Presented by

George McCloskey, Ph.D.

Philadelphia College of Osteopathic Medicine

georgemcc@pcom.edu

Executive Functions and Elementary Age Children

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EF as the Conductor of the Brain’s Orchestra or CEO of the brain (i.e., EF as “g”)

Not Quite

Executive Control �Is Not a Unitary Trait

Appropriate Metaphors for Executive Control:

• The management structure of a multinational mind corporation
• The brain’s supervisory system

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Executive Control (EC)

Executive control involves the parts of neural networks located in the frontal lobes of the brain that

cue awareness of

what to do, when to do it, and

how to do it.

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It involves the CEO

and all the other managers in the corporation

Executive Control

isn’t just a “CEO of the brain”

The brain’s supervisory system

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Supervisors:

Executive

Functions

The brain’s supervisory system

The

Workers

Tiers of Executive Control

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Perceive

Focus

Sustain

Energize

Initiate

Inhibit

Stop

Interrupt

Flexible

Shift

Modulate

Plan

Evaluate/Compare

Decide

Sense Time

Pace

Sequence

Execute

Hold

Manipulate

Store

Retrieve

Trans-Self Integration

Self-Activation

Self-Realization

Self-Awareness

Other-Awareness

Self-Analysis

Self-Determination

Goal setting

Long-range Planning &

Foresight

Self-Generation

Intention Discernment Compassion

Monitor

Correct

Balance

Gauge

Anticipate

Estimate Time

Analyze

Generate

Associate

Organize

Prioritize

Self-Regulation

The Workers

Self-Activation

Initiation and “ramping up” of basic executive functions related to an awakened state of mind and to overcoming sleep inertia.

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Self-Activation

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The brain’s supervisory system

Self-Determination

Self-Realization

Self-Regulation

The Workers

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It is important to distinguish between:

Knowing When vs Knowing How

Knowing

When

Knowing How

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e.g., knowing when to make a plan, knowing when to inhibit

e.g., knowing how to make a plan, knowing how to inhibit

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The Brain’s Supervisory System

Self-Generation

Trans-Self Integration

Self-

Determination

Self-

Realization

Self-Regulation

Self-Activation

EF/ES

EF/ES

EF/ES

EF/ES

EF/ES

EF/ES

EF/ES

EF/ES

EF/ES

The Workers

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Self-Regulation Clusters

Sustain

Inhibit

Shift

Monitor

Manipulate

Estimate Time

Plan

Organize

Sense Time

Initiate

Flexible

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Executive Control Demands Increase Gradually by Cluster Across Pre-K to

Grade 12 Educational Programs

Pre-K K 1 2 3 4 5 6 7 8 9 10 11 12

Development of Self-Regulation EFs

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• Self-Regulation neural networks begin to develop shortly after birth.
• Self-Regulation development is strengthened through frequent use of these neural networks.
• Self-Regulation development is slowed when these neural networks are underutilized.
• Although all Self-Regulation neural networks are developing from near birth, expectations for the use of these networks vary on the basis of progression through the educational system.

The Language of External Control

Pay attention!

Can you be more specific?

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Monitor

Modulate

Balance

Correct

Perceive

Focus

Sustain

Anticipate Gauge

Estimate Time

Analyze Compare

Generate Associate

Plan Organize

Prioritize Decide

Hold Store

Manipulate Retrieve

Sense Time Pace

Sequence Use Routines

Energize Initiate

Inhibit

Stop Pause

Flexible Shift

Self-Regulation Clusters

Paying Attention SREFs

• Perceiving (looking, listening, touching)
• Focusing Attention
• Sustaining Attention

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Pay Attention, �specifically speaking

Prompts for attention should include:

• a cue for Perception (P),
• a cue for Focusing (F) and
• a cue for Sustaining (S)

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Pay Attention, � specifically speaking

Instead of “Pay attention” you could say:

• “Listen (P) to me (F) until I am done talking (S).”
• “Look (P) at the book (F) until we are done with this example (S).”
• “Use [Touch] (P) the blocks (F) until you have finished building your model (S).”

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Arenas of Involvement

Symbol System

Control of Self in Relation to Communication (Reading, Writing, Math)

Environment

Control of Self in

Relation to Surroundings

Intrapersonal

Control of Self in Relation to Self

Interpersonal

Control of Self in Relation to Others

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Reward

Center

Executive

Functions

Immediate Gratification

External

Demand

Delayed Gratification

???

Internal

Desire

Extrinsic

Rewards &

Punishments

Self-Regulation and Motivation

Clear

Expectations

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Nucleus

Accumbens

Executive

Functions

Immediate Gratification

External

Demand

Delayed Gratification

Internal

Desires

Self-Regulation and Motivation

Teach how to self-regulate in a way that increases the desire to self-regulate

(External

Demand)

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Nucleus

Accumbens

Executive

Functions

Immediate Gratification

External

Demand

Delayed Gratification

Internal

Desires

Self-Regulation and Motivation

Teach how to self-regulate in a way that increases the desire to self-regulate

Self-Determination

(External

Demand)

Self-Determination

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We use executive control to do what we are motivated to do (internally desired)

Internal Desire vs External Demand

or to do what others want us to do (externally demanded).

