessesthatare
taughtthroughexternalmethods.
Thestatementmovingfromexternaltointernalisaprocessinhelping
children/adolescentstolearn.Whenweteachyoungchildrentocrossthe
street,webreakdowntheprocessintosmallsteps:a)holdmyhand,b)wait
forthewalkingman,c)lookbothways,d)safelycross.Childrenaretoldthis
bymostadultshundredsoftimes.Eventually,childrengettoastoplight,wait
forthewalkingman,lookbothways,andthensafelycross.Theyhavelearned
thematerialthatwasgiventothem(externally)andtheninternalized.When
helpingchildrenwithEFdysfunction,thesameprocessapplies.EFskillscan
betaught,andmaytakealongtimetolearn.Inthissectiontherearemany
samplesofplanstoassistchildren/adolescentstoimproveEFskills.
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PrinciplesforAssistingChildren/Adolescents
• Considerchild’sdevelopmentallevel.
• Createroutinesandschedules;beasconsistentaspossible.
• Breakdowncomplexskillsintosmallertasks.
• Modifytaskstomatchyourchild’sabilitytoexerteffort.
• Useincentives.
• Provideenoughsupporttomakethechildsuccessful.
• Keepsupportsinplaceuntilchildhasmasteredskill;donotletyour
childgetfrustratedoveratask.
• Whenyoustopsupport,doitgradually.
• Helpchildtoreducestress,anxiety,andanger.
• Ensureinstructionsareclear;writethemdown.
Useofchecklists,instructions,andotherbasicstrategies.
Onoftheeasiesttoolstohelpchildren/adolescentsistheuseof
checklists.Theycanbewrittenverysimplywithfewinstructions(and/or
pictures)foryoungchildren,tobeingcomplexforolderchildren/adolescents.
Pleaseseebelowchecklistasasample.Youcanaddorsubtractasneeded.For
youngerchildren,itisrecommendedthatthechecklistbeinsimplewords
(andpictures),andfewactivitiesonthelist.
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Checklist--ActivitiesforYoungChildren
Activity Picture(ifneeded)
Checkbox
Makeyourbed
Brushyourteeth
HelpMom/Dad/Grandmasetthetablefordinner.
Takedinnerdishestothesinkafterdinner
Puttoysaway
Putonpajamas
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Thisnextchecklistissmallandcarrieswithitinstructionsforparentstohelptheirchildorganizetheirbackpack.Achild,suchas11-year-oldAnthony,whohasdifficultywithorganizationalskillswillneedsupportinmanagingthistask.
HelpingYourChildOrganizeHis/HerBackpack
1. Donotassumeyourchildknowshowtoorganizeabackpack(evenifyouhaveshownittohim/her,ortheirteachercreatesalist).
2. IfyourchildhasanIEP,asktheschooltogothroughchild’sbackpackonceperweek.
3. Parents/guardiansneedstogothroughthebackpackatleastonceperweek.
4. Keeptoolsinbackpacksimpleandtotheminimum(havesomesuppliesathomeandatschool).
5. Throwout(orfile)unnecessarypapers.
6. Developachecklistforwhatbelongswhere(youcanguaranteefortheaveragechildwithEFdifficultiesyouwillneedtoreorganizewherethingsshouldbe—manytimes).
7. Attempttoworkwithchildtoorganizethebackpack/notebook.
8. Fortheverydisorganizedchild,youmusttakeveryslowsteps(thisislikelyanareaofgreatfrustrationforthechild/teen).Youwillneedtoreviewoftenandassistfrequently.
9. Labelallfoldersclearlyandinboldprint/largeletters(e.g.homework—bringtoschool).
10. Manyschoolsgiveloosehandouts;youwillneedtopunchholesorglueintoanotebook.
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11. Nomatterwhatsystem,yourchildwillforget,loose,ordestroypapers—Asktheteacherforextracopies(makesurethisaccommodationisontheIEP).
12. Youwilllikelyhavetoadjustyourchild’ssystemseveraltimesuntilyourchildcanfigureoutwhatworksbest(ordoesn’tworkatall)forhimorher.
13. Inadditiontobackpacklists,youcanmakeachecklistforwhatyourchildmustdodailyinschool.
a. Writeassignmentsinplannerb. Duedatesinplannerforprojectsc. PutinstructionsforprojectsinXfolder
Checklist:Youcanaddtothelist;stillkeepingitsimple.Engageyour childintheprocess.____________NotebookordividerforMath(andsubsequentclasses)____________PlannerinfrontofNotebook____________Holderforpens,pencils,ruler,gluestickinfrontofplanner____________SeparatefolderforHomework___________(Addyourown)___________(Addyourown)
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Forchildren/adolescentswithtimemanagementissues,alongwithplanningandlearningtoprioritize,suchasIryna,achecklistishelpfulforlearningtoplanforprojects.Workwithyourchildtoplanthestepsrequiredfortheprojects.
