Executive Functioning and Intervention Presentation

Executive Functions
Essentials of Executive Frontal-subcortical Circuits

Functions Assessment and Understanding of executive At least five major frontal-subcortical
Intervention functions is rooted in an circuits (FSC) have been identified through
research:
understanding of pre-frontal 1. Motor circuit
Presented by lobe/frontal lobe functions. 2. Oculomotor circuit
3. Dorsolateral prefrontal circuit
George McCloskey, Ph.D.
4. Anterior cingulate circuit
Philadelphia College of Osteopathic Medicine
5. Orbitofrontal circuit (lateral and medial
[email protected] or divisions)
[email protected] Lichter & Cummings, 2001
1 2 3
Slide courtesy of Daniel C. Miller, KIDS, Inc.
Motor Circuit Oculomotor Circuit Behaviorally Relevant FSC Circuits

Originates in the Originates in the frontal eye • Dorsolateral prefrontal circuit
supplementary motor fields: – Mediates decision-making processes
area: – These systems regulate
• Anterior cingulate circuit
preparatory premovement
– Related to premotor, activity and serial processing of – Involved in motivational mechanisms
supplementary motor, and movements initiated in the
primary motor functions cortex. • Lateral orbitofrontal circuit
(ecological validity check: – Deficits in the oculomotor – Responsible for the integration of emotional
handwriting) (Hale & circuits can lead to problems information into contextually appropriate
Fiorello, 2004). with visual attention and behavioral responses.
– Deficits in motor circuits scanning.
can lead to problems with – Ecological validity check:
• Ventromedial orbitofrontal circuit
motor control and activity. reading words and visual – Regulates impulse control and internal
tracking. emotional states
5
Slide courtesy of Daniel C. Miller, KIDS, Inc. 4 Slide courtesy of Daniel C. Miller, KIDS, Inc. Slide courtesy of Daniel C. Miller, KIDS, Inc. 6
McCloskey – Executive Functions 1

Executive Functions
Frontal-subcortical Circuits Orbitofrontal Lateral and Medial Regions Orbitofrontal Circuit

• Mediates empathic, civil, and socially
§ Lateral Lateral =
appropriate behaviors.
side of brain
Orbitofrontal (1) • Regulates our abilities to inhibit, evaluate, and act on
social and emotional decision-making.
§ Dorsolateral (2) Medial =
Left lateral
towards the • Personality change is the hallmark of orbitofrontal
§ Ventromedial middle of
orbitofrontal
dysfunction (think of Phineas Gage).
orbitofrontal (3) the brain • Involved in cognitive and affective functions such as
assessing emotional significance of events, anticipating
§ Anterior Cingulate rewards and punishments, adjusting behaviors to adapt
(5) Right lateral Left medial
to changes in rule contingencies, and inhibiting
orbitofrontal orbitofrontal inappropriate behaviors.
Right medial
orbitofrontal
Slide courtesy of Daniel C. Miller, KIDS, Inc. 7 Slide courtesy of Daniel C. Miller, KIDS, Inc. 8
Slide courtesy of Daniel C. Miller, KIDS, Inc. 9
Orbitofrontal Cortex Frontal-subcortical Circuits Dorsolateral Circuit

• Regulates the learning of reward and
punishment. § Lateral
• Related to anterior-lateral
Orbitofrontal (1)
prefrontal executive functions.
• Activated by pleasant and painful sensory
stimuli, as well as abstract reinforcements § Dorsolateral (2) • Involved in higher level executive
such as winning and losing money. function such as self-determined
§ Ventromedial
• Contains secondary taste cortex. goal setting.
orbitofrontal (3)
• As the end stage site for projections from • Cues and directs working memory
§ Anterior Cingulate
the sensory cortex, plays a role in activities.
(5)
determining the reward value of taste, as
well as the attractiveness of odors.
Slide courtesy of Daniel C. Miller, KIDS, Miller & Cummings, 2007 11
Inc. 10 Slide courtesy of Daniel C. Miller, KIDS, Inc. Slide courtesy of Daniel C. Miller, KIDS, Inc. 12

Executive Functions
Dorsolateral Circuit Damage to the Dorsolateral prefrontal circuit Damage to the Dorsolateral prefrontal circuit
• Decreased verbal fluency • Poor problem solving, goal
• Decreased design fluency Think of tests selection, planning,
Think of tests
• Abnormal motor programming that are monitoring, and use of
that are
• Impaired set shifting designed to feedback in task designed to
• Reduced learning and memory measure performance. measure
retrieval these skills
• Difficulty focusing these skills
• Disruptions in working
memory attention and sustaining
• Poor organizational skills attention.
• Poor constructional • Difficulty generating
strategies when copying hypotheses.
14
Frontal-Subcortical Circuits Anterior Cingulate Cortex Anterior Cingulate Cortex

• Can be divided anatomically based on attributed
functions into executive (anterior), evaluative
§ Lateral Orbitofrontal (1) (posterior), cognitive (dorsal), and emotional
§ Dorsolateral (2) (ventral) components.
§ Ventromedial • The anterior cingulate cortex is connected with
the prefrontal cortex and parietal cortex as well
orbitofrontal (3)
as the motor system and the frontal eye fields
§ Anterior Cingulate (5) making it a central station for processing top-
down and bottom-up stimuli and assigning
appropriate control to other areas in
the brain.
17

Executive Functions
Anterior Cingulate Circuit Anterior Cingulate Circuit Anterior cingulate circuit

• Plays an important role in the executive This system serves to ensure that processing in
other brain regions is most efficient given the
superstructure including:
current task demands: • Symptoms associated with
– Responding to novelty
– Self-monitoring of performance
– Interactions with the prefrontal cortex damage to this area:
may select working memory buffers.
Inhibiting automatic responses
–
– Shifting cognitive set – Interactions with the posterior cortex can –Increased apathy
serve to amplify activity in one perceptual
– Complex decision making.
module over others. –Diminished initiative
• Involved in motivational mechanisms as well.
– The interactions with the posterior cortex
• Processes emotional information that helps may be direct or may be mediated by
determine when to approach and connections with the prefrontal
when to avoid an event - the approach- cortex (Posner and Raichle, 1994).
avoidance paradigm.
20
Frontal Lobe Pathways Frontal Lobe Pathways

§ Miller & Cummings (2007) have done a Advances in neuroimaging
masterful job of updating the conceptions
about the basic frontal-subcortical technologies are continually
pathways. improving the ability to
§ Other researchers, such as Stuss & Knight
in Principles of Frontal Lobe Function (2nd identify neural pathways in
Edition, 2013) discuss the fractionation of the brain.
frontal lobe functions and have focused on
further refinement of the primary pathways
as well as additional circuits within the
frontal lobes. 22 23 24

Executive Functions
It is important to distinguish Management Structure within a

Holarchical Model of EF
between pre-frontal
lobe/frontal lobe functions Executive
and executive functions. Function
EF
Executive ES
Purple = Thalamic Capacities
Radiations to frontal and Executive
pre-frontal cortex Skill
Yellow = Thalamus25 26
Key Concept Self Regulation Executive Functions Self Regulation Executive Skills
It is important to Executive Functions are the parts of Executive Skills are the “how” parts
the executive network that are used of the executive network that are
distinguish between to become aware of what to do and used to cue the rest of the neural
Executive when to do it (e.g., knowing when to network needed to perceive, feel,
make a plan, think and act
Functions when to inhibit) effectively (e.g., knowing
and the parts of the brain to
Executive activate to make a plan.
Skills. 28 29 30

Executive Functions
Today’s Discussion Draws on Years of Painstaking

Research in the Field of Neuroscience
Dense Array
EEG
31 32 33
Behavior Observation and

Kaplan, E. (1988). A Key Concept Inferences about Brain Function
process approach to
neuropsychological Assessment of the
assessment. In T. Boll & What’s the difference between a
B.K. Bryant (Eds.) Use or Disuse of Similarities Scaled Score of 12
Clinical neuropsychology Executive Functions (75th percentile) …
and brain functions: Hinges on Careful
Research, measurement,
Observation of …and a Similarities Scaled Score
and practice (pp. 125-167).
American Psychological Behavior. of 12 (75th percentile)?
Association.
35
34

Executive Functions
Ability Deficits From Ability to Skill

• The conventional wisdom regarding The most critical shifts in
ability deficits represents a fixed educational thinking involve:
mindset.
1) engendering a strong
• What is needed is a new perspective belief in the growth mindset
that embraces a growth mindset.
that asserts that ability IS
• A growth mindset suggests that malleable.
abilities are not innate; they can be
changed.
37 38 39
From Ability to Skill From Ability to Skill
2) implementing and refining Marzano, Pickering & Pollock

the techniques needed to provided a blueprint for turning
change abilities into skills so abilities into skills in their book
that they are taught instead “Classroom Instruction That
of merely measured. Works: Research-based
Strategies for Increasing Student Marzano, Pickering
& Pollock (2001)
Achievement.” (2001)
40 41
42

