brain, Classroom, Emotional regulation, Executive Function, Language Therapy, Pragmatic Language, Random SLP, self-regulation, Social Cognition, Social Regulation, Uncategorized

Social Communication On Your Feet Part Two

By Hanna Bogen, M.S., CCC-SLP

screen-shot-2017-02-22-at-3-56-09-pm

In the part one post I introduced readers to the fundamental principles of improvisation (“improv”) and the connections between improv and social-regulation. Again, they include:

  •  Principle One:        Be prepared
  •  Principle Two:       Willingness (to fail spectacularly)
  • Principle Three:    Stay in the moment
  • Principle Four:      Quiet down and listen
  • Principle Five:       Action beats inaction
  • Principle Six:         Be honest
  • Principle Seven:    Let go of your need to control
  • Principle Eight:     There are no mistakes
  • Principle Nine:      Trust
  • Principle Ten:        Teamwork

These principles of improv (Peter Bromberg, 2007) demonstrate the value of flexibility, perspective taking, and reciprocity in successful social interactions. This blog post will take a deeper look at three of the principles and their necessity in the world of social-regulation, specifically: willingness, stay in the moment, and “Yes, and…”

Willingness:  One constant we can count on time and again is that social behaviors have consequences — others either have comfortable, positive thoughts about us or uncomfortable, negative thoughts about us based on the things we do. While the brain is inclined to stick with reliable behaviors with predictable outcomes, social situations often require us to push the comfort zone and try something new. Individuals with social-regulation challenges may struggle to shift away from predictable behaviors, even when they have socially-unexpected outcomes. Willingness to ask new questions, attempt new connections, and risk the possibility of failure is key to learning and adapting to increasingly more mature forms of communication. In improv, the structure and rules of the games offer a safe place to try new things because it is ok to make mistakes; mistakes are often celebrated with shared laughter, which builds confidence in in students. Along with this willingness to evolve is the need to reflect on one’s social experiences: “Did the interaction go as planned?” “How did the conversation partner react to the comment?” “What might I do differently next time to have a more socially-expected outcome?” Acknowledging that mistakes are inevitable in social development, and engaging in thoughtful reflection on social behaviors and their consequences, provide a context for successful social growth.

Stay in the Moment:  Successful executive functioning hinges on one’s ability to engage in “mental time travel” (i.e., the ability to use foresight and hindsight to make decisions in the present moment).  That being said, mindful, nonjudgmental awareness of the present moment allows individuals to make intentional decisions about how to behave at any given moment, rather than simply being carried away by impulses and emotion.  The mindful practice of staying in the moment, even when that requires regularly redirecting thought and attention from the past or future to the present, strengthens our brain’s ability to “insert the pause” between stimulus and response, thus improving self-regulation skills.  This “pause” represents an individual’s opportunity to decide whether (s)he wants to continue with a social behavior, or redirect to a new, more socially-expected one.

“Yes, and…”:  Acknowledging and validating one’s emotionally dysregulated experience does not imply inherent agreement with that dysregulated state. As stated by the Emotional ABC’s curriculum (Venice West Productions, Inc., 2012), “emotions are like the weather.” Like the weather, we don’t strive to control our emotions; instead we strive to equip ourselves with tools and strategies to cope with the emotions that appear in various social situations. Acknowledging and validating one’s emotional experience is critical to bringing awareness to the emotional state, and providing an opportunity to engage in regulating strategies. Identifying one’s emotion(s) and moving forward to initiate a regulation strategy (i.e., “Yes, and…”) embodies the process of emotional regulation, a critical component of social-regulation (e.g., Example of self-talk: “Yes, I am feeling anxious and I can use my focus tool to calm myself.”). The social landscape is complex and dynamic, often requiring individuals to demonstrate flexibility, reciprocity, and adaptation to changing social rules. The principles of improv highlight many of the skills required for successful social experiences, and practice with improv games and activities can help to build the skills needed for social success.

brain, Classroom, Emotional regulation, Executive Function, Language Therapy, Pragmatic Language, Random SLP, self-regulation, Social Cognition, Social Regulation, Uncategorized

Social Communication on your Feet

By Hanna Bogen

screen-shot-2017-02-22-at-3-47-59-pm

(This will be the first in a two part series of posts on “Improv”)

