Mini Minute Executive Functioning (EF) Tuck-Ins

This one goes out to all the teachers who are looking for ways to support Executive Functioning without giving up your carefully planned lesson times. I work with a lot of K-8 teachers who are always on the lookout for quick and easy ways to target foundational EF skills within their existing classroom routines. The thing is, EF isn’t something you do separate from your regular curriculum. The more you know about EF, the better you get at realizing that so much of what teachers are already doing is supporting and improving students’ skills. It’s like a hidden super power! The goal of this post is to help teachers become more intentional about using their otherwise lost minutes of transition time to keep that EF momentum going!

Let’s say you have two minutes between the end of your math lesson and the lunch bell. What do you do?

(a) Tell students to take out a book and read

(b) Play the “quiet game”

(c) Use an EF tuck-in exercise

(d) Let absolute chaos reign

Using our own inferential skills, let’s examine the likely outcomes of each scenario:

(a) Your announcement = 20 seconds, getting out books = 40 seconds, opening to the right page = 15 seconds, reading one paragraph = 25 seconds …then…time to clean up (followed by copious amounts of “grumble grumble grumble”). Effective? I think not!

(b) Students are annoyed with having to be quiet, you’re annoyed they can’t be quiet…who wins at the quiet game? No one!

(c) Students have fun and improve their EF skills!

(d) Total destruction of the classroom (and your sanity).

In case you’re still scratching your head, I’ll give you a hint: the answer is C. There are countless EF teachable moments (and I do mean moments) during a typical school day: lessons end a little early, students need something to keep them busy in line, you name it! Here are some ideas to turn those lost minutes into EF learning treasure troves, while simultaneously supporting general education skills.

 

EF Tuck-Ins for Cognitive Flexibility

  • Word Association: Begin by saying a random word. Snake through all students in the class, having each student say the first thing that comes to their mind when they hear the word from the student just before them. This fun game strengthens association pathways in the brain and supports cognitive flexibility during conversations (i.e., the ability to connect to others’ ideas).
  • Two-Word Association: Create a jar of random words. During the tuck-in, select two words from the jar and ask a student to come up with some way those words can be related. This task encourages strong concept association and mental flexibility.
  • Ask students to generate antonyms, synonyms, or a shade of meaning (i.e., a word that means slightly more or less intense than the provided word) for a target word. For example, if the word is happy, the antonym could be sad, the synonym could be glad, and the shade of meaning could be content (less intense) or excited (more intense).
  • Ask students to respond to yes/no questions with an answer that doesn’t involve yes or no (e.g., “Do you like carrots?” response: “Only when they are dipped in ranch”). This task requires engagement of “slow thinking” over automatic “fast thinking.”

EF Tuck-Ins for Working Memory (all tasks done verbally)

  • Ask students to repeat back increasingly longer sequences of numbers in the opposite order of how you give them (e.g., if you say “3-5-7-2,” students say “2-7-5-3”).
  • Give students a target word and ask whether various letters are in the word. This requires students to hold the word in their mind while scanning it for letters.
  • Ask students to verbally spell a target word forwards, then backwards. Switch between common, overlearned words and grade-level vocabulary or spelling words.

EF Tuck-Ins for Inferential Thinking

  • Provide three attributes of a secret object and ask students to make a smart guess about the object you’re describing (e.g., it’s white, it comes from a cow, you drink it). The more nuanced the clues, the more challenging the task.
  • Provide students with an obscure word that has a commonly known root (or a word in a different language). Ask them to make a smart guess about the meaning of the word based on a recognizable root.

EF Tuck-Ins for Problem Solving

  • Provide age-appropriate What Would You Do scenarios to students (e.g., “What would you do if your friend got an ugly hair cut and asked what you thought?” or “What would you do if you were invited to a party and didn’t want to attend?”), and ask them to generate the most expected response they can think of.
  • Ask students to judge the grammaticality of a sentence. If it’s incorrect, ask them to correct it.
  • Present If…Then verbal problems for students to solve (e.g., If Jenny is shorter than Billy, Billy is shorter than Mark, William is taller than Tony, and Mark is the same height as Tony, who is the tallest?”).