Executive Functions
From Ability to Skill From Ability to Skill
Strategies discussed include:

If these research-based
– Teaching Similarities and strategies have been shown to
Differences work, why would it not be
2nd Edition – Teaching Hypothesis Testing commonplace to expect to be
Dean, Hubbell, – Teaching Vocabulary able to increase “verbal ability”
Pitler, & Stone with good teaching practices?
(2012)
44
43
Martin’s WISC Score Changes Martin’s Achievement Score Changes Key Concept
11/2010 4/2013 9/2015 11/2010 4/2013 9/2015 Task Performance is
FSIQ 70 99 103 71 94 98 directed by Executive
Wd Reading
83 105 108 Functions or an
GAI
Wd Decoding 81 97 98 Executive Functions
VCI 73 95 106
substitute.
PRI/FRI 94 117 112 Rdg Fluency 66 95 100
The neural networks used to
VSI -- -- 111 Rdg Comp -- 87 82 perform a task depend on
WMI/AWMI 62 97 94 perceptions about how the
Rdg Vocab -- 93 112
PSI 68 85 98 task should be done. 48

Executive Functions
Key Concept Key Concept 504 Accommodation Plans

Most of what a The more specific the
When specially designed
language used by a
teacher, therapist, or instructional strategies are
teacher, therapist or
work supervisor says supervisor the more likely implemented, whose frontal
to student, client, or it is that the student, lobes are engaged?
worker is intended to client or worker will be
activate specific activating the brain
neural networks within networks needed for
that person’s brain. effective performance.
49 50 51
Functional Behavior Assessment Functional Behavior Assessment FBA: Is A-B-C Enough?

The focus of a traditional FBA: § Since the antecedent does not trigger
“Behavior support plans are designed to A B C the same undesirable behaviors in ALL
alter patterns of problem behavior. The students in the same situation, there
process by which this is done, however,
involves change in the behavior of family, In traditional functional behavior must be something about the students
teachers, staff, or managers in various assessments antecedents are said to that differs in an important way.
settings. Plans of behavior support define TRIGGER the behavior that results in the
what we will do differently. It is the change § Functional behavior assessment ignores
in our behavior that will result in improved consequences, but the reasons WHY the
antecedents trigger the behavior is not really internal considerations (i.e., perceptions,
behavior of the focus person.” (O’Neill,
Horner, Albin, Sprague, Storey, & Newon, addressed. emotions, thought) and focuses on
1997, p. 65). applying external control to effect
change in behavior.

Executive Functions
The EF Driven FBA A Key Concept EF- Driven FBA
Informed by knowledge of executive functions, the An EF-Driven FBA The goals of an EF-driven FBA are:
functional behavior assessment model can be revised
as follows: enables problems to 1) to help the child, the parents, and
be clearly stated in professionals to understand the
A B C terms of perceptions, nature of the deficit and
Antecedents
EF
Behavior
Response
Consequences B emotions, thoughts or 2) through proper intervention, to
actions that can be assist the child or adolescent in
changing the behavior from a
C changed through
negative to positive.
Perception Emotion Cognition Action
intervention. 56
EF Intervention Continuum What Are Executive Functions? The Wisdom of Kurt Lewin
“Despite the frequency with which it is
mentioned in the neuropsychological literature, “There is nothing more practical
Orienting Strategies the concept of executive functions is one than a good theory.”
that still awaits a formal definition.
External Control Strategies Research efforts aimed at exploring the
Known for his field theory
different aspects of this construct have often
of behavior that posits
yielded contradictory evidence, resulting in a that human behavior is
Bridging Strategies lack of clarity and even controversy regarding a function of an individual’s
the true nature of executive abilities.” psychological environment.
Internal Control
Jurado & Rosselli, 2007, page 213.
Strategies
59 60

Executive Functions
What Are Executive Functions? What Are Executive Functions? What Are Executive Functions?
• Baddeley (1974) The central executive • Lafleche & Albert (1995 ): Concurrent
• See Chapter 1 of Essentials of Executive coordinates the processing of information by manipulation of information, cognitive flexibility,
Function Assessment (McCloskey & Perkins, concept formation, cue-directed behavior.
the phonological loop and the visuospatial
2012) for a detailed list of many of the • Borkowski & Burke (1996): Task analysis, strategy
sketchpad.
sources of operational definitions of various selection, and strategy monitoring.
• Lezak (1983): Volition, planning, purposive • Miyake et. al. (2000): Shifting, updating, inhibition.
aspects of executive function.
action, effective performance. • Gioia et. al (1996): The executive functions are a
• Welsh & Pennington (1988): “The ability to collection of processes that are
maintain an appropriate problem- responsible for guiding, directing, and
solving set for attainment of a managing cognitive, emotional, and behavioral
future goal (p. 201).” functions.
61 62 63
What Are Executive Functions? EF as the Conductor of the Brain’s Orchestra Executive Functions Are Not a Unitary Trait
• Stuss & Alexander came the closest to offering a comprehensive
or CEO of the brain (i.e., EF as “g”)
definition of executive functions:
Appropriate Metaphors for Executive
“Many of the models of brain functioning have a hierarchical component to them, and we
EF
have postulated such a model for self-awareness. …This model has several properties:
(1) There are four operational levels; arousal-attention; perceptual-motor; executive
Functions:
mediation; self-awareness. (2) Each operational level feeds forward to higher levels,
providing a tentative digest of the analyses and associations within that level. (3) Each §The management structure of a
operational level also feeds backward to lower levels to modulate, bias, constrain or
facilitate the analyses and operations that will occur. (4) Direct contact with the external multinational mind corporation
environment is restricted to the perceptual-motor level. (5) The two highest levels are
instantiated in frontal lobes. The executive mediation level is predominantly localized to
ventrolateral and dorsolateral frontal regions. It incorporates action, planning, inhibition
§The conductor and section
and facilitation of parietotemporal association cortices and working memory capacities.
Open and closed neural loops through basal ganglia and cerebellum provide neural
leaders of the mind’s Orchestra
space for unfolding complex plans and for learning frequently used plans. (6) Self-
awareness emerges from convergence of emotional states and memory – not simply §The coaching staff of team mind
explicit remote memory of experiences or explicit semantic knowledge – but memory of
abstract mental states that allow construction of expectancy and thus memory for the
future. Human consciousness is an unstable template of experience and emotion.”Stuss
& Alexander (2000), page 295. 64

Executive Functions
Thoughts The Management Structure within a Holarchical

Key Concept Model of EF EF Trans-Self Integration
EFs
Executive Functions: EF EF EF
Self-Generation
Perceptions Self- Self-
§ Directive capacities of the mind ef ef ef ef ef Determination
Realization
§ Multiple in nature, not a single ef/es ef/es ef/es ef/es ef/es ef/es ef/es ef/es
capacity ef/es ef/es
ef/es ef/es ef/es ef/es ef/es ef/es ef/es ef/es ef/es ef/es ef/es
§ Part of neural circuits that are ef/es ef/es
ef/es ef/es ef/es ef/es ef/es ef/es ef/es
routed through the frontal lobes ef/es
§ Cue the use of other mental Self-Regulation

capacities
§ Direct and control perceptions,
Emotions Actions thoughts, actions, and to some
degree emotions
Self-Activation Activation
Domains of Functioning Directed by Executive Functions The Management Structure within a Holarchical Management Structure within a Holarchical Model
Action
Model of EF EF
Trans-Self Integration of EF EF
Action
Executive control of modes of output
including behavior in the external Executive ES
E world and storage and retrieval of EF EF EF
Self-Generation
Capacities
m
internal representations
Self- Self- EF Executive
ef ef ef ef ef
o Cognition
Executive control of thoughts
Realization Determination ES Skills
t Cognition
and thought processing ef/es ef/es ef/es ef/es ef/es ef/es ef/es ef/es
EF
ef/es ef/es
i ef/es ef/es ef/es ef/es ef/es ef/es ef/es ef/es ef/es ef/es ef/es
Executive
o
Perception
Executive control of modes of
ef/es ef/es ef/es ef/es ef/es ef/es ef/es ef/es ef/es
ef/es
Functions ES
perceptual input including external
n Perception sensory stimuli (visual, auditory, Self-Regulation EF
kinesthetic) and internal
(representational) stimuli
Emotion
Executive control of moods, feelings,
ES
and the processing of emotions
Self-Activation Activation

