Late, Lost, & Unprepared: Executive Function Struggles

Does your child struggle with planning/organizing, time management, and impulse control? Join us for our interview with Dr. Joyce Cooper-Kahn, a clinical child psychologist who specializes in the treatment of children and adolescents with ADHD, executive functioning challenges, and other learning disabilities. She is the author of Late, Lost, and Unprepared: A Parents' Guide to Helping Children with Executive Functioning.

In this episode, we cover:

• What is executive functioning?
• Example of executive functioning skills?
• What is it like for kids, youth, and adults who struggle with executive functioning?
• What is the experience of families with a child/youth with executive functioning difficulties?
• Why do some kids struggle with executive functioning? What other disabilities often occur with this deficit?
• At what age do we usually expect executive functioning skills to start developing?
• Who can diagnose an executive functioning disability, and why is it important to get a diagnosis?
• What can parents do to help kids improve their executive functioning skills or learn to live without them?
  • Use real life to teach
  • Teach rather than punish
  • Collaborate with the child or youth
  • Behavior modification
  • Adjust expectations
• When should you allow your child to experience natural consequences for behavior?
• Practical tools for helping kids plan and organize.
• Practical tools for helping kids shift gears or handle transitions.
• Practical tools for helping kids with working memory challenges.
• Practical tools for helping kids control impulses.

Additional resources:
Late, Lost, and Unprepared: A Parents' Guide to Helping Children with Executive Functioning

Boosting Executive Skills in the Classroom: A Practical Guide for Educators

Transcript

Please pardon any errors, this is an automated transcript.
Dawn Davenport  0:00  
This is Creating a Family talk about foster, adoptive and kinship care. Welcome back to our regular listeners and subscribers. It's through your support and your listening and your subscribing that we have reached where we are. We're now in the top 10% of all podcasts worldwide. We couldn't have done it without you. And welcome aboard to our new listeners, we are thrilled to have you, through your participation and your subscribing, that we're going to be able to continue to grow and to continue to reach more families who are raising kids who've experienced trauma. I'm Dawn Davenport. I am the host of this show and the director of the nonprofit creating a family.org Today we're going to be talking about why my child is always late, lost and unprepared, executive functioning struggles. We'll be talking with Dr Joyce Cooper-Kahn she is a clinical child psychologist who specializes in the treatment of children and adolescents with ADHD executive functioning challenges and other learning disabilities. She is the author of late, lost and unprepared, A Parent's Guide To Helping children with executive functioning. She is also the co author of boosting executive skills in the classroom, a practical guide to the educator. I am a mom of a child who struggled mightily with executive functioning skills challenges, I should say. And I absolutely love the title of the book, late, lost and unprepared, because it pretty much described my life. And so thank you so much, Dr Cooper-Kahn for joining us today to help talk to us about this somewhat confusing topic of executive functioning. I

Speaker 1  1:42  
am thrilled to be here, and my son also struggled with this. So I have lived this as a parent as well as a professional, and it did give urgency to my efforts to understand executive

Dawn Davenport  1:55  
function. I get that I would have loved to have had your book years ago, I would have absolutely loved it. Let's start and let me say to our audience, make sure you stick around. We're going to spend most of our time talking about practical tools to help with specific executive functioning skills. But before we get there, we do need to lay our foundation. So let's start by saying, what is executive function? And can you give us some examples of what we mean by executive functioning skills?

Speaker 1  2:26  
Sure. So executive functioning is the set of neurological processes that helps us to organize and supervise our efforts to reach a goal. So here's what that might look like at home. We tell our kids you need to go upstairs and get ready for school, and the bus leaves in 15 minutes, and then we leave our kids alone to do that if they are not challenged by executive functioning. But those folks who've raised kids who have executive functioning challenges know that that process can lead to many different detours along the way,

Dawn Davenport  3:09  
right, yeah, yeah, yes. In other words, sending them upstairs to do it is the first mistake there, but go ahead

Speaker 1  3:17  
exactly so early on in life, executive functioning is mostly impulse control, working memory, the ability to be flexible. But as kids get older, that neurological framework broadens and gets more complex, and it's about coordinating various things at the same time, as well as having the individual skills. So it might be that in a high school, or what it looks like is they were assigned a long term paper, and they get a zero, and they are totally surprised by the assignment, because they never quite caught on that it was due. Never wrote it down, you know, on and on. They

Dawn Davenport  4:06  
didn't get the assignment the due date on their calendar. In fact, they don't even maintain a calendar. They didn't. Weren't able to break the assignment down into the smaller pieces and say, okay, if I'm going to finish it by x date, I got to start by this date, and I have to get the at least Table of Contents done by this state exactly. And then how am I going to do the research for this? You know, when am I? Do have to get started on that, even though they could be very intelligent. This is not an intelligence issue. Yeah, you

Unknown Speaker  4:33  
have clearly lived this way. Yeah, I

Dawn Davenport  4:35  
have clearly. Oh, have I ever lived this?