EF Tuck-Ins for Categorization

  • Provide four+ words or numbers to all students. Ask the students to determine how they can be sorted into two+ categories based on attributes, functions, locations, materials, appearance, etc. You can use random words/numbers or ones that relate to a current lesson.
  • Provide four words that all connect through a shared attribute except for one. Ask students to identify which one word does not belong and why. The more nuanced the isolating difference, the more challenging this task will be.
  • Provide a category to students (e.g., animals, literary genres, Greek Gods, vehicle types, colors, etc.) and ask them to generate as many items as they can that belong in that category in a given amount of time.

EF Tuck-Ins for Gestalt vs. Details

  • Show a picture scene to the whole class. Ask each student to write or say the gestalt (i.e., big idea) of the picture scene and the three most relevant details that support the gestalt. This helps students improve part vs. whole awareness and how parts are relevant to the whole.
  • Ask students to tell as many parts of an object as they can think of (e.g., parts of a tree: roots, trunk, branches, leaves, etc.). Encourage students to use a strategy to determine parts (e.g., move from the bottom to the top of the object, move from small to large parts, etc.).

Here’s to a whole new, EF-filled school year!

All Aboard the Friend Ship

Remember when you had to memorize all the presidents of the United States for U.S. History Class…in order?!? It took me about 2 minutes of blankly staring at flash cards to realize I was never going to cement those names through repetition alone. So where does one turn for help at 10:00pm the night before the test? Music, of course! The Animaniacs saved my tush that night with their president song (proof here: https://www.youtube.com/watch?v=Vvy0wRLD5s8). Kids are a lot like me when it comes to learning (or should I say I learn a lot like a little kid…): they do better with multimodal, experiential, and “stuck-in-your-head” leaning styles than mere lecture from adults.

Raise your hand if you find it easier to engage kids in post-play cleaning when you sing the “Clean up, clean up, everybody, everywhere…” song (did you really raise your hand? No one can see you, silly!). That’s because the song jumpstarted a memory for the child (hippocampus activation) that it’s time to clean. We use songs in all corners of education: ABC’s, rainbow colors, counting, wh-questions, etc. I think I can skip the part where I spend a whole paragraph convincing you why songs matter for learning, because our scientific community has already agreed that music activates important association and learning centers in the brain. Instead, I want to introduce you to my favorite new set of songs for facilitating social regulation, social cognitive, and social emotional development: The Friend Ship.

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You may or may not know that I spend my days targeting social regulation skills with “boys and girls of all ages” (yeah, it’s a bit like the circus!). I am forever on the hunt for innovative ways to help my clients both learn and generalize the key concepts of expected social communication, and music is a personal favorite strategy of mine. The Friend Ship, created by speech-language pathologist Erica Bland, is a CD of songs all about social regulation. With titles like: “What’s the Plan,” “Adding to the Fun,” and “What Zone Are You In,” the songs take teaching and reinforcement phrases I find myself using like a broken record and puts them to a soundtrack of kid-friendly rock, reggae, and hip hop. Whether the songs are used as direct teaching tools or are just on as background music during collaborative play, I find that my clients are humming and singing along after the first couple replays.

Want a sneak peak? Have a listen: https://soundcloud.com/thefriendship-1/sets/the-friend-ship

So how do you get this musical gold mine? Here are a couple ways to make it happen (p.s. it’s only $9.95!!!!!):

Erica also created a companion packet of family or therapist-led support activities to go along with each song. In other words, your lesson plan is already done! So drop whatever you’re doing, pump up the Friend Ship jams, and get your social regulation on!