Assignment/ProjectChecklist
Assignment:__Ex:ScienceProject_____________________DueDate:_____Onemonthfromtoday_______________
WhatStepsNeedToGetDone??
HowMuchTimeDoINeed?
WhenDoesIt
NeedtoBeDone?
Completed
1.Writealistofitems/toolsneededfortheassignment.
10Minutes
Bytheweekend
2.Checkinthehousefortheitemsrequired/listed.
20Minutes
Bytheweekend
3.TellMom/Dad/Grandmawhatitemsmustbeboughtfromstore(orasktheschool).
10Minutes
Bytheweekend
4.Buy/Obtainneededsupplies
60Minutes
OntheWeekend
5.Plantimestoworkonproject—bespecificaboutdatesandtimes
6.Pleaseaddmorestepsasneeded.
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Manychildren/adolescentsneedhelpinlearninghowtostudy,especiallyinpreparationforexams.Regardingyoungerchildrenmostoftheinformationistaughtinclass,andreinforcedthroughhomework.Forolderchildrentheymayneedtoresearchorstudynewinformationontheirown.Achecklistmaybehelpfulforthosestudentswhohavedifficultyinorganizingstudytimefortests,orjustneedto“see”thestepsrequired.Thefollowingchecklistmaybehelpful.
StudyHabits/TestTakingSkillsChecklist1. Attendallclasses.
2. Ifyoumissaclassmakesurethatyougetthenotesfromafriendortheteacher.
3. Doallthehomework;ifyouhavedifficultywiththehomeworkgethelp.
4. Organizethematerials/notes/homeworkthatwillbeonthetest.
5. Reviewpastteststoseewhattypesofquestionstheteacherasks.
6. Whatkindoftestwilltheteachergive?Multiplechoiceoressay/shortanswer
7. Planoutyourstudytime;choosetopicsandhowlongyoushouldstudythattopic.
8. Writedownascheduleforstudying.
9. Howwillyoubestudying:readnotes,studyflashcards?
10. Forthenightbeforethetestyoushouldjustreview.
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Checklistscanbeveryhelpfulinbreakingdowncomplicatedprocessesintosmallerstepsforyourchild/adolescent.Chooseonlyoneortwoareasofconcernatatime.Youdonotwantyourchild/adolescenttogettiredofchecklists,orbegintoignorethem.Onceyourchildseemstohaveinternalizedaprocessyoucandiscontinuethatchecklist.Rewardyourchildforstickingtothechecklist,andworkingtowardsimprovingtheirskills.Afterashortbreak,youcanintroduceanotherlist. Wearenowgoingtolookatamorecomplextypeofchecklist.This
typeofchecklistisviewedmorelikeacontractwithyourchild/adolescent.It
iscalledanActionPlan.ItismosthelpfulwhencreatinganActionPlanthat
youengageyourchild/studentintheprocess.Forthistypeofbehavior
modification,wearegoingtolookfirstatsomehelpfulhintsonhowto
developthiscontract.
Theseguidelineswillhelptodevelopthistool:
• Setagoal;involvechild/adolescentingoalsetting,
• Outlinethestepstoreachthegoal,
• Turnstepsintoachecklist.
• Supervisechild/adolescentfollowingprocedure,
• Donotletyourchildstrugglewithanytask,
• Usenegotiation
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• Slowlyreducesupervision.
• Userewardsandconsequences
BelowisasampleofablankActionPlanfollowedbyacompletedPlan.
SuggestedFormatForActionPlans/SimpleTasks
________________________________________________(TitleofActionPlan)Goal/Purpose:__________________________________________________________________________________________________________________________________Objectives:
1. __________________________________________________________________
2. _________________________________________________________________
3. _________________________________________________________________
4. _________________________________________________________________
5. __________________________________________________________________
6. __________________________________________________________________
Rewards:____________________________________________________________________Consequences:_________________________________________________________________________________________________________________________________________Other:
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ActionPlanforImprovingExecutiveFunctioningAdolescentPlanForWeeklyChores
TITLEOFACTIONPLAN:WeeklyRoomCleaningGoal/Purpose:Beabletoperformroomchoresweekly,with1—2remindersObjectives:Bytheendoftheweekend,adolescentshouldbeableto:
1. Pick-upallitemsonthefloorandplaceinappropriateareasby2. Placealltrashinthetrashcans/bins.3. Bringalldishestothekitchen.4. Throwtrashinthedumpster.5. Vacuumbedroomfloor.6. Dustallsurfaces.7. Washbeddingeveryotherweek.