Executive Functions
EF Tiers within the Holarchical Model of Executive Self Regulation 33 Self-Regulation EFs
Functions Trans-Self Integration
EF
Self-Generation
§ A set of control capacities that cue § Perceive § Balance § Prioritize
EF EF EF and direct functioning across the § Focus § Monitor § Compare/Eval
Self-Realization Self-Determination
Self-Awareness Goal setting
domains of perception, emotion, § Sustain § Correct § Decide
ef ef ef ef ef Other-Awareness Long-range Planning &
§ Energize § Gauge § Sense Time
Self-Analysis Foresight
cognition, and action § Initiate § Anticipate
e
ef/es f/
ef/es Self-Regulation § Pace
ef/es e ef/es ef/es ef/es ef/es ef/es ef/es ef/es ef/es ef/es
ef/es
s Perceive Monitor Plan
§ The current model posits 33 self- § Inhibit § Est Time § Sequence
regulation executive functions
Focus Correct Evaluate/Compare
ef/es ef/es ef/es ef/es ef/es ef/es ef/es ef/es
ef/es
ef/es
Sustain
Energize
Balance
Gauge
Decide
Sense Time
§ Stop § Analyze § Execute
Initiate
Inhibit
Anticipate
Estimate Time
Pace
Sequence § Interrupt § Generate § Hold
Stop Analyze Execute
Interrupt
Flexible
Generate
Associate
Hold
Manipulate
ef/es
ef/es § Flexible § Associate § Manipulate
Shift
Modulate
Organize
Prioritize
Store
Retrieve
ef/es ef/es ef/es ef/es ef/es ef/es ef/es ef/es ef/es ef/es ef/es
§ Shift § Plan § Store
ef/es ef/es
Modulate
ef/es
§
ef/es ef/es ef/es
§ Organize
ef/es ef/es ef/es ef/es
Self-Activation
74
§ Retrieve
Activation
Self Regulation Executive Function “Clusters” Executive Functions Interventions

Key Concept ENGAGEMENT
Energize § Practice and rehearsal are best
Self-regulation ATTENTION
Initiate
Inhibit
OPTIMIZATION EFFICIENCY
suited to strengthen executive skills
Monitor Sense Time
Executive Functions Perceive Stop
Pause
Modulate Pace in the Attention, Engagement,
Focus Balance Sequence Optimization and some Efficiency
can be organized Sustain Flexible
Correct Execute
Cluster EFs
Shift
into 7 basic clusters. SOLUTION § Cognitive Strategy Instruction is best
INQUIRY
MEMORY Generate suited to enhance executive skills in
Anticipate Associate
Hold Gauge Prioritize
the Memory, Inquiry, Solution and
Manipulate
Store
Analyze Plan some Efficiency Cluster EFs
Estimate Time Organize
Retrieve Compare
76 Decide 78
77

Executive Functions
Cognitive Strategy Instruction Self Regulation Executive Function “Clusters”

Key Concept
ENGAGEMENT
The more specific the
Case
Energize
Initiate OPTIMIZATION EFFICIENCY
ATTENTION Inhibit Sense Time
language used by a
Monitor
Perceive Stop
Modulate Pace teacher, therapist or
Example: Focus
Sustain
Pause
Flexible
Shift
Balance
Correct
Sequence
Execute
supervisor the more likely
it is that the student,
Billy client or worker will be
SOLUTION
INQUIRY Generate
MEMORY activating the brain
Anticipate Associate
Hold Gauge Prioritize networks needed for
Lack of Inhibition?
Manipulate Analyze Plan
Store Estimate Time Organize effective performance.
Retrieve Compare Decide 81
80
Key Concept Bronson &

Merryman
Tools of the Mind discuss their
observations of
(Bodrova & Leong) is the Tools of the
an effective preschool Mind
/kindergarten Tools of the
curriculum in
curriculum that helps Chapter 8
Mind
Can Self-
young children Elena Bodrova
Control Be
improve self-regulation & Deborah
Taught?
Leong
executive functions.
82 83 84

Executive Functions
Engagement of Self-Regulation Engagement of Self-Regulation

External Demand External Demand
Pathway Pathway
Teach how to self-
Executive External Executive regulate in a way that External
Functions Demand Functions increases the desire Demand
to self-regulate
Internal Internal
Command
??? Command
???
Extrinsic Extrinsic
Rewards & Rewards &
Punishments Punishments
Nucleus Nucleus
Accumbens Accumbens
Internal Command Pathway: Internal Command Pathway:

86
Intrinsically Rewarding 85 Intrinsically Rewarding 87
Key Concept Internal versus External Control Internal versus External Control
The neural circuits for executive Because internally driven production

Executive Functions is much easier to accomplish than
function activation are routed
activation can be differently depending on whether externally demanded production for
internally or children with “producing difficulties”
the activation is based on an
externally driven; their lack of production on demand
internally driven desire or often stands in stark contrast to their
EFs can cue the use command versus an external seemingly effortless production
of learned strategies. demand. “when the spirit moves them.”
88 89 90

Executive Functions
Internal versus External Control Holarchy vs Hierarchy Holoarchy vs Hierarchy
The on-demand deficiencies Hierarchy § Within a hierarchy, the next stage of

observed by others are often development does not begin until the
stage preceding it is complete.
attributed to negative personal § Within a holarchy, additional stages of
characteristics such as lack of development can begin before earlier
responsibility, apathy, passive stages are completed; earlier stages can
continue to develop after later stages
aggressive stance, or begin; multiple stages may be developing
oppositional defiance. at the same time; later stages may be
better developed than earlier stages.
Holarchy
91 93
EF Tiers within the Holarchical Model of Executive

Key Concept Functions EF
Trans-Self Integration
Self-Generation
Executive
EF EF EF
Self-Realization Self-Determination
ef ef ef ef ef Self-Awareness Goal setting
Functions cue e
ef/es f/
Other-Awareness
Self-Analysis
ef/es
Long-range Planning &
Foresight
and direct in e ef/es ef/es ef/es ef/es ef/es ef/es ef/es ef/es ef/es
ef/es ef/es
Self-Regulation
s
ef/es ef/es ef/es ef/es ef/es ef/es ef/es ef/es ef/es Perceive Monitor Plan
ef/es Focus Correct Evaluate/Compare
different ways at
Sustain Balance Decide
Energize Gauge Sense Time
Initiate Anticipate Pace
Inhibit Estimate Time Sequence
different levels.
Interrupt Generate Hold
Flexible Associate Manipulate
Shift Organize Store
Modulate Prioritize Retrieve
Self-Activation
94 Activation

Executive Functions
Self Realization (of self & others) EF Tiers within the Holarchical Model of Executive
Functions EF Trans-Self Integration
Self Determination EF
§ Directs cognitive processes that EF
Self-Generation § Foresight/Long-Term Planning and
Goal Generation
EF EF
engage in awareness of self and Self-Realization Self-Determination
others, reflection about self and ef ef ef ef ef Self-Awareness
Other-Awareness
Goal setting
Long-range Planning & § Directs the use of cognitive processes
others and self-analysis. e
ef/es f/
Self-Analysis
ef/es
Foresight
to construct visions of the future and
Self-Regulation
§ Cues cognitive processes to access ef/es e ef/es ef/es ef/es ef/es ef/es ef/es ef/es ef/es ef/es
ef/es
s Perceive Monitor Plan
plans for action over longer
accumulated information about self
ef/es
ef/es Focus
Sustain
Correct
Balance
Evaluate/Compare
Decide
periods of time.
Energize Gauge
and apply it in specific situations.
Sense Time
Initiate
Inhibit
Anticipate
Estimate Time
Pace
Sequence
§ Attempts to align daily self-
regulation with long-term
Interrupt Generate Hold
Flexible Associate Manipulate
Shift Organize
goals and strengthen delayed-
EF
Store
Self-Activation gratification.
97 Activation 99
Chapter 21
Motivational
Interviewing with
Adolescents
and Young Adults
John S. Baer and

Peggy L. Peterson
100 101 102

Executive Functions
EF Tiers within the Holarchical Model of Executive

Functions EF
Self Generation EF EF Tiers within the Holarchical Model of Executive
Functions EF
Trans-Self Integration Trans-Self Integration
Self-Generation § Directs the posing of speculative questions Self-Generation

EF EF
EF EF
related to the meaning and purpose of life EF EF
Self-Realization Self-Determination Self-Realization Self-Determination

ef ef ef ef ef Self-Awareness Goal setting and/or the ultimate source(s) of reality and ef ef ef ef ef Self-Awareness Goal setting
Other-Awareness
Self-Analysis
Foresight
physical existence, mind-body relationships, Other-Awareness
Self-Analysis
Foresight
e ef/es ef/es ef/es ef/es ef/es ef/es ef/es e ef/es ef/es ef/es ef/es ef/es ef/es ef/es
ef/es f/ ef/es
e ef/es ef/es ef/es ef/es ef/es ef/es ef/es ef/es ef/es Self-Regulation
spirit, and soul; contemplates existence ef/es f/ ef/es
e ef/es ef/es ef/es ef/es ef/es ef/es ef/es ef/es ef/es Self-Regulation
ef/es ef/es
ef/es
s
beyond the physical plane. ef/es
s
ef/es ef/es
Focus
Sustain
Energize
Correct
Balance
Gauge
Evaluate/Compare
Decide § Directs the generation of a philosophy of life Focus
Sustain
Energize
Correct
Balance
Gauge
Evaluate/Compare
Decide
used to guide self-awareness, self-realization