Speaker 1  4:40  
Oh man, and it can be something as frustrating for a parent as I need you to clean your room because your grandmother's coming tomorrow and she's going to need to stay in your room, right? And they don't get started on it. They have no clue of even how to do it. Your first

Dawn Davenport  4:57  
mistake is saying, clean your room. That's. It's an undefined term. It is. I need you to pick the dirty clothes off of the floor and put them in the hamper. As soon as that is done, yell and I'm coming back in. We'll find the next thing. Yes, absolutely,

Speaker 1  5:10  
absolutely. And we'll talk later when we talk about practical skills, ways to transfer that to the child or adolescence responsibility, and how do we do that? But the younger kids are, the more hands on it requires just to get them through a day. So it can be really exhausting for a parent, and schools, as well as parents don't always recognize what it is that's going on. So you know, it may look willful. I told you to do this thing and you didn't do it. Or I told you that I needed you to bring home these four things, and you only brought home two, you know. So what's the matter with you? Or I've

Dawn Davenport  5:55  
told you a million times that if you don't bring home your book bag, you're not going to be able to do your homework. Blah, blah, I

Speaker 1  6:01  
used to say that one of the greatest assessment tools was how many agenda books a student loses?

Dawn Davenport  6:09  
Oh, that's a good one. So at what age do we normally? I mean, we don't expect preschoolers to have executive function skills, but at some point we expect these type of skills to kick in. At what age do we normally see the beginnings of executive function, or higher level thinking skills kick in?

Speaker 1  6:29  
Well, you know, in fact, you do expect to see some rudimentary executive functioning, even in very young children, so alerting to what needs to be done. You know that moment now part of its language development, but there is that stellar moment when, as a parent, you say to your young child, first do this, and then you can have your snack. And instead of whining and crying, they actually do it, and you realize, ah, they're starting to get it. So that takes some working memory ability, it takes impulse control, and it is the beginning, really of some cognitive flexibility and behavioral flexibility. So those things happen pretty early. But then as kids get older, we start seeing that differentiate into much more complex skills. And so those things we expect, particularly somewhere around mid elementary school. So mid childhood, eight, nine years old, we see some big jumps in ability towards the end of elementary school, into middle school, we start seeing another big jump. And of course, towards the end of high school, late teens, we start seeing another big jump. Those things correspond with changes in demands that are based on typical development. And so when our kids are typically developing, things click along. And you use, you know, some lags, of course, at developmental leaps, but you expect your kids to move along. So by you know, if you think about what we expect say of even a late elementary school kid versus an early elementary school kid. We do expect them to be able to manage themselves at home. We expect them to do their chores. We expect them to mostly do their own homework. You know, they need some boosting and some support, and then by the end of high school, we expect them to be really able to manage themselves, because that's when we're sending them out into the world or to college in many families, and they have to be able to handle it themselves. That's a huge amount of growth and really, and the trajectory is longer than for most other things. That means two things. First of all, it means that in kids that are delayed in their executive functioning, they're not going to be ready for some of those developmental challenges at the same time, so they'll be sort of out of sync. But at that long trajectory for growth, that big number of years in theirs also means that we have a lot of time for input, and so that's a blessing, really,

Dawn Davenport  9:27  
very much. So why do some kids struggle with executive functioning? Or maybe a better way to ask that would be, what other disabilities or disorders often occur with this deficit

Speaker 1  9:39  
the largest group are kids with ADHD, kids on the autism spectrum under that umbrella, and many kids who experience chronic early stress or trauma. Mm hmm will have difficulties with the development of the networks associated with executive functioning. Interestingly, we also have a group of kids whose development goes just fine, but executive functions those networks are dramatically affected also by various situational kinds of changes, so anxiety, depression, physical stress, emotional stress. So some kids, unfortunately, you see both, so it really exacerbates the problem. But other kids, for instance, have developed fine, and it's only when they're under particular stress that you see problems. So the two very different situations,

Dawn Davenport  10:49  
and I will throw in another one, it's because we work so much with this, and that is children who were exposed prenatally to alcohol and drugs, the parts of the brain that control higher level thinking skills and executive functioning are directly impacted by substance exposure prenatally. In fact, a hallmark symptom of prenatal exposure is children who struggle with executive functioning and higher level thinking skills. Yeah.