Improvisation (improv) is often mistaken for stand-up comedy, though the two are fundamentally different. Stand-up comedy typically involves pre-written jokes, memorization, and a polished performance. In other words, it’s the “performance” we wish we could give every time we engage in a social situation. With some realistic reflection, though, one realizes that social situations are intrinsically unpredictable. Scripting is a wonderful way to prepare for the social world, and practice with fundamental concepts of social communication can boost confidence, awareness, and overall success. That being said, there is also great benefit to strengthening our students’ abilities to demonstrate flexibility during social encounters. The fundamentals of improvisation speak directly to building that flexibility, as well as countless other core social communication and social-regulation skills:

  • Principle One: Be prepared
  • Principle Two: Willingness (to fail spectacularly)
  • Principle Three: Stay in the moment
  • Principle Four: Quiet down and listen
  • Principle Five: Action beats inaction
  • Principle Six: Be honest
  • Principle Seven: Let go of your need to control
  • Principle Eight: There are no mistakes
  • Principle Nine: Trust
  • Principle Ten: Teamwork

In addition to these ten principles, there is an ultimate, overarching principle of improv that runs, like a golden thread, through each of the other principles: “Yes, and…” The “Yes, and…” principle implies that each social experience is an offer for engagement and successful interaction. It acknowledges that all individuals bring a unique and valuable perspective to the interaction. Practice with improvisational games and activities can strengthen our students’ cognitive flexibility, perspective taking, creativity and shared interest, thereby readying them for greater success in their future social interactions.

One improv game to get you started at home is called “The Imaginary Object.”  While best played in a group, this game can be played with as few as two people.  One person begins the game by pretending to use an imaginary object; they engage in actions that would be typical of using the object.  After a moment of demonstrating the imaginary object, they “pass” the object to the next person, who must continue on with using it.  This “passing” continues until all participants have modeled use of the object. At the end, everyone can announce what object they thought they were “holding” or “using.”  This game hones awareness and use of nonverbal communication cues including gestures, facial expressions, and body positioning.  Participants can talk about which nonverbal cues were helpful in identifying the imaginary object during the game, and/or which cues they would add next time to make understanding of the object more clear.

Classroom, Emotional regulation, Executive Function, Just for Students, self-regulation, Social Cognition, Uncategorized

7 Self-Regulation Tips to Reduce Homework Battles With Your Child

I originally wrote this post for Beyond BookSmart, and it appeared on their blog on October 17, 2016: http://www.beyondbooksmart.com/executive-functioning-strategies-blog/7-self-regulation-tips-to-reduce-homework-battles-with-your-child. For other GREAT resources on executive functioning, planning and prioritizing, improving confidence, emotional regulation strategies, and focusing and attention strategies, check out the rest of the wonderful blog posts: http://www.beyondbooksmart.com/executive-functioning-strategies-blog

screen-shot-2016-10-29-at-12-14-10-pm

Few tasks test self-regulation skills like homework time. Self-regulation is critical to one’s ability to manage challenging or complex situations, and homework time is no exception. Strong self-regulation is multifaceted; it involves regulation of one’s thoughts, emotions, actions, and motivation. Although these skills continue to develop into adulthood, building and strengthening them from an early age can reduce stress and provide the drive to attempt new experiences. Students can integrate practices into home and school activities that strengthen and support a foundation of self-regulation. Below are seven tips students can use in their daily routines to promote happier homework time.

1: Make a homework plan

It doesn’t always make sense for your child to start with the homework assignment from his first class of the day. Some students feel more motivated when they get the biggest assignment out of the way first, while others need to get started with a small task in order to avoid a state of emotional overload. Encourage your child to first make a list of all tasks on deck for the day, and then arrange them into an order that will promote success. Setting aside a few minutes to make a homework plan before getting started can save time, frustration, and stress in the long run.

2: Stock your homework space ahead of time

A quick trip to find a sharp pencil can easily turn into an hour-long distraction. Before getting started, consider what supplies are needed to complete the homework and stock the workspace. Some students benefit from a tri-fold poster board used as a makeshift study station to reduce visual distractions. Wherever your child plans to complete homework, make sure the area is distraction-free and that the necessary supplies are readily available so precious work time isn’t wasted looking for more graph paper.