Sorry I’m Not Sorry

It’s been a long time since I last posted. As in, really long. You could have watched every episode of Bones, Friday Night Lights, and, probably, Dr.Who on Netflix since I last posted. You’re welcome (and also, my apologies). My main rationale for my MIA status is a little thing called my clinical fellowship. The real world is crazy and busy and hard, but oh so rewarding! Even on my worst days, I love what I do (and that’s a hard position to beat)! The good news is that my CF is officially over! I’m a real, live SLP now. The bad news is that my caseload and workload didn’t suddenly dip, so I get to stay as busy as before. That being said, I wake up each morning with the privilege of knowing that something I do that day might actually help someone. So cool.

This post is all about apologies, which is timely for a few reasons. For one, I owe my readers an apology for my absence. Explanations for our unexpected behaviors are nice, but they don’t necessary fix the situation. Just because I gave you my (really good) reason for not writing, it doesn’t mean you didn’t lament my absence (at least, that’s what I tell myself). Secondly, my consulting role in a K-8 school this year has given me a lot to think about when it comes to apologies. Kids (AND adults) do unexpected things all the time. We may say and do things that we immediately regret, but can’t take back. In those moments, all we have to fall back on is the skill of a genuine apology that reveals not just an acknowledgement of our behaviors, but also an action plan for the future. Third, Jonah Hill gave an amazing apology on Jimmy Fallon’s show this week in response to a not-so-nice thing he said to a not-so-nice paparazzi dude.

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I bet that if you counted up all the apologies you’ve given in your lifetime, they would outweigh a lot of things you wish you did more often (like eating watermelon, laying on a sunny beach, or playing with puppies). Despite how that may manifest for you, I don’t say this because I think we are inherently bad people who are inclined to do unkind things all the time. I say this simply to point out how often we engage in apologies. Yet considering the number of times we do this action, we don’t spend much time actually teaching our children how to apologize. As a result, we’ve ended up with the drive-by apology; the “sorry I’m not sorry” apology.

Apologizing is a critical social communication and social regulation skill. It’s the verbal attempt to repair a social breakdown, and requires relatively in-tact cognitive flexibility, emotional regulation, and perspective taking. Not only are these tough skills for children with existing social regulation or social cognitive challenges, but these are tough skills for just about anyone. I would argue that our responsibility as adults with (more or less) developed executive brains is to teach children howwhen, and why to apologize in order to support their social successes. My script for apologies may seem simple, but it targets 2 critical cognitive processes: hindsight and foresight. Once an unexpected situation has been identified for all parties (and everyone is re-regulated enough to engage in a social repair), I recommend the following script:

1. “I’m sorry for [unexpected behavior], which caused you to feel [emotion of other(s)]“

  • This step involves hindsight. Hindsight is the ability to recognize past situations (what you did and how someone felt as a result). Children may need support and mediation to reach this level of awareness, but it’s a critical step before starting an apology. I recommend using a social behavior map to help children understand the relationship between their actions and the feelings of others.

2. “Next time I will [description of expected behavior]“

  • This step involves foresight. Foresight is the ability to anticipate how the future might be same/different when compared to the past, or how new situations might be same/different when compared to past experiences. Anticipation of future consequences allows us to manage our present decisions so they align us with our ultimate goals. You can think of this step in the apology as the mental re-do; a chance to script a more expected behavior for next time.

So what does this look like all put together? Here’s an example from my own heart: “I’m sorry for being away from my blog for so long, which may have caused you to feel confused or disappointed. Next time I anticipate taking a break, I will share those plans with my readers so you know what to expect.” How do you feel? Validated? Appreciated? Perhaps a bit more understood and acknowledged? That’s my hope.

I said it before and I’ll say it again, apologies are hard. They’re uncomfortable, embarrassing, and humbling. AND they’re a critical social repair skill we need to master in order to make it through this tricky world. Just as it benefits children to receive explicit instruction in emotional and behavioral regulation, all children benefit from scripting and support for effective apologies. If you work with older students, I recommend showing the Jonah Hill apology clip, and creating some space to discuss students’ reactions and thoughts.

Until the next post, I wish you all a happy Thursday!

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Stop Using L1?!? Ain’t No One Got Time for That!