Sense Time Sense Time
Initiate Anticipate Pace Initiate Anticipate Pace
Inhibit Estimate Time Sequence Inhibit Estimate Time Sequence
Stop
Interrupt
Analyze
Generate
Execute
Hold
and the other levels of executive function Stop
Interrupt
Analyze
Generate
Execute
Hold
Flexible
Shift
Associate
Organize
Manipulate
Store
processes; serves as a basis for an ultimate Flexible
Shift
Associate
Organize
Manipulate
Store
source of intentional behavior direction. Modulate Prioritize Retrieve
Self-Activation Self-Activation
Activation 104 Activation
Trans-Self Integration EF Key Concept Executive Function Development
§ Directs the engagement of mental

Executive Functions Some EF-based clinical syndromes,
processes that enable realization and such as ADHD, demonstrate clear
experiencing of a trans-self state of are developing from patterns of delayed developmental
ultimate or unity consciousness.
§ In most spiritual traditions, this state is
birth; maturational progression. Barkley (1998)
considered the highest achievement of delays can cause estimates developmental delays of
human consciousness and therefore very
difficulties. about 30% associated with various
different from the maladaptive states EF processes such as Inhibit,
characteristic of clinical diagnoses of
dissociative states. Manipulate, Shift, Sustain, Time,
Monitor, Correct.
106 107 108

Executive Functions
Developmental Progression with a 30% Delay EF Development does not progress EF Development
100 by continuous equal intervals
90
§ EF development does not progress in a
80 smooth, continuous upward slope; there
E 70 are many peaks and valleys along the
F
60 way. Periods of increased use may be
A 50 followed by even longer periods of
G 40 regression or lack of use.
E
30 § The goal of intervention therefore cannot
20 be to “turn on” an EF that is “off”; but
10 rather to strive for a cumulative effect of
0
“more on than off” over a prolonged period
6 8 10 15 21 30 39 60 90 of time.
Chronological Age 109
110
111
EF Development does not progress DAILY PROGRESS BY CLASS END OF YEAR SUMMARY ALL CLASSES
WEEK 1 WEEK 2 WEEK 3 WEEK 4
ENGAGEMENT 4-Feb 5-Feb 6-Feb 7-Feb 8-Feb 11-Feb 12-Feb 13-Feb 14-Feb 15-Feb 19-Feb 20-Feb 21-Feb 22-Feb 23-Feb 25-Feb 26-Feb 27-Feb 28-Feb 1-Mar
by continuous equal intervals Math

Science
Social Studies
3
3
3
3
3
3
3
3
3
3
2
3
2
0
0
0
2
2
3
0
0
2
0
0
3
1
0
3
1
3
0
0
3
3
3
2
0
0
3
3
2
2
2
1
2
0
3
2
English
Reading
Math Facts
3
3
2
3
0
3
3
3
3
3
3
0
0
3
3
0
0
3
3
3
0
3
0
3
3
3
0
0
0
0
3
3
0
3
3
3
3
3
3
0
3
3
3
3
3
3
3
3
3
ENGAGEMENT %
WEEK 5 WEEK 6 WEEEK 7 WEEK 8
Rated 3, 2, or 1 78%
Rated 0 22%
ENGAGEMENT 4-Mar 5-Mar 6-Mar 7-Mar 8-Mar 11-Mar 12-Mar 13-Mar 14-Mar 15-Mar 18-Mar 19-Mar 20-Mar 21-Mar 22-Mar 25-Mar 26-Mar 27-Mar 28-Mar 29-Mar
Math 3 3 3 1 3 3 2 1 0 0 1 0 3 1 0
Science 0 2 1 3 3 0 0 0 0 0 3 1 3
Social Studies 3 3 2 1 3 3 3 3 3 3 3 3 3
English
Reading
Math Facts
2
0
2
3
3
3
3
0
1
2
3
3
3
3 3
3
3
3
3
3
3
3
3
3
3
3
3
0
3
3
3
3
3
3
0
3
3
3
3
3
3
3
ATTENTION %
ENGAGEMENT
WEEK 9
1-Apr 2-Apr 3-Apr 4-Apr 5-Apr
WEEK 10
WEEK 11
WEEK 12
29-Apr 30-Apr 1-May 2-May 3-May
Rated 3, 2, or 1 78%
Rated 0 22%
Math 2 2 3 0 0 3 0 0 3 0 0 3
Science 3 3 3 0 0 0 3 3 3 3 2 2
Social Studies 3 3 1 3 3 3 3 3 1 2 2 0
English 3 3 2 0 1 3 3 0 3 3 0 3 3
Reading
Math Facts
3
3
3
3
3
0
2 3
3
3
3
3
3
1
1
3 3 3
3
3
2
3
3
3
3 WORK
WEEK 13 WEEK 14 COMPLETION %
ENGAGEMENT 6-May 7-May 8-May 9-May 10-May 13-May 14-May 15-May 16-May 17-May
Math
Science
0
2
1
3
0
2
1
3
2
2 2
0
1
1
1
1
0
Rated 3, 2, or 1 70%
Social Studies 3 3 3 0 0 0 0
112
English
Reading
3
3
3
3
3
3
3
3
0
2
3
3
2
2
0
3 113
Rated 0 30% 114
Math Facts 3 3 3

Executive Functions
Key Concept Key Concept Producing versus Learning
Intervention efforts require a Producing difficulties

therapeutic perspective that Executive Function difficulties of
emphasizes a Growth
are different from a severe nature (especially in
Mindset over a Fixed Mindset learning difficulties; the Symbol System Arena) do
vs
and a patient belief in the producing difficulties not result in Learning Difficulties;
idea that EF difficulties “won’t reflect poor use of they result in Producing
last forever; but probably Difficulties.
longer than you would like.”
vs
115 116 117
A General Model for Conceptualizing

Learning and Producing Difficulties Key Concept Arenas of Involvement
Learning
Often NOT recognized as a Intrapersonal Interpersonal
Difficulties
Only
Learning Disability, even Effective use of Control of Self in Control of Self in
when severe, unless an
Learning
evaluation involving process Executive Functions Relation to Self Relation to Others
assessment is done
Difficulties can vary by Arena of
And Recognized fairly quickly
Producing as a Learning Disability Involvement as well
Difficulties
When severe, typically
as by Domain of Environment Symbol System
Control of Self in Control of Self in
Producing attributed to lack of Functioning. Relation to Relation to Academics
Difficulties motivation, character flaws,
Surroundings (Reading, Writing, Math)
Only or behavior/personality
problems 118 119

Executive Functions
The Multidimensional Nature of The Multidimensional Nature of

EF Assessment Key Concept
Executive Functions
§ The Multidimensional Nature of the use Effective EF assessment
§ Use of Executive Functions of Executive Functions necessitates a is multidimensional in
varies depending on: Multidimensional approach to their nature and addresses the
§the arena(s) of involvement in assessment.
use of Efs within all four
which the EF(s) are operating, § Assessment of Executive Functions
domains of functioning
needs to address the use of Efs within
§the domain(s) being directed all four domains of functioning and
and across all four
by the EF(s) across all four arenas of arenas of involvement.
involvement
123
EF Assessment Perspective x Method

Assessment Method
Key Concept The Multidimensional Nature of EF Assessment
Assessment Formal Methods – Informal Methods –
Perspective Using interviews, records reviews, and
observation and interpretation methods
Using interviews, records reviews,
and observation and interpretation The most effective Conducting a thorough clinical interview:
that make use of standards established
through normative comparisons
methods that do not make use of
standards established through approach to EF
normative comparisons § Identify arenas of involvement that are of
assessment involves concern, within the arenas of concern:
Indirect Perspective – Behavior Rating Scales Interviews of Parents, Teachers
Collecting information in Parent & Teacher Behavior
Rating Scales
(e.g., use of the EFSO)
Review of School Records
1) Clinical interview(s) § Identify domains of functioning that are of
a manner that does not
require direct contact Self-Report Rating Scales
(e.g., BRIEF or MEFS Parent,
Process-oriented Interpretation
of Parent and Teacher Ratings
2) Use of additional data concern
with, or observation of,
the client
Teacher and Self Rating forms) and Self Reports
collection methods to § Identify the specific executive function
Direct Perspective – Individually-Administered Child Interview
Systematic and Nonsystematic
test hypotheses levels that are of concern
Collecting information Standardized Tests
through direct (e.g., D-KEFS,
Behavioral Observations (e.g., use
generated from the § Identify the specific executive functions
of the EFSO and EFCO)
interactions with, or NEPSY-II, WCST, that are of concern within the level
through direct BADS, BADS-C)
Process-oriented Interpretation of
Standardized Test Performance interview(s) 125
and Classroom Work Samples
observations of, the client