Speaker 1  11:15  
One thing to say about that also is that often early trauma leads to difficulties with that emotional regulation piece of executive functioning, as well as some of the cognitive issues with executive functioning. So a lot of times, what you see is this general irritability, and that irritability is sort of a neurological irritability that also has to do with just difficulty managing emotions and strong feelings. We

Dawn Davenport  11:51  
certainly see that for kids who've had experienced trauma, and that can be also an executive function skills emotional regulation is an executive function skill is that what you're saying correct?

Unknown Speaker  12:01  
It is okay.

Dawn Davenport  12:04  
Let me take a moment to tell you about some free courses we have at creating a family. These courses are brought to you by The jockey being Family Foundation. We are so happy for their support of both this podcast, but also for these free courses. They are one hour. They are self paced, meaning you take them on your own. They are free, and there is a certificate of completion if you need that, primarily if you're a foster parent and need continuing ed credit. And they're for parenting. So they're less for preparation for adoption or fostering, and more for when you're in the moment, in the trenches of parenting. Check them out at Bitly, slash, J, D, F support. That's B, I T, dot, l, y, slash, j, b, f, support. So who can diagnose a child with executive functioning disabilities?

Speaker 1  12:57  
So this part is really confusing to parents. So you know, generally, the folks who diagnosed executive functioning difficulties are psychologists of one sort of another, or sometimes it's educational staff. But there's a whole large variety of folks involved in assessment of executive functioning, and it depends not only on what their discipline is, what their profession is, but also on what their particular interests are. So I know a lot of occupational therapists who do a lot of work with executive functioning. I know a lot of speech and language pathologists who do a lot work with executive functioning. Overall, the most important thing is, generally, to put together a team of people. I am biased, of course, some psychologist, and I think a psychologist is a good place to start when you can, because what you want is someone who will take four steps back and look at it from the broad view, and also help you to know what kinds of assessments you need. So when we assess for executive functioning issues, we also have to rule out a variety of things that can cause executive functioning problems that are more primary than what we're seeing in everyday life. We need to look at, you know, these co occurring conditions as we've talked about. We need to talk about ruling out some things, and we also need to sometimes consider what might be masquerading as an executive functioning problem. So that's a lot of different areas. It's never quite as straightforward as it seems, and I can tell. You that a lot of times we'll have people come in, the parents will say, I'm told my kid has ADHD and executive functioning problems. And so you think you're in for a nice, straightforward, simple evaluation. And of course, as soon as you start talking, you discover that there's a lot more going on, and those things need attention as well. Yeah,

Dawn Davenport  15:23  
and educational psychologists are usually the ones that I have always been told that at least start there.

Unknown Speaker  15:30  
Yeah, it's a great place to start.

Dawn Davenport  15:34  
Let me interrupt this interview to tell you about our podcast weekend wisdom, which is our opportunity to answer your questions. So we need your questions. Please send them to info at creating a family.org every week, we spend five to 10 minutes with one question sent into us by one of our audience members, and we try to answer that question as part of that is the week in Muslim that's what we do. We answer your questions. So send them to us at info, at creating a family.org and now back to the show. All right. Now I want to move on to the practical part of our discussion. We're going to talk at the end about practical tools for helping kids with planning and organizing, with transitioning, with working memory and with controlling impulses. But before we get to the specifics of what to do with those specific executive function skills, what I want to do is you give some overarching guidance to apply to all executive function skills. And so I'd like to start there, because I thought they were very helpful. So what can parents do to help kids improve their executive functioning skills or learn to live without them? And this, by the way, all of this is included in late, lost and unprepared so let's start with one of the ones you had, which I really appreciated, was use real life to teach what do you mean by that? Yeah,

Speaker 1  17:08  
so we need to use examples, situations from daily life so that we can teach kids practically how to manage this. Now, after all, if we as adults have trouble even understanding this concept of what is executive functioning, think about what it means if we start talking with kids in general terms about these things. So there are two things to understand. You can't tell a kid just we're going to teach you about planning and organizing right in the abstract. There's always content to that. And so if you use real life to teach it motivates the child, because they have a task to accomplish, and it's concrete, and they know what it is. And by teaching them about a specific situation, you are, in fact, teaching them more general skills that they can then apply to other situations. So let's say we have the choice between a study skills class that meets in the summer, when the child is not taking classes and it's not in school, versus using their getting ready for summer camp every day to teach how to plan and organize. I take summer camp every time because then we have a very specific goal, we can help the child manage that goal, and there's a time to practice it immediately, and we're not inventing work. One of the things that some of the classes in our area do, that I find just like so frustrating, is that they will teach a class and planning and organizing during the school year, and then they invent tasks that the child has to do to show they can learn to plan and organize, and they have to do that on top of their schoolwork. And I always think there are so many opportunities, yeah, in the course of a day, why give them extra work? Yeah,