Internal versus External Control

Internal self-motivation energizes executive control making it easier for us to effectively self-regulate to achieve our desired goals.

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External demand does not always energize executive control and can make it harder to self-regulate in a way that is not consistent with what is internally desired.

Internal versus External Control

Because internally driven production is much easier to accomplish than externally demanded production for children with “producing difficulties” their lack of production on demand often stands in stark contrast to their seemingly effortless production “when the spirit moves them.”

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Internal versus External Control

The on-demand deficiencies observed by others are often attributed to negative personal characteristics such as lack of responsibility, apathy, passive aggressive stance, or oppositional defiance.

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James Age 10, NEPSY Design Copying:

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Scaled Score 12, 75^th percentile

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Now copy this:

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James Age 10, Rey Complex Figure Copy:

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1^st percentile

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James Age 10,

Self-generated

freehand drawing

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Production based on External Demand:

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Production based on

Internal Command:

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James Age 10,

Rey Complex Figure Copy

Verbally Mediated by Psychologist:

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James Age 10, Rey Complex Figure Copy:

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Self-initiated

Verbally Mediated

James Age 10, Rey Complex Figure Copy:

Self-Regulated On-Demand Production

2 ½ Hours Later

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Executive Control Intervention Continuum

Framework for Interventions

• Orienting – help child become aware of need to change, set goals for change, and identify ways that change can happen.
• External Control –show child when and how to produce and guide child’s efforts to produce.
• Bridging Strategies – teach student strategies for how and when and provide feedback about child’s use of strategies (feedback gradually faded).
• Internal Strategies – child self-cues use of strategies that increase self-regulation.

Orienting Strategies

• Identify goals (with younger children / Motivational Interviewing (with older children and adults).
• Identify problems that prevent goal attainment.
• Identify solutions/strategies to address problems.
• Explain brain functions involved in positive change.

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External Control Strategies

• Teachers mediate production – become the “supervisory system” for the child’s “workers”
• Teachers obtain production from child with rewards or negative consequences.
• Teachers provide or structure management aides: calendars, clocks, timers, schedules, tutors, coaches

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Bridging Strategies

• Align external demands with internal desires / motivations
• Practice & Rehearsal with Feedback
• Modeling
• Reflective Questioning with Feedback
• Cognitive Strategy Instruction
• Collaborative Problem-Solving

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Internal Control Strategies

• Self- Monitoring
• Self-Talk
• Self-Administered Rewards

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Intervention efforts require a Growth Mindset over a Fixed Mindset, patience, and a belief in the idea that executive control difficulties “won’t last forever; just longer than you would like.”

EC Intervention Mindset

EF Development

• EF development does not progress in a smooth, continuous upward slope; there are many peaks and valleys along the way. Periods of increased use may be followed by even longer periods of regression or lack of use.
• The goal of intervention therefore cannot be to “turn on” an EF that is “off”; but rather to strive for a cumulative effect of “more on than off” over a prolonged period of time.

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EF Development does not progress by continuous equal intervals

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Executive Control and School

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The

Workers

Teacher-Directed

New Learning

Executive Control and School

• Although executive functions can be used to guide new learning, many new learning situations are structured in ways that reduce the need for strong executive direction.
• Teachers become the supervisory system of children’s brains and lead them through the learning process.

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Executive Control and School

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The

Workers

Self-Directed Production

Executive Control and School

In contrast, producing (demonstrating what you have learned) usually requires a lot of executive function involvement.

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Learning and Producing

• We can’t observe learning directly; we only observe production.
• Referrals are made on lack of production not lack of learning. The assumption is that a lack of production is the result of a lack of learning.
• In many instances, the lack of production is not the result of a lack of learning but a lack of knowing when or how to demonstrate what was learned.

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Difficulties

Only

Learning

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and

Producing

Difficulties

Only

Production is good but at great cost (stress, anxiety, exhaustion); No assessment is done. Learning Disability is not recognized unless an evaluation is requested.

Lack of production leads to early assessment and identification of the Learning Disability.

Lack of production leads to early assessment but no Learning Disability is found. Lack of production is attributed to lack of motivation, character flaws, or behavior/personality problems.

A General Model for Conceptualizing

Learning and Producing Difficulties

Learning

Producing

Difficulties

Difficulties

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Difficulties

Only

Learning

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and

Producing

Difficulties

Only

Interventions focused on strengthening the workers; the earlier the better

Interventions focused on strengthening both the workers and the supervisors.

Interventions focused on strengthening the supervisors

Interventions within the Learning and Producing Difficulties Model

Learning

Producing

Difficulties

Difficulties

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