Blog post explosion! I went from 2 months of no posts to 2 posts in 1 day! You’re welcome. I would normally wait a day or so to add a second post, but this feels too important to wait. In the past 2 weeks, I’ve had 3 different experiences of hearing from bilingual or multilingual parents that their child’s teacher, doctor, or (gasp!) speech-language pathologist has recommended limiting or eliminating all language input other than English in order to decrease the negative impact of a communication disorder.

SAY WHAT Y’ALL?!?!?!? The belief that having input from multiple languages either causes language disorders or makes them worse is FALSE!

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I’d like to think that all my SLP friends and colleagues know better than to disseminate this kind of information to parents, but I’m finding that lots of people out there still are woefully behind on their bilingual/multilingual/ELL research and how it relates to communication disorders. With that in mind, I’m sharing a wonderful website that provides lots of information about the myths surrounding bi/multilingualism and communication disorders: Multicultural Topics in Communication Sciences and Disorders (www.multicsd.org). Here are some of the long-standing MYTHS they discuss:

  1. Delays are to be expected in bilingual children because they are processing two languages at the same time

  2. Code-Switching is a sign of disorder in bilingual children

  3. If a bilingual child has a language disorder, parents should avoid using L1 in the home

  4. If a child has a communication disorder, introducing a second language will make it worse

  5. Bilingual children should only receive instruction and intervention in English in order to lighten their linguistic load

  6. If your child is learning English at school, you should speak English at home, even if it is not your first language

If you are still mistaking these myths as facts, you better check yo’self and EBP (evidence-based practice) it up! Sit back, kick up your feet, sip a cup of tea, and read some research articles! Here’s to supporting a better educational environment for our amazing, fabulous, and uniquely special linguistically diverse kiddos!

ANAMAzing Ideas for Therapy! (Thanks Pixar)

While sitting in a day-long conference on school-based SLP challenges associated with qualifying kids from culturally and linguistically different backgrounds, one the the presenters mentioned using the Pixar animated short film, Partly Cloudy, as a great interactive, informal assessment or treatment tool to evaluate a child’s narrative skills, emotional recognition, inferencing skills, etc. This got me thinking that there might be other Pixar “shorts” out there that would be fantastic for use in treatment sessions. Below are some ideas about how you can use a few of these fun mini movies with your clients:

“PARTLY CLOUDY”

Screen Shot 2013-04-27 at 12.22.50 PMWhat your client can be working on:

  • Recognizing and analyzing facial expressions (and explaining why the character might be feeling that way)
  • Pausing the video at different points and making predictions about what will happen next (immediately next, after an hour or two, tomorrow, etc.)
  • Problem solving when the character(s) feel sad/upset/disappointed
  • Comparisons between happy/joyful/ecstatic/proud characters and sad/upset/disappointed/angry ones

“LUXO JR.”

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What your client can be working on:

  • Create a script for one or both lamp characters. This involves perspective taking, theory of mind, prediction, etc. (lots of those tough social cognition/executive functioning/social communication skills that many kiddos struggle to learn and use)
  • Inferring how each lamp character feels at different points in the mini movie
  • Making predictions about what will happen next (and supporting those predictions with contextual clues from the mini movie)

“DAY AND NIGHT”

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What your client can be working on (this short is best for older elementary/middle/high school students):

  • Create a script for one or both characters. What kinds of expressions are they likely to be using? Are these characters friends? Siblings? Strangers? How do you know?
  • Categorize the differences between things that happen during the day versus at night. Work on finding an efficient way to document all of these examples without having to re-watch the short over and over (this is a critical study skill!)
  • Pause the mini movie at various points and discuss how the characters feel and how you know

“THE BLUE UMBRELLA”

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What your client can be working on:

  • Fill in thought bubbles for each umbrella and notice and discuss the changes in what each umbrella is thinking as the short video goes on. Why do these changes in thoughts/emotions/behaviors occur?
  • Make predictions about what will happen next

Media can be such a great way to engage students of all ages in working on therapy objectives. Any other animated shorts out there that folks are using?