Dawn Davenport  19:17  
exactly. Not only that, kill two birds with one stone help them get one organized, you know, or whatever it is, exactly.

Speaker 1  19:23  
So we want to use real life to teach. And we also know that kids need help at the point of performance. There is not a single kid that has trouble with planning and organizing that doesn't know they need to be better at it, so just telling them to do a better job is not what it's about. They know what they should be able to do and they can't. So we want to help them at the point that they have to perform the behavior, and that's why we need to get parents on board. We need teachers to help in the school setting. At that moment. So if we can use their real life everyday, moment to moment situations, to teach them, then they become more competent at handling those situations, and that's what we're going for. Your

Dawn Davenport  20:13  
next overarching guidance for helping our kids improve their executive functioning skills is self explanatory, but it's worth saying, and that is, teach rather than punish. I'm assuming that gets to the notion that children are not intent to punish. If they're doing something intentional, this is not intentional. They are lacking a skill. And when you lack a skill, you teach

Speaker 1  20:36  
exactly. So you know, it's funny, because although it may require more repetition over time, it's not unlike teaching any skill. So you know, we would never think of yelling at kids in first grade because they can't read yet, right? And it's essentially the same thing. They're lacking the skills, and so your job is to teach them, teach practice reinforce, teach practice, reinforce until they can do it independently, right? And the same thing is true. The risks of punishing kids for something that they can't do are just so huge. You know, you end up with these demoralized kids who feel like they can't please anybody, and they know they're not doing it well, and they either turn it back on themselves or turn it at the people who are making these demands of them, and it's not the way you want to teach anything. Exactly.

Dawn Davenport  21:35  
Yeah, your third one was collaborate with the child are the youth, yeah.

Speaker 1  21:41  
So anytime you can use something that motivates the child, then you're going to get a hit of dopamine, and dopamine helps the circuitry responsible for executive functioning. So that's a really interesting principle to me. So we want to collaborate with the child to come up with things that motivate them. And at the same time, we want to collaborate because we want to teach executive thinking. So we want to be able to say to a kid, essentially, you know what? That last paper for English you got in two weeks late, and that would just be such a shame again, because you understand the stuff. It's really all about how you get it organized. So tell me, what do you think got in the way last time? And gradually, we teach kids to recognize what it is. They will sometimes begin by saying, I did fine. I'm going to work harder, leave me alone, whatever. But you can help them to recognize that, and by collaborating with them, you get their goodwill, you give them some respect, and you also start to teach them how to think through the problem solving for these issues,

Dawn Davenport  23:14  
which is going to have to be helpful, ultimately, and hence why we need to get them on board. Yeah, all right, let me hit the fourth one, the fourth overarching tool for parents to use, regardless of the executive functioning deficit, and that is behavior modification.

Speaker 1  23:31  
So whenever there is something that is hard for us to do, we want to go back to those basic principles of behavior modification, so anything followed by a positive is more likely to recur. Anything followed by a negative is going to be less likely to recur, right? So because we know that part of the problem with executive functioning is that these networks are not working all of that well, and we know that dopamine helps to grease the skids, so providing rewards brings a hit of dopamine, and it makes the brain hum, right? And so we always want to go back to those things that will heighten motivation by boosting the rewards. And at the same time, we want to make clear when something is not going well. And I'm a big proponent of being honest with kids when they haven't hit the mark. I'm not a big proponent of punishment in that sense, but I do not have trouble with taking away things that are not a child's God given, right? You know, nobody has and in. Inherent right to watch as much television as they want to, right or and some of those things, and I don't mind taking those away. I prefer to start with rewards. But you know, we've all learned in parenting that sometimes just rewarding is not going to get you to where you need to be, and sometimes what I call a punishment, is withholding a reward until that has helped,

Dawn Davenport  25:25  
yeah, which is inherent in the nature of giving a reward is you don't get the reward if you don't do the action that with the reward. Is reward was promised Exactly.

