Implementing Strategies to increase Executive Function Skills in Young Children

1
Implementing Strategies to increase
Executive Function Skills in Young Children

• Patricia M Blasco, PhD
• Teaching Research Institute
• Western Oregon University
• Presentation at the Division for Early Childhood
  Conference
• St. Louis, MO
• 2014

2
Learner Objectives

• Participants will gain knowledge of executive
  function as cognitive capacity and how to improve
  skills for children who were born LBW or have
  developmental delays impacted by EF.
• Participants will learn how intervention
  strategies on components of executive function
  may help to strengthen EF skills and buffer or
  ameliorate learning difficulties in young
  children prior to school-age.

3
Chief Executive Officer
Hes the CEO of his brain
4
(No Transcript)
5
Executive Functioning Birth to 3

• Refers to a group of neurocognitive processes in
  the brain that direct, connect, and organize
  information that is manifested in planned
  behavior.

6
Co-Conductors in a Holarchical Model of EF
Domains Of Functioning
Executive Function Capacity
Activation
7
(No Transcript)
8
Neurocognitive Processes

• Self Regulation
• Inhibition
• Working Memory

• Cognitive Flexibility
• Goal Selection
• Planning and
• Organization

9
Early Childhood and EF

• Components follow their own developmental
  trajectory
• growth spurts in the last half of the first year
  and then from 3 to 6 years of age Diamond,
  2006

10
Why are these so important in Early Childhood?

• Inability to plan and organize actions, maintain
  attention to tasks, and recall past experience to
  apply to new learning experiences lead to
• Learning disabilities (LD) as well as problems
  with Attention-deficit/hyperactivity disorder
  (ADHD)

11
Model of Early Indicators and Later Learning
Disabilities
Executive Processes
Attention Concentration
Self Regulation (Social Mastery Motivation)
Visual Spatial/Motor
Language
Memory
Cognitive Problem-Solving Self-Regulation Early
Language
Blasco Saxton, 2010
12
Video
13
First Year of Life

• By 12 months, infants should be able to
• Engage in a simple problem-solving task requiring
  working memory of an item (find a hidden toy
  under a cloth when it is changed)
• A not B task (Shift)
• Regulate behaviors (inhibit actions, waking,
  sleeping, eating, etc)

14
Video
15
Self-Regulation

• Self-regulation functions are developing from the
  first years of life on throughout a persons
  entire lifetime.

16
Toddler (24 months)

• Spatial Reversal
• Concealed behind screen, reward under one of two
  cups, side of hiding reversed
• Multilocation Search (A not B)
• Object hidden at one of three or more
  locations

17
Three years and up

• Dimensional Card Category Sort (DCCS)
• Cards depicting colored shapes
• Child sorts cards by 1 dimension then another
• Knock tap
• Child knocks when Examiner taps

18
Dimensional Change Card Sort- Separated Task

• Rule Sort by Shape

Rule Sort by Color
19
What about children born LBW

• Major medical conditions, such as cerebral palsy
  and other severe disabilities, are well known
  outcomes of low birth weight (LBW) ( 2500 grams)
  and preterm birth ( 37 weeks).

20
Research on LBW

• Longitudinal research has shown that, although a
  large portion of this population did not have
  major disabilities, many had lasting cognitive
  impairments, particularly in executive functions
  (EF)
• Anderson Boyle, 2004 Vohr, Wright, Poole,
  McDonald, 2005

21
Research on LBW

• Very preterm infants ( 2500 g, 37 weeks
  gestation) scored lower on tasks of executive
  functioning than full-term infants.
• Outcomes include poor cognitive function,
  learning difficulties, and behavior problems.
• Aarnoudse- Moens et. al., 2009 Sun, Mohay,
  OHallahan, 2008

22
National Early Intervention Longitudinal Study
(NEILS)

• National longitudinal study that followed
  children and families from the time they entered
  Part C Early Intervention through kindergarten.
• LBW data from CDC in 2002
• 7.8 of all births are LBW
• Of those, 1.5 were ELBW (lt 1,000 grams)
• NEILS LBW data
• n 19,000 were ELBW (lt 1,000 grams)
• Conclusion Far fewer ELBW infants are in EI than
  in the general population.