Communication Matrix

Do you know about the Communication Matrix? If not, then this is your extra lucky day! I, along with my fellow UW grad clinicians, use this measure during lots and lots of evaluations, especially when the client is at a developmental stage where they are not using a huge number of conventionally communicative behaviors. I’ll give a short and sweet overview of the Communication Matrix, but the best way to learn more about it is to go to the website and check it out yourself!

http://www.communicationmatrix.org/

What is the Communication Matrix?

The Communication Matrix is a structured assessment measure designed to determine how an individual is communicating, and to provide a framework for determining logical communication goals. It was first published in 1990 and was revised in 1996 and 2004 by Dr. Charity Rowland of Oregon Health & Science University (yeah, Oregon!). Based on responses from the child’s caregiver, a matrix profile is generated that describes the types of behaviors the child is currently using (e.g., Unconventional Communication, Conventional Communication, Concrete Symbols, etc.) and the purposes for which those behaviors are being used (e.g., to refuse, to obtain something, for social purposes, and to gain information). The measure can be completed online by making a profile for the client, or in a printed, paper-based format. I’ve only ever done the online version and since we live in 2013, I recommend you give that format a try too! See that picture below? THAT’s what your results look like once you get through all the sections and questions (it’s called a “matrix” for a reason).

How is the Communication Matrix Administered?

This measure is based on information provided by the child’s primary caregiver. In my experience, it works best to have a clinician actually sitting with the caregiver and walking them through each of the questions and sections to ensure they understand what’s being asked and to take any informative notes that might come up (there’s a place for notes in each section so you can keep track of this information in an organized way). I realize that you won’t always have a clinician to spare during assessments, so the parents could certainly be set up to fill this out while you’re working your magic in the eval!

What Do the Matrix Results Tell Me?

Remember that picture a little ways up in the post? You can probably still see it from where you’re currently reading! If not, it’s time for some scrolling action! Along the vertical axis (going from top to bottom, along the left) are the types of behaviors a child is currently using to communicate. These are ordered (from top to bottom) based on when they appear in typically developing children (i.e., Preintentional Behavior all the way down to Language). If you hold your cursor over each stage, a pop-up with a more detailed description of that stage will appear (on the actual website…not on my blog post). Along the horizontal axis (going from left to right, along the bottom) are communicative functions/purposes for which communication is used. The overall matrix gives you a visual sense of the client’s skill level with different communicative behaviors for various communicative functions (not yet used, emerging, or mastered). In other words, how are they using communication and for what purposes?

How Can the Communication Matrix Compliment My Other Assessment Tools?

Good Question! This tool is a fantastic way to support findings from other measures. If you plan to use the Rosetti, MacArthur Bates CDI, or other caregiver questionnaire as part of your assessment, it’s always a good idea to have a second caregiver measure to ensure reliability in their responses. The matrix gives both a qualitative description of the child’s current communicative functioning as well as a quantitative description of which developmental age range their communicative abilities fall into. And that’s pretty darn cool!

How to Get Started:

Go to the website and create an account. It’s free! You can add individualized profiles for clients and save their results for later reference! All in all, it’s an amazing resource!

There’s lots more detailed information about the Communication Matrix on the website, so I highly encourage you to check it out and give it a try! You can find it by clicking here: http://www.communicationmatrix.org/

Since I’m so confident that you’ll find this tool helpful…YOU’RE WELCOME!

Home Is Where The Therapy Is!

Ready…Set…Ponder: Why do speech-language pathologists (and other child development professionals) deliver birth-3 services in the child’s home? Why not just bring all those kiddies into our clinic rooms and bestow our communication brilliance upon them?

I’d say that we go into the home because the focus of our intervention is to engage that child’s caregiver(s) in an ongoing process of supporting his/her communication development. It can’t just be about the hour or 2 a week that we have the child in front of us in a little clinic room, because the first 3 years of life are critical for providing the richest possible language environment we can. And who better to learn how to talk to kids, play with kids, scaffold kids’ language, and foster kids’ social competencies than the parents and caregivers of those kids?!? We go into the home because that’s where 99.9% of that child’s communication development will take place.