Speaker 1  25:33  
Yeah, exactly. And the other thing is that sometimes there are goals that are more important to the adults than they are to the child. And so a reward introduces something that's important to the child, yeah,

Dawn Davenport  25:48  
helps you be on the same team, yeah? And the last of the overarching tools that you can use, that I want us to talk about, is adjusting expectations, and I am assuming that means parental expectations, yeah, and school expectations, adults, adult expectations, right? Exactly. Yeah.

Speaker 1  26:06  
You know, kids can only develop at the pace that they develop, and unfortunately, sometimes our kids are out of sync with the world's expectations, and so then we have to adjust those expectations when we're helping with executive functioning or with almost anything else, we're always looking to have the kids working at the very edge of their ability, but we can't work too far ahead of their ability, right? So if I decide I'm going to start jogging, and you say to me, great, I expect you to jog five miles on Tuesday, that's doomed to fail, right? But if I say, Well, I know I could walk fast for a mile, then you say, Well, why don't this time? Why don't you try walking fast for a mile and a half next week, we'll pick up the pace, right? So we're that's what we're always trying to do. We're trying to help kids just to stretch what we see they can already do, to the next little step in that chain of behaviors we're trying to build. Okay?

Dawn Davenport  27:17  
That makes sense. So when should you allow your child to experience the natural consequences for whatever it is that they're not doing or whatever it is they are doing that has negative consequences?

Speaker 1  27:31  
Yeah, I think there are two things we usually consider about natural consequences. One, is it within their range to hit that target, so they don't have to be able to do it now, but perhaps if they just stretched a little bit, they could. So okay, that makes sense, then natural consequences might be useful. And then we're also looking at how detrimental are those natural consequences. So the example that I like to use is learning to cross the street. We can teach kids to cross the street. We can't teach them at three we don't say, Well, if you go out and get hit by a truck a few times, you'll start looking for trucks, right? Because that's just silly. It's just not going to happen. We start teaching the rules for how you cross the street, but we stay with one hand on the kids shoulder for a long time, right? So we're looking for signs that they're getting close to being able to do it on their own, and we are not risking major, major problems by doing it,

Dawn Davenport  28:44  
those are good suggestions of how to know to use, because natural consequences are a good teaching tool, but only if they're used in the appropriate ways. Yeah. Okay, let me pause here to ask a favor if you're enjoying this podcast, will you please subscribe? And we'd really, really, really appreciate it if you would rate and review the podcast. It truly helps us. We are growing, and we want to continue to grow, because that helps us accomplish our mission. So please follow or subscribe to the podcast and then rate and review it. Thank you so much, and now we'll get back to the interview. All right. Now we're going to move to the practical tools. And as I mentioned, we're going to cover these are not in late, lost and unprepared. You cover many of the executive function, individual skills, but I selected four. So what I'd like to do is talk about these four give us some practical, implementable whoever is listening can go home and today, or they're probably already home when they get out of the car, or whenever, whatever they're doing when they are listening to this, they can implement some of these tools. Let's start with planning and organizing. So if you have a child. But you have a child who struggles with executive functioning, then you are going to have a child who struggles with planning and organizing. And so what are some practical, implementable tools for parents to help work with the child? So

Speaker 1  30:13  
let's think first about what the problem is when a kid can't plan and organize, right? So essentially, the issue is they have trouble overlaying a structure onto a task, right? So whatever that task is, they have trouble figuring out how to get to that end. If they have trouble planning and organizing, though they also may have trouble organizing, putting a structure over information. So you think of that, it's like if someone has a file cabinet, and instead of having file folders labeled, they just open the drawer and throw something in, right? And the next time they open the drawer and throw something in, well, eventually you have these drawers full of stuff. And if somebody tells you, can you find the information about that book you read you don't know where to look, right? And if you've raised a child like this, it just makes me smile, even to think about some of the situations we found ourselves in from time to time, right? So all of the interventions are designed, first to help kids structure information and tasks, and secondly, to build templates for how you organize a task or information. So practical strategies. We start out when kids are really unable to do this at all, we have to start out by giving them a structure for information so we can say to a kid, I need you to meet me at the car in 10 minutes. Be sure you have everything you need for school. And then we're going to stop on the way home, and we're going to go to the library. So you have to have your library books. And then after that, is soccer practice. So make sure you have your soccer back right. We have now talked, talked, talked, and we have not given the child anything that they can use to structure that. But if instead, we create a checklist for them, here are the things you need to be ready for school. If we have three tasks we want them to do, like, you know, school, library, books, sucker, we now have three separate templates, and we might need to give them a checklist that includes all of that. I remember one time after my son learned to drive, I said to him, you know, while you're out, I need you to stop the grocery store. I need you to get, you know, just milk, eggs, bread, cheese, whatever. And he looked at me and he said, Oh, Mom, you know, once we get over three things, you need to write them down for me. I thought, okay, you're starting to get it to which I said, of course, because he was old enough and had had enough experiences with I said, I won't write it down for you, but here's a pen and a piece of paper, and I will say them more slowly so you can write them down, because I wanted him to go through the process himself. Okay, so we're going to build templates for a variety of different things every time a child is assigned a new task, they need a template for