23
Results for Yes EI vs. No EIN 375

Attends EI by BW Yes No
LBW 41 59
VLBW 60 40
ELBW 54 46
For the purpose of this analysis, Group 1 are
labeled LBW (lt2500 grams gt 1500 grams), Group 2
VLBW (lt1500 grams gt 1000grams) Group 3 ELBW
(lt1000 grams). The percentages demonstrate that
there were more children born LBW who were not in
EI than those who were in EI. The percentages in
EI are slightly higher for the VLBW and ELBW
groups. However, there remain significant
percentages of children not in EI in all groups.
Blasco Saxton, 2014
24

• So why are some of these children who are at risk
  not in EI?
• This question remains unanswered at present.
  However, we know this population is highly at
  risk not only because of LBW but many of these
  children are from low SES and high poverty
  communities with limited resources (Blasco,
  Spiken, Shaw, 2013).

25
National Childrens Study

• There are no standardized tests that assess
  these specific abilities in infants, there are
  tests of attention, memory, and executive
  function that have been well-researched and
  replicated, yielding robust and consistent
  findings.

26
Need for Measurement tools

• Executive functioning is important to cognitive
  development during the birth to three years.
• Comprehensive measures of executive functioning
  are needed for infants and toddlers.

27

• Lowe, MacLean, Shaffer, Watterberg, (2009)
  completed a study of object permanence as an
  indicator of early working memory on 18 to 22
  months olds using scores extrapolated from the
  Bayley Scales of Infant and Toddler Development
  III (Bayley, 2005).
• Duvall, Blasco, Dolata, Atkins, Saxton (2014)
  replicated this research in a pilot study with
  LBW toddlers and found gender differences
  favoring females on these Bayley tasks.

28

• We will further examine the influence of each
  individual category of a measure of
  self-regulation and mastery behavior, the
  Dimensions of Mastery Questionnaire ( DMQ 17)
  Bayley III items to see if we can extrapolate
  indicators of Executive Function for children who
  were born LBW from 6 months to 3 years.

29

• Researchers have demonstrated that aspects of
  executive functioning can be improved in infants
  and toddlers with intervention.

30
The Behavior Rating Scale of Executive
Functioning Preschool version (BRIEF-P)

• A 63 item rating form for parents or caregivers
  to rate a child's executive functions within the
  context of his or her daily environments
• Gioia, Espy Isquith, 2002

31
How can we help?

• Inhibit
• Stop, redirect activity
• Inability to inhibit
• does not notice when his/her behaviors cause
  negative reactions
• talks in places too loudly
• Engages in inappropriate behavior

32
Video
33
Cognitive Flexibility (Shift)

• Moving from one idea/activity to another
• Difficulty
• becomes upset in new situations
• has trouble changing activities
• resist changes in routine, foods, places
• acts overwhelmed or overstimulated in crowded
  and/or noisy environments

34
Video
35
Emotional Control

• Ability to control frustration, think before
  acting
• Difficulty with
• overreacts to small problems
• after having a problem will stay disappointed for
  a long time
• has outbursts for little reason
• small events trigger big reactions

36
Working Memory

• Holding information in mind and recalling it
• Difficulty with
• has trouble with activities or tasks that have
  more than one step
• cannot stay on the same topic when talking
• has a short attention span
• unable to finish describing an event, person, or
  story

37
Video
38
Planning and Organizing

• Mastery Motivationi
• Difficulty with
• does not complete tasks even after given
  directions
• when instructed to clean up put things away in a
  disorganized/random fashion
• trouble following established routines for
  sleeping, eating, and/or play activity

39
ACTIVITY BASED TASKS

• Verbal Working Memory Tasks
• Questions I eat bamboo? What am I?
• Simon Says
• Red Light/ Green Light
• Dot to Dot pictures