Rewards:1.DinnerwithMom-monthly2.Tendollargiftcard—monthly3.Carprivileges
Consequences:1.Unhealthylife2.UnhappymomCues/needs:Momwillsupplywithneededitems:
• Dustcloths/cleaningfluids• Vacuum• Laundrydetergent/fabricsoftener• Trashbags
Planwillbereviewedweeklyuntilremindersnolongerrequired.
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Let’sreviewtheActionPlanandthedifferentsectionsrequired.
1. TitleoftheActionPlan
a. Thisisthebehaviorthatyouwishtoimprove.
2. Goals:Theseshouldbemeasurableandgivenatimeframe.
3. Objectives:Canbeblendedtogetherwiththechecklistsorseparated.
Thesearethestepstomeetthegoals.Youcaneasilyaddboxestocheck
attheendofeachobjective.
4. Rewards/Consequences:Theseshouldbeage-appropriateand
determinedwithyourchild/adolescent.Note:Keepbothrewardsand
consequencesmild;familieswillhavedifferentideasofappropriate
rewards/consequences.
5. Cues/needs:Pleasenotethatadultwillalsohavearoleinensuringthe
successoftheActionPlan.
OnthenextpageisanothersampleofanActionPlan.Ifwethinkbackto
Rosa,the9-year-oldchildwhohasdifficultygettingreadyforschoolinthe
morning,wecandesignaPlantoassistherwithwhatisexpected.Thiswill
helpreducethemorningfrictionbetweenherandher
mother/father/guardian.Itwillalsooutlinerewards/consequencesforthe
behaviors.Pleasenotehowspecifictheplaniswithtimeschedules.For
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childrenwhocannotyettelltime,adjustmentswillneedtobemade.Useof
alarmsanddigitalclocksmayhelpchildrenwhocannotyettelltime.
SAMPLESuggestedFormatForActionPlans/SimpleTasks
___________MORNINGROUTINE_____________(TitleofActionPlan)Goal/Purpose:Beontimetoschoolatleastfourtimesperweek.Objectives:Beableto:
1. Getupinthemorningby7:20am;withonly1-2remindersbyparent/guardian(s).
2. Washfaceandhands;brushteethby7:35am3. Getdressedby7:35am4. Eat/DrinkBreakfast(by7:48am)5. Takemedication(withassistance—agedependent)by7:48am6. Rememberallpersonalschoolbelongingswith1-2remindersbyparent(s)(theseshouldbesetoutthenightbefore—andplacedbythedoor).
7. Bereadytoleavethehouseby7:50amwithonly1-2reminders.
Rewards:Extra30minutesofTVtimeontheweekend;Extraplaytimeovertheweekend;chooseadinnerormovie.Consequences:Lateforschool,missimportantinformation,mayhaveschoolconsequences(notplayingsportonteam),lossofTVtimeathome.Ifchildrequiressomecuesorspecifichelp:
1. Providealarmclock2. Setphoneorotherdevicefortimetocompletecertaintasks(example:20minutesforpersonalhygiene).
3. Alarmfor7:48orclocksaroundthehousetovisualize.4. Foryoungerchildrenhavefewerstepsormorereminders.
Youcanwriteastatementofwhentoreviewplan(weeklyatfirst—asbehaviorimprovesdecreasetimetoreviewandsupports(reminders).
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Inorderforcheckliststobesuccessful,theyshouldbereviewedat
regulartimeintervals.Everyweektostartmightbehelpful.Asthebehavior
improves,checkingcanbedonelessfrequently.Forsomefamilies,keeping
trackofbehaviorimprovementishelpful.Inaddition,asonebehavior
improves,anothercontract/ActionPlancanbedesigned.Itisrecommended
thatnomorethantwobehaviorcontractsexistatonetime.Belowisasampleof
aprogresschartthatmaybeusedtoshowachild/adolescenthowtheyare
improvingovertime.
ProgressChart
Date EFSkill WhatistheBehavior?
HowOften? Howlongdoesitlast?
Howstrongisit?
July
EmotionalControl
DifficulttoControlFrustration/Anger
1-2TimesperWeek
10—15Minutes
Severe
August
EmotionalControl
DifficulttoControlFrustration/Anger
1—2TimesperWeek
Lessthan10Minutes
Severe
September
EmotionalControl
DifficulttoControlFrustration/Anger
1TimeperWeek
5Minutes
Moderate
October
EmotionalControl
DifficulttoControlFrustration/Anger
1TimeperWeek
5Minutes
Mild--
Moderate
August
Time
Management
Lategettingupinthemorningandlategettingto
school
3—4TimesperWeek
N/A
Moderate
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September TimeManagement
Lategettingupinthemorningandlategettingto
school
1-2TimesperWeek
N/A Mild-Moderate
October
Time
Management
Lategettingupinthemorningandlategettingto
school
1TimeperWeek
N/A
Mild-
Moderate
November
Time
Management
Lategettingupinthemorningandlategettingto
school
0Timesper
Week
N/A
Skill
Completed
Incompletingthissection,alastrecommendationfor
children/adolescentswithdifferenttypesofissuesistohaveascheduleofthe
individualsactivitiespostedinthehome,sothattheycanseehowtheirdayis
planned.