Dawn Davenport  33:46  
that. When an example of a template is going to be like a checklist. You mentioned a checklist for yes, these are the things, the tasks that need to be accomplished when you get home immediately, when you get home from school, another checklist,

Speaker 1  34:00  
when I say clean your room, here's what I mean. And you you know, throw trash away, dirty clothes in the hamper, you know, looks in there on the bookshelf. What you have to do is you think about what would it take to hit this target of having a clean room, and you have to be able to break it down into steps, and at first you do it for them. If they have a long term assignment, like a paper or study for a test, we have this strategy that my co author on boosting executive skills came up with it. It's so simple, if you have a paper and pencil planner, if you're assigned a long term task, you write that it's due on the date that it's due. But think about it, if you are sitting there on January 10 and somebody says. This project is due on March 15. These planners are all week by week. You don't see that till the beginning of that week in March. It's way too late to start it by then. But if you've written it on March now, it's out of your head if you don't plan and organize well. So whenever you have a due date that is not tomorrow, you turn your agenda book sideways and you write horizontally on that top of the paper, you write what it is that's due and the due date. So you know English paper due March 15. If something is written at the top of your planner when you get home, that is your cue that you have planning to do, and that's the date. And early on in this process, we have to really help kids with this. We look at what it is you have to do, what are the tasks that you're going to have to do in order to achieve that. How long will each one take? And then we teach kids the difference between due dates, D, U, E and due dates, D, O. When are you going to do task number one on your list? We can use simple templates such as, you know, fold a paper into thirds, and in each column you put a header to do in process done, right? And then the first day, when you're planning, you put in that to do list all the sub tasks, right. And then as you're working on one, you get to move it to the middle column, and the best thing of all is you get to cross it off when you get to the end. We have to teach kids if you have to pack a soccer bag, here are the things you need to do. I used to keep a laminated checklist in my son's soccer bag. At first, I created those sorts of lists, and then I would still have to prompt him. Have you looked at your checklist? Let's look at it together, and eventually I could move out of that role entirely. Right? So,

Dawn Davenport  37:19  
calendars and checklists, and you can have checklists for every you know, getting ready for bed. This is what has to be done, picking up your room. So those are some good practical tools for planning and organizing. Now let's talk about practical tools for helping kids shift gears or handling transitions. This is a real one. Yes, it is. So what are some practical things that parents can do today if they've got a kid who struggles with transitions?

Speaker 1  37:51  
Okay, so again, the issue with making transitions, what is it kids get an idea in their head and they want to stick with the idea in their head, or the task that they're already started on. So we're always trying to come up with strategies that help kids to get out of that mindset and into the next number one, always give a kid a branch to swing across the creek with. Right? You want to give them something to hold on to. So we don't say to them, you need to stop playing. Now what we do is we tell them what we want them to do, to carry it across. How are they going to get to that stop? So tell them what you want them to do. So I need you to take those toys and put them in the box now, right? As opposed to stop what you're doing, because stopping is what they would don't want to do. And so if we can focus on the transitional piece of it, that can be helpful. Doesn't take care of the whole thing, but it can be helpful when we have something positive we can offer on the other side, that's even better. And instead of saying you need to stop playing now, if we can say, once the toys are put away, it will be time for us to leave to go get pizza. Can I help you put those away? Concrete young kids. We also do it by helping them. I'm going to put all these Legos in the box. How about if you get the crayons. And then as kids get older, we want to teach them about their difficulty with transitions, and then we can teach them again templates for how you handle a transition, I think you might be going through your new teacher anxiety blues here. You don't like new things. You don't like new teachers. What can we do to help you get prepared for that? Here are some ideas I have. Do you. Have something you'd like to do, another thing that I really like, and we do this, or I try to do it with adults. Often, if you're going to say something difficult, we try to give kids a chance to collect their resources first by preparing for that Sally, I know you're not going to like what I'm about to tell you, so take a deep breath now, before I even say it, you know something that just prepares them and allows them to orient themselves, something is coming, right?

