Books - Executive Function "Dysfunction" - Strategies for educators and parents

Another book in my holiday reading list, another one from the Dunedin University Bookshop. This book by Rebecca A. Moyes gives a good insight into executive function, what it is, some strategies to help educators and parents, and she uses real examples to explain difficulties that can arise when it is dysfunctional. Executive function is about the neuropsychological processes that impact self regulation. We see it often in students who have a lack of time management skills, lack of attention, or behavioural difficulties. These are my notes, with a few more links to go deeper into topics.

Behavioural Inhibition

This is where students don't seem to be aware of social laws that govern behaviour. Examples could be of inappropriate conversations, or sharing of information. Extreme examples are those with Tourette's Syndrome who are not able to control voicing out loud what they are  thinking. Those with Alzheimers can also make inappropriate comments due to deterioration of executive function. It's important to work out if behaviour at school is because of noncompliance or if it is because they are not competent in this area. If it's about competency, then they need to be taught self management skills rather than be disciplined. This book gives lots of examples of what this can look like and offers lesson plans for teaching students to refrain from using negative words and perseverative talk (always on a certain topic eg trains).

Those with a large executive function deficit appear to be ones that struggle with change in routine, Children with ASD often struggle and can use visual supports for transitions to help with this. Some children also experience 'rule-governed' behaviour, perseverating on the rules (a lesson plan to help this is included). Sometimes what could be seen to be extreme inflexibility and stubbornness could be a sign of executive function disorder. The Stroop test (words saying colours in different colours) can be highly effective in identifying deficits, as can the Wisconsin Card Sorting test.

Theory of Mind

This is the ability to understand other's beliefs and how they are different to yourself. It's being able to understand how someone else feels and why. This chapter includes a lesson plan to help teach theory of mind through emotions pictures.

Working Memory

4 types of memory are described:

Sensory memory - brief, lasts a few seconds - eg my lips are dry, I need a drink

Immediate memory - 30 sec to a few minutes - eg instruction at school to use T for true and F for false - need immediate memory to recall this.

Rehearsal memory - up to 4 hours - eg repeating statements or actions so you can access it later

Long short term memory - 1 hour to 2 days - Can increase this by the use of mnemonics eg EGBDF for note naming. This is a step into long term memory.

Students forget 90% of what is earned in class within 30 days and most of it within the first few hours of a class. To improve memory recall you need to repeat important things less than 30 seconds after you say them, again within the hour, then review over time. To help support this you can use songs, chants, visual and tactile experiences. This chapter gives a good list of how to help support students with working memory deficits.

Organisational skills, time management, planning, and decision making

Most of this is self explanatory, talking a lot about graphic organisers. I have seen this Freeology site before but it is mentioned here as well and reminded me of it, so many great free resources. One comment really resonated with me:

"Educators must adapt work so that it is appropriate for the students. Otherwise, problem behaviours and anxiety levels will most likely escalate."

Initiation and Motivation

Sometimes what can seem like a lack of motivation is a lack of the ability to initiate which is part of executive function deficit. Students may need reinforcers or a list of steps. Motivation is also an executive function but it's about being able to actually do the task. There is a discussion about intrinsic and extrinsic motivation including some needing rewards or reinforcers to get work done. Many think it isn't fair that some get rewards and some don't, but some children need these to succeed, it's about what the reward is, and for come it could be a perseveration as a reward.

Self talk and emotional supports

This chapter unpacks stress and the effect it has as well as about having good coping mechanisms. There is a stress detective worksheet to identify what activities cause stress and a stress meter to help identify levels of stress. A useful chapter with lots of ideas and worksheets.

Attention

This chapter unpacks a lot about how there are different types of attention issues. Many are unpacked more on this Misunderstood Minds website which is one theory about how we pay attention. This  chapter gives some good strategies on how to help improve attention, including food and water, reinforcers and technology.

I did enjoy this book. It has a lot of examples and good practical ideas. It is reasonably short which helps when you are reading heaps and I found it easy to read. On the way through, doing more research, I found this great site called Understood - lots of info on here about all sorts of things, I'll spend some time having a look through. Meanwhile, for now, I'll finish my blog with the same anonymous quote that she uses in the book:

"If they can't learn the way we teach, maybe we should teach the way they learn."

Books - Autism Spectrum Disorder in Aotearoa New Zealand: Promising practices and interesting issues

The holidays give me time to read some books, some for pleasure and some for work. Over the last week or so I have been reading Autism Spectrum Disorder in Aotearoa New Zealand: Promising practices and interesting issues edited by Jill Bevan-Brown and Vijaya Dharan. This book caught my attention before Christmas while looking through the University Bookshop in Dunedin with my friend Tara. She and I found a wide range of educational books there and we may or may not have purchased a large number of them - woops.... So I thought as I read them I would give a bit of a summary which may inspire a few others to read them as well. 

I really liked that this book is based on New Zealand practice. It shows practices of NZ kaiako and educational professionals who use Evidence-based practice (EVP) and implement interventions for those with Autism Spectrum Disorder (ASD) in the classroom. Overall the book has some great interventions and tips for dealing with the 1 in a 100 students who are diagnosed with ASD. It also has a lot of tips specifically for Māori students and talks about components of culturally responsive evidence based practice, referencing Sonja Macfarlane's work. There are also some great links throughout the book to websites that can be used for more in depth research. I have done a quick note about each chapter to give an idea of what information is available in this really practical book and added a few links for more information about each topic.

Part 1 - Interventions

Chapter 1 - Using an adapted SCERTS framework with a 4-year-old - Anna Christie

SCERTS stands for Social Communication, Emotional Regulation, Transactional Supports. This chapter has descriptions and case studies about how it can be used in the classroom, building competency in each of the three areas by using strengths and interests.