3: Support basic (subcortical) needs

The brain’s sub-cortex involves the “downstairs,” lower-level brain structures that manage emotions and generate seek and avoid impulses. When the sub-cortex is dysregulated, the brain devotes most or all of its cognitive resources to those structures in order to ensure that we feel safe and comfortable. This leads to decreased cognitive energy reaching the prefrontal, “thinking” parts of the brain that students need to successfully complete homework. Your child can support subcortical regulation by ensuring that he/she has had enough sleep, hydration, food, and movement.

4: Know your triggers and plan ahead

If a certain type of task is a consistent emotional trigger for homework battles with your child, encourage him/her to pre-regulate. This might involve intentionally setting up the environment to be as calming as possible, using a favorite pen or pencil to add a little fun to the task, taking some deep breaths prior to starting, identifying a small reward for completing the task, or setting aside time for a break mid-way through the homework. Anticipating the likelihood of dysregulation and planning ahead helps to avoid the emotional hijacking that otherwise feels like it sneaks up out of nowhere when students are working through an assignment they don’t enjoy.

5: Use future emotion to motivate present action

Often, students get stuck in a “now bubble” about how annoyed, frustrated, bored, or overwhelmed they feel at the thought of starting homework right now. It’s no surprise that these uncomfortable emotional states don’t provide much motivation to get started. Encourage students to shift their focus from how they feelright now to how they will feel when the homework is complete. Proud? Relieved? Accomplished? Use this future emotion to motivate the present action of getting started.

6: Snack smarter

Not all foods impact the brain’s endurance equally, and choosing the wrong snack can lead to a major blood sugar crash mid-homework time. Fueling up for homework is a great way to support the brain’s sub-cortex, and students should consider snacks that provide consistent energy to the brain and/or feed their sensory processing needs. Snacks with complex carbohydrates and protein-rich foods provide slow-release energy for the brain without the intense low soon after consumption. Chewy foods (e.g., dried fruit) and crunchy foods (e.g., nuts, whole-grain crackers, raw veggies) can provide sensory input for students who might otherwise feel distracted by sensory-seeking impulses.

7: Plan breaks wisely

The brain is most attentive for fifteen to twenty-minute increments. While some students can make it through marathon homework sessions, many need to break up the time to give their brains a rest. Breaks can be wonderful, but only if the student can successfully shift back to the homework task. Avoid break activities that involve nebulous timing (e.g., playing outside for a while) or ones that can’t be easily paused (e.g., video games that require the player to reach the next level before stopping). To avoid the drama of transitioning from a break back to homework, consider break activities that have explicit start and end boundaries(e.g., a five-minute YouTube video, twenty jumping jacks, listening to three songs, etc.). If vague end times can’t be avoided, set a timer to create a strict cut-off time.

Emotional regulation, Executive Function, Random SLP, self-regulation, Uncategorized

Regulation by the Numbers

Making the Case for the Role of Objective Data in the Subjective World of Emotional-Regulation

Emotional-regulation is inherently subjective: my emotions are mine and mine alone. You may agree or disagree with how I should feel, though you can no more control emotions than the weather. When it comes to emotional-regulation, the goal is all about regulating the way you respond (i.e., behave), despite how you may be feeling, in order to meet the demands of the situation.

If the emotions we feel are out of our conscious control, it follows that asking a child to control his/her emotions is a recipe for failure, anxiety, frustration, and disillusionment. The focus, then, must shift to improving intentional, mindful, conscious control over behavioral responses in the midst of strong emotions. For many individuals, increased activity in the limbic, emotional brain is mirrored by decreased engagement of the cortical, thinking brain. In other words, stronger emotions = less critical thinking and more impulsive reacting.

Screen Shot 2016-04-21 at 11.59.45 AM

The challenge with emotional-regulation is that however aware you might be that a situation demands certain calm and collected behaviors, parts of the logical brain want to justify the experiences of the emotional brain. This is why we feel so good and justified (in the moment) when we yell at someone who has said something that triggers a strong, angry emotion. No one likes being told to “calm down” or “take a deep breath” at the height of experiencing a dysregulating emotion (however helpful those suggestions might be). In fact, for many children, the feeling of invalidation that comes with being told to “calm down” ultimately triggers greater emotional dysregulation. Kids, especially those who tend towards the impulsive side of the spectrum, are at a developmental disadvantage when it comes to emotional-regulation; the maturity and brain development that comes with reaching adulthood helps to create a bank of personal experience, world knowledge, and anticipation of future consequences that makes it easier to pause one’s initial reactions in order to devise a more useful response during emotionally triggering situations. While we, as adults, might have great regulation advice for a triggered child, the state of dysregulation can make it impossible for him/her to hear and process the advice. The subjective nature of emotions makes for rocky regulation-coaching terrain.