Executive Functions
Assessment of Executive Functions Assessment of Executive Functions Key Concept

Norm-referenced assessments of The limitations of the current Standardized,
executive functions are currently individually-administered
available, including:
methods available need to be measures of executive
understood and taken into functions only assess
§ Individually-administered
tests
account when conducting an the use of executive
assessment. functions within the
§ Behavior rating scales Symbol System Arena.
129
EF Assessment Using Individually Key Concept Executive Functions and Intelligence

Administered Tests
Although limited in scope,
Perception Emotion Cognition Action individually-administered § The concept of executive
Self assessment of executive functions is not synonymous with
functions can provide the traditional concepts of
Others
valuable information about intelligence or “IQ”
Environ- the clients capacities to self- § Executive functions are not
ment regulate perception,
directly assessed with standard
Symbol cognition and action within
Systems X X X the Symbol System arena, intelligence tests
= EF?
especially in school. 131

Executive Functions
Measuring Executive Functions

Measuring intelligence with a reasoning task
with a Reasoning Task
Executive Functions and School
Directions for the Wisconsin The more classroom instruction

Card Sorting Test (WCST): resembles tests of executive functions
like the Wisconsin Card Sorting Test
I can’t tell you much about how
(figure out what we’re learning, I’ll tell
to do this task. Which of these
you whether you are right or wrong), the
do you think this one goes
more executive difficulties are going to
with? I’ll tell you if your answer
impact classroom learning and
is right or wrong.
performance.
= EF? = EF?
The Multidimensional Nature of EF Assessment Parent, Teacher, Child & Adult Inventories
Use additional data collection methods to test

hypotheses generated from the clinical interview: Assessing Efs Ideally, behavior rating inventories
§ Parent, Teacher, Self Report and Adult would offer coverage of a broad
Inventories Using array of executive functions
§ Background information/Records across all 4 domains within all 4
review Rating Scales arenas of involvement.
§ Individually-administered standardized
testing (for Symbol System arena
concerns)

Executive Functions
EF Assessment Indirect Formal Assessment of EFs BRIEF Parent, Teacher, Self-Report Forms
Norm-referenced rating scales provide § Ideally, a rating scale designed to assess Behavior Rating Inventory of
standardized scores, but it is important to EFs would identify specific strengths and
weaknesses within EF Levels (Self- Executive Functions (BRIEF, 1996;
keep in mind that the scores that are
Regulation, Self-Realization, Self- BRIEF 2, 2015)
provided usually are normalized T-
Determination, Self-Generation), Domains §Parent, and Teacher and Self-
scores; the ratings do not distribute of Functioning (Perception, Emotion,
normally but rather are negatively Thought, Action), and Arenas of Report Forms (BRIEF 2, 2015)
skewed. Involvement (Intrapersonal, Interpersonal, §Preschool and Adult forms
Environment, Symbol System).
§Norm-referenced scores
Parent, Teacher, Self-Report Inventories Interpretive Levels Framework Parent, Teacher, Self-Report Inventories
Recently, 4 additional EF Rating Scales have been Global Composite
published: (E.g. GEC) The BRIEF assesses self-regulation EFs
D-REFS (Delis Rating of Executive Specific Composites/ under the following 8 headings:
Function; 2012) Clinical Clusters Level
Inhibit, Shift, Emotional Control,
BDEFS-CA (Barkley Deficits in Executive
Functioning Scale; 2012)
Subtest Level Initiate, Working Memory,
CEFI (Comprehensive Executive
Item Ratings Level Plan/Organize, Org. of
Functions Inventory; 2013) Cognitive Constructs Materials, Monitor
Level
MEFS (McCloskey Executive Functions (What does this item really
assess?)
Scales; 2016)

Executive Functions
Parent, Teacher, Self-Report Inventories Parent, Teacher, Self-Report Inventories Parent, Teacher, Self-Report Inventories
T-Scores and (Percentile Ranks)

Social Language Learning
BRIEF Interpretive Cautions: BRIEF Interpretive Cautions:
Scales Mother Father
Math
Teacher
Studies
Teacher
Arts
Teacher
Support
Teacher § Identical BRIEF Scale T-scores § An elevated T-score can result
Inhibit
Shift
49 (65)
38 (14)
47 (55)
42 (28)
53 (75)
53 (78)
49 (65)
45 (50)
77 (96)
65 (92)
85 (98)
57 (85)
can result from very different from a rating of “Sometimes” for
Emotional
Control 37 ( 8) 39 (17) 50 (65) 46 (50) 54 (80) 46 (50)
response patterns. all, or nearly all, items on a
Initiate
Working
56 (80)
60 (84)
53 (71)
62 (88)
69 (95)
85(>99)
85(>99)
92(>99)
96(>99)
92(>99)
81(>99)
106(>99) § Critical EF difficulties may be Scale, or from a rating of “Often”
Memory
Planning/ 62 (86) 60 (83) 73 (95) 80 (98) 80 (98) 92 (>99)
masked by low T-scores based on for a smaller subset of items on
Organize
Organize 49 (52) 43 (33) 57 (88) 46 (60) 69 (95) 111(>99)
aggregation of multiple items. a Scale.
Materials
Monitor 46 (42) 40 (20) 63 (90) 66 (93) 80 (98) 77 (97)
Parent, Teacher, Self-Report Inventories Parent, Teacher, Self-Report Inventories EF Assessment

BRIEF Interpretive Cautions: Indirect Informal:
BRIEF Interpretive Cautions:
§ Example: The BRIEF Inhibit Scale
§ Because each BRIEF Scale combines items assessing Inhibit, § Interviews
is an amalgam of multiple Modulate, and Stop. If a client only § Records Reviews
EFs, certain areas of deficit exhibits Modulate problems, the T-
score may not be clinically elevated. § Process-oriented analysis
may not be reflected in the The low T-score will be masking the of rating scale scores and
Scale T-score. Modulate difficulties.
items
150

Executive Functions
BRIEF 2 Inhibit Scale Parent and Teacher Form Parent, Teacher, Self-Report Inventories
Items
Executive Functions
Advances in the
INHIBIT SCALE
Item Description P
Likely to be Associated with Behaviors
T PRIMARY EF SECONDARY Efs
Ideally, behavior rating inventories
FIDGETY X X MODULATE MONITOR would offer coverage of a broad Assessment of Efs
OUT OF SEAT WRONG TIME X X INHIBIT MONITOR
OUT OF CONTROL X X MODULATE MONITOR array of executive functions Using
TOO WILD X X MODULATE MONITOR
Trouble STOPPING X X STOP MODULATE MONITOR across all 4 domains within all 4
TOO SILLY
Talks at WRONG TIME
X
X
MODULATE
X INHIBIT
MONITOR
MONITOR arenas of involvement. Rating Scales
NO THOUGHT BEFORE ACT X ANTICIPATE INHIBIT
IMPULSIVE ACTIONS X X INHIBIT MONITOR
151
Parent, Teacher, Self-Report Inventories MEFS Parent, Teacher, Self-Report Forms MEFS Parent, Teacher, Self-Report Forms
Always or almost always does this on his or her own.
The McCloskey Executive Function Raters make judgments about level of 5 AA Does not need to be prompted or reminded (cued) to
Scales (MEFS) assess 33 self-regulation competency as well as frequency: do it.
4 F Frequently does this on own without prompting
executive functions across multiple § Frequency of EF Strength (EFS)
domains of function within multiple § Frequency of Executive Function 3 S Seldom does this on own without being prompted,
reminded, or cued to do so.
arenas of involvement: Deficit (EFD) 2 AP Does this only after being prompted, reminded, or
cued to do it.
§ School (Symbol System) § Frequency of Executive Skill Only does it with direct assistance. Requires much
§ Social (Interpersonal) Deficit (ESD) 1 DA more than a simple prompt or cue to be able to get it
done in situations that require it.
§ Self (Intrapersonal) 0 UA Unable to do this, even when direct assistance is
provided.