Chapter 2 - Picturing the future: A video modelling package - Tracy Watkin

This is based around Albert Bandura's Social Cognitive Learning Theory which is about behaviour acquisition through imitation. The idea is that an individual learns a behaviour by watching a video of a demonstration of that behaviour. It also talks about Vygotsky's Zone of Proximal Development which talks about a "more knowledgeable other".

Chapter 3 - The development of a Makaton resource for Samoan children - Heather Polson

Makaton is a signing system for hearing but can also be used for communication and learning differences. It uses sign and speech together as a bridge to verbal communication. This supports the idea that the preferred learning option for many individuals with ASD is visual rather than verbal.

Chapter 4 - Social Scripts: SpongeBob helps Sam - Tangi Jackson-Ross

There are lots of different social narratives - statements, comments and questions individuals can use in social situations they find difficult. This one is focussed around SpongeBob Squarepants where the author wrote scripts with illustrations for a child to help them with having a conversation or to deal with different situations.

Chapter 5 - Colourful semantics: An approach for teaching literacy and communication to children with ASD - Dervla Hayes

This chapter was about using colour coding to show the structure of a sentence. It is a possible intervention to show how language works, but not necessarily for Māori due to the sentence structure being different. This is based on the Colourful Semantics approach by Alison Bryan.

Chapter 6 - TEACCH in a New Zealand regular classroom setting - Sharon Ketter

TEACCH stands for Treatment and Education of Autistic and related Communication-handicapped Children. It is a strengths based approach based on structured teaching. This chapter gives examples in writing and mathematics, using the individual's strengths to teach them to work independently in the classroom. It is highly individualised and is based on the premise that:

If an individual with an autism spectrum disorder is not learning a skill or behaviour that we seek to develop, then we are not learning from them and we are not modifying our instructional tactics to their needs effectively. (Powers et al., 2011, p. 86)

Chapter 7 - Creating a social skills toolkit - Fran Dawson

This includes a Functional Behaviour Assessment, musically and electronically adapted Social Stories, video modelling. An example is of a group making a song and video about keeping their hands to themselves.

Chapter 8 - Pivotal response training for individuals with ASD - June Chiaroni

This was about enabling ASD students to respond to naturally occurring learning opportunities and build on their own interests. Parental involvement was very important. Lots of choices were available to students. For examples in literacy they had a choice of seat, a choice of pencil, marker or ballpoint, a choice of writing in a book, on coloured paper or on a computer. A lot of this is drawn from an Autism Internet Module on pivitol response training (which I suggest anyone with an interest in ASD signs up to and does some courses - free).

Chapter 9 - The Ziggurat Model in planning interventions for students with ASD - Jenny Tippett

This model has 5 heirachical levels that all need to be  addressed for intervention. Sensory and biological, reinforcement, structure and visual/tactile supports, task demands and skills to learn. These are all unpacked in this chapter and a case study example is given.

Part 2 - Issues

Chapter 10 - The role of culture - Jill Bevan-Brown and Alexandrina Moldovanu

This chapter is about how culture has influence on how ASD is viewed. In some cultures the symptoms of ASD may be ignored or not noticed as they are considered 'normal' behaviours or may be seen just as a  'naughty child'. There is also discussion about how interventions developed in the Western world are not always appropriate in other cultures. A very strong message that it is important to listen to and be guided by parents.  Bevan-Brown's three-step stairway to cross cultural competence is also mentioned. This is about understanding one’s own culture first, about the influence of the Pākehā culture on the New Zealand education system second, and third, about recognising the necessity to increase our own knowledge of the cultural background of the students.

Chapter 11 - Narrative assessments: Inclusive educational 'selfies' - Natalie Paltridge

Narrative assessments or learning stories can be used to show progressions, depth or ideas for next learning steps. They are used widely in Early Childhood, but not always at other levels. A good discussion in the chapter about how we perceive, apply and use assessment. I do like this quote:

Assessing everyone in the same way will not meet the needs of all students.

A reminder that is assessments are to be meaningful, they need to be student-centered and responsive to each student's learning needs. 

Chapter 12 - Dual diagnosis of deafness and ASD - Sharyn Gousmett

This chapter discusses the challenges and implications of this diagnosis. 12% of children with a hearing loss have some form of disability and a further 12% are thought to have an unconfirmed disability. One thing that jumped out at me was not having a diagnosis until later in life meant that students  "missed out on vital opportunities for intervention support". Early intervention needs to happen at age 2 or 3 and it can make a big difference.

Chapter 13 - Sensory therapies and interventions for individuals with ASD - Julianne Swanepol

A few approaches are described in this chapter. A sensory diet, where there are scheduled activities that can be integrated into a day. The ALERT programme which helps to recognise what those with ASD need to do the help themselves adjust to different situations. Handle Therapy, by Judith Bluestone, which is current not available in NZ. The chapter also has information about a Sensory room and how this works. There are a lot of resources at the end of this chapter as well.

Chapter 14 - PATH: Planning alternative tomorrows with hope - Alison Browning

This chapter was about planning transitions from school to the world. Some key issues were discussed. Transition should be over 5 years from age 14 where students would be introduced gradually to community based learning until their final year of school which should be mainly in a community context. 

I really enjoyed reading this book. I learnt a bit more about some different interventions and it reinforced what I already knew. Some things that went through all of these chapters are:

Getting to know your students is most important

Consultation with the person with ASD and their whānau is so important

The need for programmes to be individualised

Interventions are all built on interests

Interventions should be used with ALL children

You need a sound knowledge of ASD characteristics and strategies

More learning - there is always more to learn

Bring on the next book.