So what’s the solution? Turn a subjective process into what feels like a data-driven, objective process! Words and advice may feel biased, but numbers don’t lie. The Charting Re-Regulation worksheet is a simple way to help a child objectively see his/her patterns of regulation, and how long it typically takes to go from “super triggered” to “re-regulated.” Here’s how it works:

Step 1: Note the triggering situation and emotion(s) being felt (if this is too triggering in the moment, save this step until later).

Step 2: Mark the intensity of the emotion(s)…

  • At the time of the trigger
  • After one minute
  • After two minutes
  • Etc.

Step 3: Notice when the emotional intensity reaches 30% or below. This is usually an indication of being mostly re-regulated and ready to logically process and/or problem-solve.

Step 4 (optional): Record what tools/strategies you used at each phase of re-regulation. In other words, what helped at the 80%-100% range? What helped at the 60%-80% range? What helped at the 30%-60% range? Identifying helpful strategies provides a bank of regulating tools for future triggering situations.

FullSizeRender

FullSizeRender-1

Fill out a new worksheet for each of five or more triggering situations in order to have enough data to determine a pattern for how long it typically takes to feel re-regulated. Three minutes? Eight minutes? What children can glean from their own data is the time frame they need to fill with regulating tools before they can expect to feel calm. An average of three to four minutes in the 80%-100% zone might mean a quick labeling of the emotion(s) with three to four minutes of a distracting brain break (i.e., Daniel Siegel’s Connect and Redirect strategy). Does the re-regulation go pretty fast once the child is below the 80% mark? That might mean that he/she needs some quick, simple sensory and/or mindfulness tools to take up the remaining few minutes in the countdown to calm. Does re-regulation tend to take longer? Strategies like a reading or drawing break might be a better fit for a child who needs more time to truly return to a calm, regulated state.

FullSizeRender-2

FullSizeRender-4

FullSizeRender-3

In the examples included here, the child tends to remain highly dysregulated (80%-100% intensity) for two to three minutes across all situations. He reaches a re-regulated state (30% intensity or below) after six to seven minutes. Using the data he generated and collected, we collaboratively determined that an adult should wait at least seven minutes following a triggering situation to talk with him about what went wrong or how things could have been handled differently. In the meantime, he could pull from his bank of previously useful strategies to remain safe and mindful during the re-regulation process. After seven(ish) minutes, his thinking brain was more engaged and he felt ready to strategize with a peer or adult.

How else can charting re-regulating be beneficial?

  • Children receive concrete, visual feedback about the abstract, subjective process of emotional de-escalation. This feedback can be an important reminder to a frequently dysregulated child that he/she can successfully re-regulate!
  • Using a simple graph to chart the re-regulation process provides opportunities for children to note whether their emotion(s) changed throughout the process. Did they feel varying “shades” of angry the entire time, or did the emotion change to disappointed or confused? It’s important to remind children that emotions can change, and that we often feel multiple emotions at the same time.

You can access the worksheets using the PDF links below:

Charting Re-Regulation 1-10 min. intervals

Charting Re-Regulation write-in min. intervals

Know of other benefits? Share in the comments!

brain, Executive Function, self-regulation, Social Cognition, Uncategorized

The Present NOW versus the NOW Bubble

 How is mindful awareness of now different from being stuck in a NOW Bubble?

 

Screen Shot 2016-03-10 at 1.16.11 PMTANG YAU HOONG

“There are only two ways to time travel (that we know of): to look at the stars and to think with the front of your brain.”

 

I heard this from a friend years ago while on a camping trip that offered some of the best stargazing I’d ever done. Although she was actually referencing a conversation about delayed light coming from the stars, this statement was the start of a deep fascination with the human brain’s ability to shift between awareness of the past, present and future. This phenomenon, known as mental time travel, encompasses our unique ability to use past experience, and future interest, to impact our decisions about present action. Mental time travel heavily involves the frontal lobe of the brain, especially the prefrontal cortex, and is at the crux of successful self-regulation. One’s ability to self-regulate is ultimately judged by how they act in the present moment. The integration of mental time travel into responding is dependent upon how well someone can expand his/her NOW Bubble long enough to self-assess his/her current state, past experiences, and future interests before acting.