Executive Functions
MEFS Parent, Teacher, Self-Report Forms MEFS Parent, Teacher, Self-Report Forms MEFS Parent, Teacher, Self-Report Forms
Attention Cluster Engagement Cluster Optimization Cluster

BECOMING AWARE INHIBITING MODULATING OR ADJUSTING
Physical activity level fits the situation when doing school tasks
Knows what he or she should be doing for school tasks and Waits for turn. (Not hyperactive or inactive).
knows when to do it. Considers the consequences before saying or doing things he or
Makes eye contact with, listens to, and touches others in an Physical activity level fits the situation when working in a group
she may regret. (Not hyperactive or inactive).
appropriate way in social situations.
FOCUSING ATTENTION Refrains from acts of physical aggression. Emotional response fits the situation when working on school
Focuses attention on school tasks. Does not make inappropriate or thoughtless comments (for tasks (Doesn’t overreact or underact).
Focuses attention on others in social situations. example, name-calling, insulting, inappropriately tattling on Emotional response fits the situation when interacting with
SUSTAINING ATTENTION others). others (Doesn’t overreact or underreact).
Controls emotional reactions well in frustrating situations.
Sustains attention for school tasks until a task is completed. Avoids being overstimulated or understimulated by sights,
Maintains emotional control when disagreeing with others. sounds, or touches.
Sustains attention to others in social situations.
MEFS Teacher Inventory Table 3.9 Percentages of Students Rated as Exhibiting Executive
Table 3.8 Percentages of Non-identical Executive Function
Function or Executive Skill Deficits
Level Classifications between Ratings
within the Academic Arena and Self/Social Arena Non-clinical Clinical Samples
Clinical Group Mean Item Ratings by Cluster Self-Regulation

Standardization
Female Male Speech/

(Clinical Standardization and Additional Cases)
Learning ADHD ADHD Autism Emotional/

Non-clinical Clinical Samples Cluster/Arena (n=442) (n=371) Language Disability Medicated Nonmed (n=38) Behavioral
Standardization (Clinical Standardization and Additional Cases) (n=34) (n=48) (n=47) (n=56) (n=21)
ADHD ADHD Female Male Speech/ Learning ADHD ADHD Autism Emotional/
Percentages of Students with Executive Function and/or Executive Skill Deficits
Attention-Acad.*
CLUSTER NONE S/L LD -M -N ID ASD ED Self-Regulation
Cluster
(n=442) (n=371) Language
(n=34)
Disability
(n=48)
Medicated
(n=47)
Nonmed
(n=56)
(n=38) Behavioral
(n=21) Attention-Se/So*
25% 38% 41% 67% 77% 86% 84% 76%
16% 23% 22% 50% 57% 54% 87% 76%
Attention 4.2 4.1 3.4 3.3 3.0 2.8 2.3 2.7
Percent of Cases with Non-identical Classifications across Arenas
Engage-Acad.
24% 38% 35% 65% 81% 87% 87% 100%
Attention 17% 27% 15% 31% 36% 43% 32% 48% Engage-Se/So
Engagement 19% 34% 26% 50% 68% 75% 89% 90%
4.3 4.2 3.6 3.3 3.1 2.9 2.5 2.1 Engagement 14% 20% 9% 17% 23% 23% 13% 24% Optimize-Acad.
31% 51% 56% 87% 85% 93% 87% 95%
Optimization 4.1 3.9 3.3 2.9 2.7 2.4 2.2 1.8 Optimization 13% 20% 38% 42% 17% 30% 29% 29%
Optimize-Se/So
24% 37% 38% 62% 81% 80% 92% 95%
Efficiency-Acad.
34% 46% 53% 90% 79% 89% 87% 100%
Efficiency 4.0 3.8 2.9 3.1 2.9 2.2 2.4 2.2 Efficiency 17% 24% 21% 42% 21% 18% 10% 71% Efficiency-Se/So
35% 41% 53% 77% 70% 77% 89% 90%
Memory 4.1 3.9 2.8 3.4 3.2 2.5 2.4 2.1 Memory 20% 22% 18% 54% 43% 25% 21% 43% Memory-Acad.
33% 33% 38% 97% 70% 73% 87% 80%
Inquiry 20% 21% 32% 44% 28% 25% 18% 24% Memory-Se/So
18% 23% 41% 70% 47% 54% 87% 71%
Inquiry 3.9 3.6 2.8 2.7 2.5 1.8 1.9 1.7 Inquiry-Acad.
Solution 16% 24% 26% 52% 40% 53% 62% 90% 87% 96% 95% 90%
30% 29% 18% 38%
Solution 3.9 3.6 2.7 2.8 2.6 1.9 1.7 1.9 Inquiry-Se/So
34% 49% 50% 73% 83% 87% 95% 95%
Solution-Acad.
161 45% 52% 65% 92% 81% 96% 92% 100%
162
Solution-Se/So
38% 45% 53% 81% 68% 79% 97% 90%

Executive Functions
MEFS Teacher Inventory

Arena
Table 3.10 Percentages of Students Rated as MEFS Cluster Parent
Academic
Teach Isaac Parent
Self/Social
Teach Isaac
er er
Exhibiting Executive Skill Deficits EFS = EF Strength EFD = Executive Function ESD = Executive Skill
Non-clinical
Standardization
Clinical Samples
(Clinical Standardization and Additional Cases) EF Deficit Percentages within the Attention Cluster Parent & EFS
Deficit
1
Deficit
3 3 1
Attention EFD 1 2 2 2
Self-Regulation Female Male Speech/ Learning ADHD ADHD Autism Emotional/
ADHD ADHD
Teacher ESD
EFS
2
2
1
2 4 14 15 13
Cluster/Arena (n=442) (n=371) Language Disability Medicated Nonmed (n=38) Behavioral
(n=34) (n=48) (n=47) (n=56) (n=21) Attention NONE S/L LD -M -N ASD ED Cluster Engagement EFD
ESD
1
4
5 3 1 2
Percentages of Students with Executive Skill Deficits

Attention-Acad.
2% 4% 0% 21% 11% 20% 34% 19% Cluster n=813 n=34 n=48 n=47 n=56 n=38 n=21 Strengths Optimization
EFS
EFD
ESD
1
2
3
3
3
3
3
6
1
1
7
1
6
2
Attention-Se/So
Engage-Acad.
1% 1% 0% 6% 4% 7% 37% 10%
SREF % % % % % % % & Deficits Efficiency
EFS
EFD
3
2
5
5
1
9
3
1
3
1
2
2
1% 3% 0% 8% 15% 23% 40% 48% ESD 5
Engage-Se/So
Optimize-Acad.
1% 1% 0% 6% 13% 13% 29% 33% Percieve -A 17 27 54 38 71 71 67 Memory
EFS
EFD
1
2
2
1
2
1
4 3
1
4
1% 3% 6% 15% 26% 29% 40% 48% ESD

Optimize-Se/So
0% 2% 3% 6% 17% 14% 47% 38% Percieve -S 14 24 35 36 43 79 62 EFS 1 2 3 6 6
Inquiry EFD 4 3 2
Efficiency-Acad.
3% 5% 9% 31% 17% 21% 37% 48% ESD 4 1 1
Efficiency-Se/So
1% 3% 6% 13% 6% 14% 34% 19%
Focus -A 25 27 65 68 71 78 71 EFS 1 1 3 5 7 5
Solution EFD 5 2 1 2
Memory-Acad.
3% 5% 9% 35% 15% 13% 34% 38% Focus -S 13 15 33 45 34 82 57
ESD 5 1 1
Memory-Se/So
1% 2% 3% 10% 4% 11% 42% 14% TOTAL
EFS
%
9
22%
13
32%
17
42%
38
81%
44
94%
37
79%
Inquiry-Acad.
4% 6% 15% 38% 32% 30% 50% 48% Sustain -A 28 32 65 79 84 76 76 EFD 8 25 22 6 3 10
% 20% 63% 55% 13% 6% 21%
Inquiry-Se/So
1% 4% 15% 19% 17% 21% 42% 43% ESD 23 2 1 3 0 0
Solution-Acad.
4% 7% 12% 42% 32% 27% 47% 57%
Sustain -S 14 21 35 49 48 87 62 % 58% 5% 3% 6% 0% 0%
163
Solution-Se/So
1% 4% 9% 19% 17% 20% 53% 29%
Cascading Individually-administered
Key Concept Assessments of EF
Production
EFs in the Symbol Construct Decrement § Identify a specific cognitive construct
System arena are best baseline using a measure that
Start here
assessed by using Construct + EF minimizes EF involvement.
methods that can reveal § Select and use a measure that adds
Construct + + EF
Cascading Production executive function demands to the
Decrements or Progressive deterioration baseline construct and observe the
Construct+ + + EF
of performance is observed results.
Cascading Production as executive function
Increments demands (+ EF) become § Continue to add additional EF demands
166
greater. and observe results.