Dawn Davenport  40:39  
Another thing that you haven't mentioned, but I think most parents who have kids who struggle with transitions have figured out on their own, and that is setting a timer and letting the kids set the timer. The Smart speakers are great for this, because kids can say, hey, whatever the name is, I won't say it because it tends to set it off. So we're going to need to stop playing and go wash our hands for dinner. How much time do you need? That goes back to the collaborating, okay, I need five minutes. And if they're not good about that, you can say, do you need two minutes? Or you need five minutes? And so they're going to pick five. And then you can say, Can you set the alarm? And if use a smart speaker, or if you have a they can use it on your phone or whatever, and then remind them when the timer goes off. What are we going to do? So that they enunciate, ask them to tell you what they're going to do, what action are they going to do when the timer goes off? So giving them as advanced notice as much as you can in allowing them to be as involved as possible in that transition in the setting of a timer or whatever, to give them the heads up and having them enunciate what it is that they're expected to do when that time comes.

Speaker 1  41:50  
Yeah, I love that. And then the other thing is sometimes just siding with the kid. And you can say, when they say, No, I don't want to you say, I know I hate changing too. And you know what I hate to change? Here's what I hate to change. But you know what we do need to eat dinner at five o'clock. And so do you want to set the timer? Or do you feel like having me do it today? Do you want to talk to our electronic digital friend here? Or do you want me to do? Yeah, exactly, you know, yeah, right.

Dawn Davenport  42:24  
So now practical tools for helping kids with working memory challenges, and this one might be helpful if you explain what a working memory challenge is. First, that is, again, a term that educators use, psychologists use, but that's not how parents think in terms of that.

Speaker 1  42:44  
It's not so let's call it a scratch pad instead, right? Okay, that's what working memory is. It is a scratch pad. It's a dynamic scratch pad, but it's a scratch pad. So working memory is where we store information that we only need long enough to do the next step right? And so at its simplest, it might be, get your hat, your coat, your shoes, meet me in the kitchen. And so there are things you have to write on your scratch pad. And unfortunately, kids with executive functioning challenges, it's like their scratch pad is smaller than everyone else's, and everything is written in disappearing ink, so the information falls off more quickly. At its more complex it can be remember like sitting in a classroom and your teacher says, we're going to talk about the Civil War today. I want you to to take special note of the three reasons we got into the Civil War. So now people with good executive functioning are working memories, are doing a couple of things there. They're already calling up information from their long term memory about the Civil War. They're putting that on their scratch pad. They've put on the scratch pad that the goal is to remember the three reasons they got into the Civil War. And all the while that that's happening, the teacher is still talking, and you've got to take in that information. And you have to decide, does that go on your scratch pad? Prioritize it? Do I need it? Do I not need it? She gives new information. You're comparing it to what you've pulled up from long term storage. It's a really complex process. It also affects things like holding in mind the steps in a process. So all of the practical strategies then are essentially about externalizing that scratch pad coming up with ways to store information when your brain doesn't do it easily. There are some people who talk about strengthening working memory. There are some computerized tasks that supposedly strengthen working memory. So. Far, my read on all the research is those are promising, but not proven techniques. Interesting. What is always a proven technique is externalizing the scratch pad. So I have some kids who will sit with me in therapy and their working memory is so bad. Here's what you notice. They will start answering a question, they'll start talking, and then their voice gets softer and softer, and the words start coming slower and slower, and they'll look up with you and say, What was the question again? So they have lost the question in the time it takes them to listen to it, call up the information. They start talking, and they've lost the question already. So we teach kids to write things down. Write things down. Write things down. At first, you may need to write it down for them. So if you are doing some of those things you do for planning and organizing, you're also helping with working memory. When you're giving templates, you're giving concrete reminders of things. Every time you say something out loud, that information only lasts until the sound waves dissipate, right? So we want to make sure there's information they can re inspect if they forget. As parents, and I'll go out on a limb here and say, particularly, mothers do this. As women, we are taught to soften things by using a lot of words, and that gets in the way, right? So we as parents, we need to learn to simplify the information. You need to be ready at four o'clock, because last time you weren't ready till 430 and then your sister had to stand outside in front of the school building until we got there. So I need you to get it done now. The kid has forgotten it. All right, what you need to be able to do is, here's the list, hat, coat shoes. Got that hat. Coat shoes meet me in the kitchen. I'd like to make it into a game for small kids. I'll put it into a rhyme, or I'll do a little dance with it. So then give them something else to hold on to. You want to make sure that when your child tries to find the information, it stands out in sharp relief in their head. We want to teach them to write things down. We want to teach them to check things off as we go. And we want to help schools and classrooms to do the same. Now, a kid who has a lot of trouble with working memory may need have information handed to them that other kids can get other ways. So for example, if you have a really poor working memory and you have math problems on the board that you have to complete every time you have to take your eyes off your paper, put them on the blackboard, bring that information down to your paper, and write it down as an opportunity to forget. And you're going back and forth and back and forth trying to remember what it was I was supposed to write. Oh yeah, that's a seven next, right? And so things will take a lot longer to get done, and they may not have the time frame, so that's an easy accommodation. Can you just give him the math problems rather than have him copy it from the board? But always, we're thinking in terms of externalizing the scratch pad so the information is accessible to re inspect,