Understanding the NOW Bubble

In Brain Talk, the curriculum I co-created with Carrie Lindemuth, the NOW Bubble is the immediate moment following a trigger or stimulus. In this moment, impulses are activated in order to drive action that seems most in line with the brain’s seek and/or avoid urges. For example, if someone cuts you off on the freeway, you may feel the impulse to yell out your car window in the NOW Bubble. For some, that impulse takes over and drives a reaction; they find themselves moving faster than the speed of thought. In this case, action is driven only by what would feel good right now; past experience and future interest are not considered.

Understanding mindful awareness of now

According to Jon Kabat-Zinn, mindfulness is openhearted, moment-to-moment, nonjudgmental awareness of now (i.e., the present moment). Mindful awareness of now involves observational, curious examination of present emotions, sensations, and thoughts. For example, mindful awareness of now following news about a promotion at work might involve nonjudgmental identification of your emotional state (e.g., elated, proud, excited), sensations (e.g., warm, energetic, heart racing), thoughts (e.g., “This is going to be such a great opportunity!”), and impulses (e.g., desire to celebrate, wanting to share news with friends).

How do the now’s compare?

Being stuck in your rigid NOW Bubble makes you a hostage to your present impulses rather than an empowered participant in the present experience. One of the goals of mindfulness is to “insert the pause” between stimulus and response to allow for choice in how to respond rather than feeling “along for the ride” with your reaction. When practicing mindful awareness, you remain in control of your engagement with the now as opposed to the now is controlling you. The more effectively you can mindfully observe the now, the more you can expand your NOW Bubble to incorporate past experience and future goals. In other words, you are less likely to react faster than the speed of thought.

Often, one’s awareness of their present experience is rooted in his/her emotion(s) in the moment. Emotions are like the weather: you can’t control whether you have calm, gentle emotions or strong, stormy emotions. You can, however, control how you respond to your emotions. This is the core of emotional-regulation. Although you can’t control the forecast (emotional or weather forecast), you can engage mental time travel to sometimes predict your emotional experiences based on your past memories of a triggering situation. Acknowledging that similar triggers create similar emotional climates allows individuals, especially those with strong capacities for mental time travel, to anticipate how they might feel going into a situation. This creates a platform to proactively plan, practice, and master emotional coping strategies to help make uncomfortable situations a bit more comfortable.

Without awareness of your emotional state, your reactions are driven by the intensity of the feelings. In a highly triggering situation, the limbic (i.e., emotional, survival) brain shuts down communication with cortical thinking areas of the brain. This occurs as part of the brain’s survival mechanism: staying alive in a threatening situation is more important than engaging in critical thinking. The problem with this survival safeguard is that not all triggering situations are life threatening. Tests, public speaking, arguments with friends, schedule changes…while emotionally triggering, none of these lead to eminent demise. In triggering situations like these, cortical shut down prevents the brain from engaging in mental time travel to consider the past and future in order to manage the present. Mindful awareness of now allows you to be in a dynamic, aware, open, flexible cognitive “head space.” The cortical thinking brain remains online, meaning you are able to access present awareness (i.e., “What do I notice right now?”), past experience (i.e., “What do I know from the past?”), and future thinking (i.e., goal identification, anticipating consequences, awareness of emotional and/or physical motivation), in order to choose: do I follow my impulse and react, or do I consider my options and respond?

 

 

brain, Classroom, Executive Function, Random SLP, self-regulation, Social Cognition, Social Regulation

Building Metacognitive Skills with Brain Talk

Screen Shot 2016-01-13 at 9.59.58 AM

As adults, we spend an extraordinary amount of time thinking we’ve got our students’ and children’s problems figured out:

“I know why he’s mad…it’s because he can’t get the Legos to fit together!”

“She must be sulking because her friends left her out during recess today”

Grown ups certainly have more life experience than kids, and sometimes we are great at reading between the lines to sense what might be going on under the surface of a seemingly shallow problem. That being said, I’m always amazed at how often I (and others) forget to do the most logical first step in problem-solving with children: asking them what’s wrong. I’m not talking about a “grazing” question; the kind you ask when you already have an answer in mind and are merely extending a formality. I’m talking about a thoughtful, considerate, invitation into problem-solving and self-regulating dialogue; the type of invitation that comes along with Ross Greene’s initial steps of Collaborative Problem Solving (for more information about Collaborative Problem Solving, visit: http://www.livesinthebalance.org).