Today I’d like to pose the argument that we need to revive the birth-3 model of service delivery in non birth-3-aged kids who need significant, ongoing executive functioning support. I wouldn’t dare to say that these are the only kids who would benefit from this type of service delivery, but you have to start somewhere, right? If you work with kids with general social communication challenges, you likely also see executive functioning deficits in those kids. Making a plan? HARD! Breaking down tasks into individual steps? PAINFUL! Self-talking your way through an activity? YEAH RIGHT! These kids need strategies to frame how they function in the world, not discrete skill training (ok, ok, some definitely need discrete skill training too, but that’s just not the best way to support improved use of executive functioning skills). Some of these kids will likely never reach a point where they can independently use a strategy like Get Ready, Do, Done (see my last post); the strategy is still fantastically helpful, but they’ll need a caregiver to cue them to use it and/or prompt them through it. These are the kids I believe would gain a world of good from receiving services to enhance the use of executive functioning strategies at home rather than in a clinic. WHY?, you ask…

  • Intervention in the home = access to actually training everyone in that child’s home. If you’re working on strategy use with kids who likely will need ongoing caregiver support with those strategies/frameworks, you should be training the caregiver right along with the kiddo. Plain and simple. You are not always going to be there to support DudeFriend through the process of making a plan or figuring out what the task will look like when it’s done (at least, I hope you won’t…). But you know who’s likely to be there a lot more often? Mom/Dad/Grandma/Aunt Lulu (the caregivers)! If dad can appropriately cue DudeFriend to use a trained strategy at home, in the car, at the grocery store, AND at the neighbor’s birthday party, then you just scored some serious generalization points. How do Dad/Mom/Aunt Lulu know how to appropriately cue DudeFriend, though? You train them to do it in functional tasks (homework, getting ready for dance class, making a snack, packing a backpack, etc.) in functional settings (at home). I’m under no delusion that SLPs should start following kids and their families around everywhere they go teaching them to use executive functioning strategies in every possible setting, but think of how much more likely your work is to generalize if you train the child and the parents in the environment where they’ll be using that strategy 95% of the time!
  • Intervention in the home means that your vision gets to come to life. I’m currently working with one of the caregivers of the client who sparked this post to train her in supporting DudeFriend to use our treatment strategies with various tasks outside of clinic. In my mind, I know exactly how I would set up my Get Ready, Do, Done posters in the kitchen for snack prep. BUT, since I don’t have the luxury of carrying this training out in Dudefriend’s kitchen, I’m stuck trying to describe my vision to her (and it’s hard!). She is motivated, intelligent, and wonderful, but that doesn’t necessarily mean she can read my mind and carry out my vision…and the kitchen is just 1 place where I’m encouraging them to implement this strategy. If I were able to carry this intervention out in Dudefriend’s home, I could be modeling cues and prompts, collaboratively brainstorming the best places to put visual aids, and fitting my vision in with the family’s vision. And THAT would be a beautiful thing.
  • Intervention in the home means that you are actually using materials available to that family, rather than your own treatment materials that may or may not be functional for the kiddo outside of your sessions once or twice a week. Instead of handing parents tools and saying, “Here…make this work,” you can strategize with them to use what they have in the home to bring target strategies and frameworks to life. My sense is that you bring about much more lasting change when you’re not putting unrealistic expectations on the family to find or buy materials that are unfamiliar and uncomfortable to them.

In my naivety, I don’t actually know whether SLPs are out there delivering executive functioning services in the home to kids outside the birth-3 range. My gut sense is that if you’re out there, you’re one of the few, and I think that needs to change. As SLPs, we have a valuable service to be offerring not just the clients, but their families too. We work tirelessly to make activities in clinics as functional as possible for kids, so imagine if you could skip the step of recreating “home” in your clinic room and instead work on using strategies in their actual homes!

If this is already your jam, I’d love to know! If it’s not, but it sounds like a cool jam, I’d love to know too! And maybe one day we’ll team up and start a great new wave of service delivery ;)

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