40
Lets Try It
41
Name the Ink Color Outloud.

• Red
• Green
• Yellow
• Red
• Green
• Blue
• Yellow
• Red
• Green
• Blue
• Red
• Blue
• Yellow
• Red
• Blue
• Green

42
Name the Ink Color Outloud.

• Red
• Green
• Yellow
• Red
• Green
• Blue
• Yellow
• Red
• Green
• Blue
• Red
• Blue
• Yellow
• Red
• Blue
• Green

43
Inhibit Interventions

• Frequent Breaks
• Environmental Structure
• Limit distractions
• Behavior programs
• Frequent Redirection and Limit Setting
• Smaller Student-Teacher Ratio

44
Shift Interventions

• Displaying a daily schedule
• Development of positive routines
• Two minute warning
• Working in small groups

45
Emotional Control Intervention

• Preview social situations
• Review rules
• Behavioral management techniques

46
Working Memory Interventions

• Establishing Eye Contact
• Frequent, brief, breaks
• Reduce distractions
• Increase Supervision/Aide
• Time of Day important
• Encourage verbalization, paraphrasing, repetition
• Memory, Number-Letter Sequencing, Songs

47
Planning and Organizing Interventions

• Increase external structure
• Parent/Teacher modeling
• Provide examples
• Present information in an organized fashion
• Book of common routines

48
Get Ready for Outdoor Play

• What do we need?

• Check the Weather
• Make a list / visuals

• Coat
• Hat
• Water bottle
• Boots

49
Organizational Skills

• Plastic containers are a great way to organize
  different toys, especially the smaller ones that
  can fit in one drawer.

50
Organizational Skills

• Picture/label the toys inside and have children
  return materials to the right drawer.
• Use a large picture calendar of daily routines or
  storyboard

51
Organizational Skills

• Teach the children how to place lunch plates or
  cups in a designated place after a meal
• Use a fun folder that the child picks out to pass
  notes back and forth with family

52
Organizational Skills

• Videotapes on cell phone to remind child of daily
  routines
• Talk about past and future events
• Use visual strips or book to help child with
  routines

53
Executive Function Intervention

• 12 months
• Use a shape sorter, show the child how to insert
  a simple shape circle, provide them the
  opportunity to place the same shape. Now ask
  them to place other shapes. Watch the child for
  signs of frustration or lack of interest. If the
  task is too challenging, reduce the number of
  shapes.

54
Executive Function intervention

• 24 Months
•  Find six pair of socks and place them singularly
  in a basket. Ask the child to find the matching
  sock and put them together. To add a challenge
  use small and large socks so the child has to
  match both color and size. To add a fine motor
  component, have the child clip the matching socks
  together with a large clipper for snacks.

55
Executive Function Intervention

• 36 months
• Build a road with blocks and make an obstruction.
  Ask the child to rebuild the road without the
  obstruction. Let the child experiment with
  problem-solving as they try to rebuild the road.

56
Preschool Executive Functions

• Perform simple chores and self-help tasks with
  reminders (e.g., clear dishes from table, brush
  teeth, get dressed).
• Inhibit behaviors knows not to touch a hot
  stove knows not to run into the street knows
  not to grab a toy from another child hit, bite,
  or push, etc.

57
EF Kindergarten Grade 2

• Kindergarten
• Complete errands (two to three step directions
  more complex).
• Organize bedroom or playroom toys (put in bin,
  etc.).
• Perform simple chores, self-help tasks may need
  reminders (e.g., throw tissue in trash).

58
EF Kindergarten Grade 2

• Bring backpack to and from program.
• Complete simple assignments (20-minute maximum).
• Decide how to spend money (allowance).
• Inhibit Behaviors follow safety rules, raise
  hand before speaking, keep hands to self.

59
Organization of Materials for K 2nd Grade

• Talk with child about goals, plan of approach,
  and provide appropriate guided approach
• Parents and teachers should help in reviewing
  materials needed
• Provide organization time at the end of the
  school day

60
Video
61
The End
Patricia M Blasco, PhD blascop_at_wou.edu