Here’s the tricky thing about asking a child to describe an underlying trigger for dysregulation: more often than not they don’t yet have the awareness and skills to effectively communicate it. The way I see it (stemming from my research brain rather than my opinion brain), you need the following, in this order, to effectively express a trigger for dysregulation:

1. Metacognition: the ability to think about your own thinking and emotional state well enough to figure out what’s going on internally. This is where brain learning and mindfulness-based strategies come in!

2. Self-regulation: regulation of your thoughts/attention, emotional responses, actions, and motivation in order to behave in an expected way for a given situation. Self-regulation and executive functioning are inherently tied, since self-regulation sandwiches executive function thinking skills (i.e., using mental schemas to manage complex tasks) by allowing for inhibition of impulses and the ability to follow through with the plan.

Screen Shot 2016-02-19 at 12.26.27 PM

3. Strong (or at least functional) verbal and nonverbal communication skills: collective expressive communication skills to allow you to get your ideas from your “thought bubble” into someone else’s “mind movie.”

I know I’m a speech-language pathologist, and therefore would typically hone in on the third step of this structure. But I’m a unique breed of SLP when it comes to my areas specialization, and I actually live far more in the domains of steps one and two. In my adventures (and misadventures) of working in the world of self-regulation and executive functioning (ok, ok, they’re essentially one in the same), I’ve become very clear that kids need to understand their brains. More generally, everyone should have a basic understanding of their brains that goes beyond “It has a left side and a right side.” As therapists (and teachers, and administrators, and psychologists-hi everyone!), we are, at the core, brain specialists. If we want kids to get to step three (effective communication of their triggers), we need to start by TEACHING them metacognition and self-regulation.

This matters so much to me and my fabulously brilliant colleague, Carrie Lindemuth, M.Ed/ET, that we created a curriculum designed to teach students about key concepts and functions of the brain: Brain Talk. This narrative-based curriculum consists of eight short, white-board animated videos and corresponding lessons plans, discussion points, worksheets, and activities. Different lesson plans and activities exist for early elementary, upper elementary, middle/high school, and a therapy model. Through these videos and the corresponding learning activities, students are introduced to their amygdala (Myg), basal pleasure-and-reward system (Buster), hippocampus (Ms. Hipp) and prefrontal cortex (The Professor), and what happens in the brain during a “Myg Moment” (i.e., fight/flight/freeze avoiding reaction) or “Buster Bam” (i.e., dopamine-driven grab-and-gulp reaction). Additionally, they learn how the integrated conversation (i.e., Brain Talk) between their “emotional” limbic brain and their “thinking” cortex leads to strategic thinking and self-regulated decisions.

Screen Shot 2015-08-28 at 10.10.19 AM

 Screen Shot 2015-08-28 at 10.14.06 AM

Many of us don’t have the opportunity to learn about our brains until we are in the midst of a crisis, whether it be anxiety, depression, hyper-impulsivity, or significant dysregulation. What a gift we could give to our students to teach them these critical metacognitive skills from the get-go! The Brain Talk curriculum is available through an annual subscription ($50.00/year) at the Brain Talk website (www.braintalktherapy.com). An annual subscription to the curriculum provides access to the full curriculum suite, as well as new materials as they are added throughout the year.

Classroom, Executive Function, Just for Teachers, Social Cognition, Social Regulation

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!

Executive Function, Language Therapy, Pragmatic Language, Social Cognition

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.”

Screen Shot 2013-04-27 at 12.32.22 PM

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”

Screen Shot 2013-04-27 at 12.44.03 PM

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”

Screen Shot 2013-04-27 at 12.50.17 PM

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?

Executive Function, Pragmatic Language, Social Cognition

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 😉

Executive Function, Random Therapy Ideas, Social Cognition, Uncategorized

With the End in Mind

What does it look like when it’s done?

Sarah Ward, M.S., CCC-SLP brings us this fabulous question from her executive function-directed therapy. The concept is rather simple: start with the end in mind…then go back and figure out how to get there. Despite its simplicity, I am finding that structuring tasks around this one little question can radically alter the outcomes for the better. Although it’s often promoted as a great strategy for working with kids who have social cognition and executive functioning deficits, I would argue that Sarah’s method is relevant in just about every nook and cranny of our lives!