Executive Functions
Cascading Cascading James Age 10, NEPSY Design Copying:
Reasoning Ability:
Production Production
Matrix Reasoning Decrement Visuo-motorAbility: Decrement
Design Copying
Start here
Start here Ability + EF:
BVMGT
Reasoning
Ability
Ability + + EF
+ + + EF:
Progressive deterioration WCST Ability + + + EF:
of performance is observed Progressive deterioration
RCFT
as executive function of performance is observed
demands (+ EF) become as executive function
greater. demands (+ EF) become
greater.
Scaled Score 12, 75th percentile
171
Production based on
Now draw this: External Demand:
Production based on
Internal Command:
James Age 10, Rey Complex Figure Copy:
Self-initiated Verbally Mediated
172 173

Executive Functions
Subtest/Item Level Process

Subtest/Item Level
EF Assessment Process Approach
Approach
Example
Direct Informal: Specific Behavior Observation
§ Process-oriented analysis Examples will be provided in the What Does Block Design
Neuropsychological Approach to Measure?
of norm-referenced subtest WISC-V Interpretation Chapter
scores and subtest items (McCloskey, et. al.) in Essentials Consider the following quote from
of WISC-V Assessment (winter, John Carroll (Human Cognitive
2016). Abilities, 1993, page 309) :
175 176 177
Subtest/Item Level What Does Block Design

Process Approach Measure?
Example
What Does WISC/WAIS Block Design Measure? From Carroll’s description, Block
“…difficulty in factorial classification arises Design can be measuring at least 5
from the fact that most spatial test tasks, distinct cognitive processes:
even the “simplest,” are actually quite § Visual perception and discrimination
complex, requiring apprehension and
encoding of spatial forms, consideration and § Reasoning with visual stimuli
possibly mental manipulations of these § Visualization (optional)
forms, decisions about comparisons of other § Motor dexterity
aspects of the stimuli, and making a
response – often under the pressure of being § Speed of motor response
required to respond quickly.”
179 180
178

Executive Functions
Measuring Problem-Solving or Executive What Does Block Design What Does Block Design Measure?
Functions with a Block Design Task
Measure?
Who will have the best Block Design score? From Carroll’s description of Block
Design, which of the 5 distinct
cognitive processes do you think
Subject 3 lacked?
• Visual perception and discrimination
• Reasoning with visual stimuli
• Visualization (optional)
• Motor dexterity
Raw Score 56 56 43 • Speed of motor response
16 20 22 181
Scaled Score
14 14 10 182
183
The Process Approach to Analysis of Block Design What Does Block Design What Does Block Design
Consider the following quote from Carroll (1993, p. 309):
Measure? Measure?
…considerable confusion exists about the identification of factors
in the domain of visual perception… Some sources of confusion
are very real, and difficult to deal with. This is particularly true of Carroll’s description leaves out a An appropriate statement regarding the
confusion arising from the fact that test takers apparently can
arrive at answers and solutions – either correct or incorrect critical 6th cognitive process, or group performance of the third subject would
ones – by a variety of different strategies. French (1965)
demonstrated that different “cognitive styles” can cause wide of processes, essential for effective be:
variation in factor loadings; some of his most dramatic cases had
to do with spatial tests, as where a sample of subjects who performance of Block Design – the “John’s superior capacity for problem-
reported “systematizing” their approach to the Cubes test yielded
a large decrease of the loading of this test on a Visualization factor
ability to initiate, focus, sustain, solving with nonverbal visual material
(that is, decreased correlations of Cubes with other spatial tests),
as compared to a sample where subjects did not report
coordinate/balance, and monitor the was applied inconsistently resulting in a
systematizing. It has been shown (Kyllonen, Lohman, & Woltz,
1984), that subjects can employ different strategies even for
use of the other cognitive processes Block Design Subtest Score in the
different items within the same test. Lohman et al. (1987) have
discussed this problem of solution strategies, even rendering the
– i.e., Executive Function processes. average range.”
judgment that factor-analytic methodology is hardly up to the task
of dealing with it because a basic assumption of factor analysis is
185
that factorial equations are consistent over subjects. 184 186

Executive Functions
Martin Age 9, NEPSY Design Copying: Martin Age 9, Rey Complex Figure Copy: Martin Age 9,
Rey Complex
Figure Copy
Verbally
Mediated by
Psychologist:
187 188 189
Alphabet Writing Nov 2010 WJ-III Writing Fluency Nov 2010 Martin Age 9,
Rey Complex
Figure Copy
Self-generated
5 months later:
190 191 192

Executive Functions
Martin Age 9, Martin Age 9, Martin Age 9, Rey Complex Figure Copy:
Rey Complex Rey Complex
Figure Copy Figure Copy
Self-initiated Verbally Mediated
Self-generated Verbally
Nov, 2010 August, 2011
8 months later: Mediated
8 months later:
193 194
Questions about Intelligence Martin’s WISC Score Changes Martin’s Achievement Score Changes
§ Do you believe it is possible to 11/2010 4/2013 9/2015 11/2010 4/2013 9/2015

raise a child’s FSIQ from 70 to FSIQ 70 99 103 Wd Reading 71 94 98
100 through intervention? GAI 83 105 108
Wd Decoding 81 97 98
VCI 73 95 106
§ Can it be done in 6 months? A 66 95 100
PRI/FRI 94 117 112 Rdg Fluency
year? Two years?
VSI -- -- 111 Rdg Comp -- 87 82
WMI/AWMI 62 97 94
68 85 98 Rdg Vocab -- 93 112
PSI
196

Executive Functions
Assessing Retrieval Fluency Assessing Retrieval Fluency Assessing Retrieval Fluency
Examples: Examples of response patterns: Examples of response patterns:

§ Naming animals in 60 seconds § Semantic “Flooding” – Retrieval § Semantic “Flooding” results
§ Naming foods in 60 seconds with minimal executive direction;
in uneven performance
§ Naming words that begin with uncontrolled flow of words
across a 60 second interval
the letter “s” in 60 seconds § Controlled Access – Executive
with decreased production in
§ Naming words that begin with Functions used to organize
retrieval of words by semantic
each successive 15 second
the letter “f” in 60 seconds interval.
clusters
199 200 201
Assessing Retrieval Fluency Assessing Retrieval Fluency Assessing Retrieval Fluency
1” – 15” Largest number of responses 15 responses

Examples of response patterns: 1” – 15” 6 responses
§ Controlled Access typically results in a Similar

16” – 30” Reduced number of responses 4 responses more even distribution of responses 16” – 30”
numbers 6 responses
across a 60 second interval. of
Responses are often reflect organized, responses
31” – 45” Reduced number of responses 1 response 31” – 45” for 5 responses
sequential access of various
each
subcategories (e.g., water animals; interval
46” – 60” Few, if any, responses 0 responses flying animals; farm animals; forest 46” – 60” 5 responses
animals; jungle animals;

202 203 204

Executive Functions
Cascading Cascading Cascading

Production Production Process: Production
Decrement D-KEFS
PAL-II Decrement Color & Decrement
Start here Retrieval Ability: Rapid Word Naming
Semantic Fluency Automatic
Retrieval Naming Process + EF:
Progressive
Ability + EF: PAL-II
Progressive deterioration D-KEFS CWI
Initial Letter Fluency Rapid
deterioration of performance Inhibition
Progressive deterioration Automatic is observed
of performance
of performance is observed Switching as executive
is observed
as executive function function Process + + EF:
as executive function
demands (+ EF) become demands (+ EF) D-KEFS Inhibition/
demands (+ EF)
greater. become greater. Switching
become greater.
Self Regulation Capacity: Focusing and sustaining attention when working independently on tasks. Progress Monitoring Form for Zach Date: __________________
Progress Monitoring Duration
1 2 3
Frequency
4 5 6 7 Goal 1: Managing Frustration and Engagement
Never Occasionally Sometimes Often Very Often Almost Always Always
0% of the Approximately Approximately Approximately Approximately Approximately 100% of
time. 10% of the 20%-40% of the 50%-70% of the 80% of the time. 90% of the the time.
3 Fully engaged Maintained positive engagement throughout
Progress monitoring
time. time. time. time.
1
Unable to focus and sustain
without class and no frustration was apparent.
attention for more than a few
frustration
techniques for interventions seconds when independently
working on tasks.
2 2 Frustration Frustration was apparent but was effectively

targeting the improvement of managed with managed and positive engagement occurred
Able to focus and sustain attention
for about 1 minute when working
independently on tasks.
self cued likely due to self-cued use of strategies.
the use of executive functions.
3
for about 2-3 minutes when working
strategy
4
1 Frustration Frustration was apparent but was effectively
for about 5 minutes when working
managed with managed and positive engagement occurred
5
teacher cue or after teacher provided a cue for strategy use
independently on tasks. Reset Or Zach returned after using the Reset strategy.
6
0 Frustration not Frustration was apparent and strategy use was

7 managed cued by teacher but positive engagement did

not occur and student left class.
for 20 or more minutes when
208 working independently on tasks. 210

Executive Functions
Executive Function Difficulties Executive Function Intervention Interventions for EF Difficulties