Dawn Davenport  48:39  
and we can model that even if we don't struggle with that, we can model that if we have a kid who struggles all right. So the last of the executive function skills that I want to provide practical tools for is impulse control. That's one that is common with kids with ADHD, but it's also common with kids who have experienced a great deal of trauma, for

Speaker 1  49:02  
sure. So again, for impulse control, remember, we start first with an external structure, and we may start by creating visual supports. We all learn everything first with an external structure, and then we work towards internalizing it. So clear and straightforward directions are, of course, the first thing telling kids what we want them to do, not what we don't want them to do. We can be creative with this. So kids who tend to put their hands on everything. Instead of saying, you know, stop touching everything, we say, I need you to put your hands in your pockets. Can you do that? Or I need you to hold this for me. Can you hold this? Use two hands please. Right? And so we create a situation where we have something that interferes with the. Impulse, we want to use a lot of short term directions positive rewards for those short term directions, and those positive rewards can be as simple as a thumbs up or a great job. As kids start getting older, we start looking to their motivations to help create a way to up that motivation which will help with the impulse control. So impulse control is all about using your thinking to override the urge to do something in the moment. So we want to create rewards that are meaningful to the child, that are perhaps stronger than that urge to do something in the moment. So I can't let you drive until I start seeing that you can be thoughtful about what you're doing when I see these behaviors, then I will take you for the first part of your driving lesson so that you can get a learner's permit. We can work on it. One of the things that most teens love is earning phone time, and so we help them to think about controlling themselves, you know, not kicking their brother, not, you know, pushing their way to the front of the line. We start very structured with them when they're young. We'll take them by the hand, or we have them stand with us. We give them very specific directions. We give them lots of reminders. We plan in advance for times that we know may be problematic. So I'm going to the doctors. You have to go with me. You will need to sit in the waiting room. Let's bring some things you can do while you're in the waiting room, right? We're going to go to visit grandma. I need to talk with her about some things. You will need to sit quietly after we first greet grandma. So let's plan in advance. How about if I talk for 10 minutes, then you'll get a chance to talk with us for 10 minutes, then I need another 10 minutes with grandma on the way home, if everything has gone smoothly, we'll stop and get an ice cream cone. But as kids get older, life is not as easy as buying them an ice cream cone, so we have to tie the motivator to their showing us more mature behavior in some ways.

Dawn Davenport  52:43  
And again, we start, as you had mentioned earlier, our expectations are we start with we want them to be at the edge of what they're capable of, but we don't want to be expecting something that we know they are not yet capable of. Exactly yes. So we would have that tied in with impulse control as well. We know if they are simply not going to be able in a crowded playground with lots of kids and they bring their ball, and we know that they're going to struggle with having their own ball with lots of kids, because they are going to end up pushing somebody or doing something that we don't like, then we don't let them bring the ball exactly,

Speaker 1  53:26  
or we give them a choice. You know what? This is a good chance for you to practice sharing that ball with other kids. But if you are not feeling like you want to share that ball, how about if we leave it at home,

Dawn Davenport  53:37  
and that's if we know whether they are capable. If we don't think they're capable of that, don't set them up for failure. But if we think they're, they're at that edge, they might be able to share then we give it a try. Yeah, excellent. Well, thank you so much, Dr Joyce Cooper con for talking with us today about executive function struggles as you've heard. I truly, I've lived it. I truly appreciate your wisdom and your information and the book, late, lost and unprepared, A Parent's Guide To Helping children with executive function. Thank you so much.

Unknown Speaker  54:10  
Thank you. Applause.