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Table3.DailyScheduleandTimeManagement/Youdoawholeweekordaybyday
Daily/WeeklyActivities
TimeforActivity
MON
TUE
WED
THUR
FRI
SAT
SUN
GettingupintheMorning
10min
7–7:10am
7–7:10am
7–7:10am
7–7:10am
7–7:10am
8:30
8:30
GettingreadyforSchool
30min.
7:10-7:40am
7:10-7:40am
7:10-7:40am
7:10-7:40am
7:10-7:40am
X
X
DoingMorningChores
30-60min
X
X
X
X
X
60min
30min
AttendingSchool
7hrs.
8-3:30
8-3:30
8-3:30
8-3:30
8-8:30
X
X
AfterSchool
1hr
Chess3:30-4:15
Basket-ball3:30-4:15
Tutoring
1hr.
Math3:30-4:30
Scouts 2hr. 7--9 SportsActivities
Soccer1pm
GettingHomefromSchool
4:45
5:00
4:45
4:00
4:00
FreeTime/OutsidePlay
Until5:45
Until5:45
Until5:45
Until5:45
Until5:45
Shopping/Errands
Dinner/Clean-up
1hour
6:00pm
6:00pm
6:00pm
6:00pm
6:00pm
Homework
7:00–8:00
7:00-8:00
7:00–8:00
7:00-8:00
Reading 2hrs. 2hrs.RelaxingTime GettingReadyforBed/PreparingforNextDay
8:00-8:30pm
8:00-8:30pm
8:00-8:30pm
8:00-8:30pm
9:00-9:30pm
9:00-9:30pm
8:00-8:30pm
Sleep
9:00pm
9:00pm
9:00pm
9:00pm
10:00
10:30pm
9:00pm
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Thesechecklistscanbehelpfulinmanagingsomeissues/concernsthat
yourfamilyexperiences.Thesetoolscanhelpyourchild/studentathomeand
atschool.Thechecklistsshouldnotsubstituteforprofessionalhelpifneeded.
Theycan,however,beusedinconjunctionwithrecommendationsfrom
teachers,therapists,andotherproviders.
Useoftechnologicaldevicesmaybeveryhelpfulingettingyour
adolescentmoreorganized(unlessofcourse,s/helosesthedevice).Theycan
behelpfulfororganizationalskills(useofcalendarsandreminders),settingof
alarms,andofcourse,theoccasionaltextfromaparent/teacher.
Ifyouneedmorehelporinformation,pleasecontactParentsReaching
Out.Theirspecialistswillbemorethanhappytoassistyou.
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SectionIV
References Cantin, E., Gnaedinger, K., Gallaway, M., Hesson-McInnis, S., & Hund, A.
(2016). Executive functioning predicts reading, mathematics, and theory of mind during the elementary years. Journal of Experimental Psychology, 146, 66-78. Retrieved from the internet http://ac.els-cdn.com/S0022096516000242/1-s2.0-S0022096516000242- main.pdf?_tid=0a26965a-1ad7-11e6-a564- 00000aab0f02&acdnat=1463342337_27b3cdfbb64aab2d53dda4401454f288
HarvardUniversity,CenterontheDevelopingChild
www.developingchild.harvard.edu
Kroesbergen E.,Van de Ritt,B., and Van Luit, E. (2007). Working memory and
early mathematics: Possibilities for early identification of mathematic learning disabilities.International Perspectives: Advance in Learning and Behavioral Disabilities, 20. DOI: 1016/SO735-004X(07)20001-1.
Morgan-Borkowsky, L. (2012). Executive functions in the school: What do
teachers know about executive functions and how they impact student progress? Philadelphia College of Osteopathic Medicine Psychology Dissertations, Student Dissertation,
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Thesis and Papers 2012 . Retrieved from the internet
http://digitalcommons.pcom.edu/cgi/viewcontent.cgi?article=1229& context =psychology_dissertations Packer,L.(1998-2015).OverviewofExecutiveDysfunction.Retrievedfrom
theinternethttp://www.tourettesyndrome.net/disorders/executive-dysfunction/overview-of-executive-dysfunction/
Parents Reaching Out. (2013). Mission statement. Retrieved from the internet
http://parentsreachingout.org/our-mission/ Romer, D., Betancourt, L., Giannetta, J., Brodsky, N., Farah, M., & Hurt, H.
(2009). Executive cognitive functions and impulsivity as correlates of risk taking and problem behavior in preadolescents. Neuropsychologia, 47, 2916- 2926. Retrieved from the internet www.elsevier.com/locate/neuropsychologia
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