Toddler, child, adult…we rely on this structure all the time. “You’re done with dinner when your broccoli is gone.” “I’ll know you’re ready to have a cookie when all the toys are put away.” “We’ll leave the house when you’re completely ready to go…not with only one shoe on.” I even came across an example while walking through the hair-care aisle at Walgreens: boxed hair dye! The first thing you’d consider when buying a box of hair dye is: What’s the end result? Or as Sarah Ward would say: What does it look like when it’s done? Not only is this question paramount in helping you decide whether to buy the dye in the first place (yes, blond and purple are verrrrrrry different colors), but it also gives the critical visual cue of “See this little swatch of color on the bottom? We call that Maple Walnut Espresso Chocolate Surprise. That is what your hair shall look like in a mere 25 minutes. If it’s lighter than Maple Walnut Espresso Chocolate Surprise, leave it on longer. If it’s darker…oops.” Only after you’ve internalized the end result do you go back and figure out what tools you need for those luscious new locks (dye kit, towel, comb, etc.) and the steps you should follow to get to the end result.

College courses are on board with “What does it look like when it’s done?” every time a professor passes out a syllabus. As professors, we give syllabi to our students to tell them: “This is what your quarter/semester will look like! These are the projects you must complete, here are the dates for their completion, and these are the specific instructions for each project.” The students know what the expectations are before class 1 even begins, theoretically giving them a chance to organize their time to meet those expectations.

So why do we use this structure in so many parts of our lives? Because it works! In my very humble opinion, recognizing the power of starting with the end in mind should be pervasive in how we plan and present our therapy each and every day. For those already working with kids who have executive functioning deficits, this is your jam! For those who work with other populations, though, here are a couple simple ways you can begin to embed Sarah Ward’s “What does it look like when it’s done?” mindset into your daily routines:

  1. Before starting therapy with any new client, take the time to tell them and/or their parent (or guardian) what it will look like when it’s time to exit from therapy. None of us have crystal balls that can confidently determine how much progress every child or adult can make. That being said, I lately have been hearing from parents that they go into into therapy with no clear idea of what their child is supposed to look like at the end. Although this is a great strategy for kids with clear-cut challenges (e.g., “We’ll know Dudefriend is ready to leave therapy when he can say his “s” sound correctly in conversations.”), it may be even more important for clients with more pervasive impairments. What does the end of therapy look like for a child with moderate autism? Or Down syndrome? Does it look like a typically developing child? I don’t think so. Instead of leaving parents and clients in this realm of uncertainly, “What does it look like when it’s done?” can more clearly outline therapy benchmarks or exit times for everyone on board! If it doesn’t make sense to define the very end of therapy right at the get-go, start by defining your first benchmark: “We’ll know it’s time to move onto new goals when Dudefriend looks like X/can do X/ meets X expectations…”
  2. Use the “What does it look like when it’s done” strategy to provide clients with clear expectations for a task. Instead of saying, “Now I want you to use your skinny “s” to read this sentence,” you can say “Here’s what reading looks like when it’s done…” with a model of the skinny “s” in all the target words in a similar sentence. Kids with social-cognition challenges benefit from this structure ten-fold. I go so far as to take a picture on my iPad of what the task looks like when it’s done so we have an extremely clear model available. What does reviewing Social Detective terms look like when it’s done? It looks like all the visuals are put back into my client’s paper tool kit and he’s sitting with a calm body (I literally take a picture of that before we start actually reviewing the term). Only when that model is in place do we go back and gather the tools we’ll need for completing the task, determine the necessary steps, and begin working. It should be no shocker to anyone that kids perform better when they understand the expectations being placed on them ahead of time. We should never assume that our clients can read our minds to know what we want them to do (I mean, come ON, when has that ever worked with a kid?!?). Working with them to determine what the end result looks like at the onset can be the difference between success and significant frustration!

I highly encourage readers who are unfamiliar with the rest of Sarah Ward’s Get Ready, Do, Done method to learn more about it and begin implementing it with your clients. This structure for completing tasks can be replicated in the clinic, in the classroom, at home…you name it! I am a big proponent of strategies that are applicable in all settings for a given client, and this is one that’s right on the mark!