§ EF Self-regulation skills eventually need to
§ Are they the result of: For intervention purposes, it is best be just that—Self-regulated.
§ Disuse through to assume that EF deficiencies are § During classroom instruction, it is necessary
the result of disuse through
Nonconscious Choice to find the balance between providing
nonconscious choice. The general enough EF SR cueing to help students
§ Maturational Delay intervention goal then becomes function, but not too much to prevent EF
§ Innate Deficiency education to make the child conscious skill-development.
of the EFs needed and how to engage § It is easy to underestimate the multiplicity of
§ Disuse through Conscious them. EFs required and focus only on those
Choice related to attention and organization.
Executive Function References EF Intervention Continuum Interventions for EF Difficulties
§ Promoting Executive Functions in the Classroom– Requires keeping in mind:

Lynn Meltzer (2010) § The need to increase awareness and
§ Executive Function Skills in Children and Orienting Strategies provide goals.
Adolescents 2nd Edition – Dawson & Guare (2009) § The need to move from external control
§ Smart but Scattered – Dawson & Guare (2009) to internal control through bridging
§ Late, Lost, and Unprepared – Cooper Kahn &
External Control Strategies
strategies.
Deitzel (2008)
§ The environment in which intervention is
§ Assessment & Intervention for Executive Function Bridging Strategies happening: Requires those close to child
Difficulties – McCloskey, Perkins & VanDivner
(2009) to have reasonable EF capacities and be
§ Executive Functions in the Classroom – Chris
Internal Control able to model those capacities.
Kaufman (2010) Strategies

Executive Functions
Explanation of Executive Functions

Key Concept Key Concept
Improving students’ Orienting Strategies
executive functions increase awareness of
starts with increased executive functions
awareness and goal and expectations for
setting and progresses their use and provide
from external control to self-regulation goals
internal self-regulation for students.
217 218 219
Explanation of Internal Command/External Demand Engagement of Self-Determination and Self-Regulation

Chapter 21
Self-Determination Motivational
Executive Functions
Interviewing with
Self- Adolescents
Regulation
Executive and Young Adults
Functions
John S. Baer and

Peggy L. Peterson
Nucleus
Accumbens
Internal Command Pathway:
220
Intrinsically Rewarding 222
221

Executive Functions
Key Concept External Control Strategies

External Control Rewards can be a tremendous
strategies enable an benefit to an individual who has
individual to perform difficulty aligning internal desires
more effectively but do with external demands. Use
not necessarily help to rewards, but heed the following
improve an individual’s cautions:
capacity for self-
223
regulated performance.
224
Using Rewards to Increase Production External Control Strategies Using Punishment to

Increase Production
§ Rewards do not teach how to reflect on and
alter perceptions, emotions, thoughts or
Punishment in mild form can § Punishment does not teach how to reflect on
and alter perceptions, emotions, thoughts or
actions, they simply reward the presence of be an effective means of actions, they simply punish the presence of
desired behaviors. obtaining compliance with undesired behaviors.
§ Reward programs imply that one can do it if external demands. When § Punishment implies that a person can do it if
he/she wants to or is motivated enough. This he/she wants to or is motivated enough. This
often leads away from the realization that choosing to use punishment,
often leads away from the realization that
many persons who are motivated and do heed the following cautions: many persons who are motivated and do
want to change their behavior don’t know want to change their behavior don’t know
what to do to change it. what to do to change it.

Executive Functions
External Control Strategies External Control Strategies Perceive
Provide predictable, consistent § Perceive cues the use of sensory and

structure to classroom environments Provide external prompts perception processes to take information in
from the external environment or “inner
and routines: and cues as a substitute awareness” to tune into perceptions,
emotions, thoughts, or actions as they are
§ Post and discuss class rules and for self-regulation. occurring.
schedules
§ Review and rehearse routines § Prompt examples: “Listen to this.” “Look up
at the board.”
§ Maintain basic room “How are you feeling right now?”
arrangement
Focus Sustain Energize

§ Focus cues the direction of attention and § Energize cues the investment of energy to
§ Sustain cues sustained attention to the most
effort to the most relevant specifics the level needed to achieve the desired
relevant specifics (perceptions, emotions,
(perceptions, emotions, thoughts, and/or results
thoughts, and/or actions) of a given
actions) of a given environment, situation, or
environment, situation, or content.
content while downgrading or ignoring the
§ Prompt example: “This will require a lot of
less relevant elements.
§ Prompt example: “You will need to watch effort.” “You’ll need to focus all of your
the computer screen carefully for the entire energy on task if you want to finish.”
§ Prompt example: “Pay attention to 10 minutes.”
what happens to the baking soda after
the vinegar is added.”

Executive Functions
Initiate Inhibit Stop

§ Inhibit cues resistance to, or suppression of,
§ Initiate cues the initial engagement of urges to perceive, feel, think, or act on first § Stop cues the sudden, immediate
perceiving, feeling, thinking, or acting. impulse. discontinuation of perceiving, feeling,
thinking, or acting.
§ Inhibit prompts direct capacities to an § The Stop cue always precedes the Shift cue
alternate source rather than drawing when altering problem-solving based on
§ Prompt example: “Start walking now.” attention to the perception, emotion, changing conditions, and switching or
“Begin work on the count of five.” thought, or action that should be inhibited. alternating attention.
§ Prompt example: “Don’t start until I tell you § Prompt example: “Stop writing now.”
to go.”
Pause Flexible Shift

§ Pause cues the brief cessation of, and the § Flexible cues a willingness to alter the § Shift cues a relatively quick change in the
return to perceiving, feeling, thinking or frame of reference for the direction and direction and engagement of perceptions,
acting. engagement of perceptions, emotions, emotions, thoughts or actions in reaction to
§ Efficient use of the Pause cue enables a thoughts or actions in reaction to what is what is occurring in the internal or external
quicker return to a previous mental state or occurring in the internal or external environments.
activity. environments.
§ Prompt example: “The museum is closed
§ Prompt example: “Pause for a moment and § Prompt example: “It doesn’t need to be for emergency repairs, so we won’t be able
listen, then I want you to go back to what
you were doing.” done exactly the same way each time.” to go on the field trip.”

Executive Functions
Monitor Modulate/Adjust Balance

§ Monitor cues the activation of appropriate § Balance cues the regulation of the trade-off
§ Modulate cues the regulation of the amount between opposing processes or states
routines for checking the accuracy of and intensity of mental energy invested in (e.g., pattern vs detail; speed vs accuracy;
perceptions, emotions, thoughts or perceiving, feeling, thinking, and acting. humor vs seriousness) to enhance or
actions. improve experiencing, learning, or
performing.
§ Prompt example: “Let’s all use our indoor
§ Prompt example: “Periodically check the voices now.”
§ Prompt example: “Work as quickly as you
task directions to see if you are following “Please tone it down a bit.”
can, but be careful not to make any
all of them.” mistakes.”
Correct Sense Time Pace

§ Correct cues the use of appropriate routines § Sense Time cues the monitoring of the § Pace cues the awareness of, and the
for correcting errors of perception, emotion, passage of time (e.g., cueing the regulation of, the rate at which perceptions,
thought, or action based on feedback from engagement of the mental functions that emotions, cognitions, and actions are
internal or external sources. enable a person to have an internal sense of experienced or performed.
how long they have been perceiving, feeling,
thinking or acting).
§ Prompt example: “Correct any errors you § Prompt example: “You will need to work
find.” quickly as there is not much time left.”
§ Prompt example: “How long have you been
working on that?”

Executive Functions
Sequence Execute Hold

§ Sequence cues the orchestrating of the § Execute cues the engagement of a well- § Hold cues activation of the necessary
proper syntax of a series of perceptions, known series of perceptions, feelings, cognitive processes required to maintain
feelings, thoughts, and/or actions, especially thoughts, and/or actions, especially in cases information in working memory and
in cases where automated routines are being continues cueing these processes until
where automated routines have been
accessed or are initially being developed. the information is manipulated, stored, or
practiced and used frequently. acted on as desired.
§ Prompt example: “Remember the order of the § Prompt example: “Use the routine you § Prompt example: “Hold that thought while
steps needed for completion.” learned to do these.” we hear a reaction from the other group.”
Manipulate Store Retrieve

§ Manipulate cues the use of working § Store cues the movement of information § Retrieve cues the activation of cognitive
processes responsible for finding and retrieving
memory and other cognitive processes for about perceptions, feelings, thoughts and previously stored information about perceptions,
the manipulation of perceptions, feelings, actions from the mental processing feelings, thoughts and actions.
thoughts or actions as they are being held environment of the present moment into § The more specific the demands or constraints
“storage” for possible retrieval at a later placed on the retrieval task, the greater the
in mind or being accessed in the requirements for precision of retrieval cues.
environment. time.
§ Prompt example: “To answer the question
§ Prompt example: “This is important; it will correctly, you will probably need to recall all that
§ Prompt example: “Visualize what it would we learned about photosynthesis.”
be on Friday’s quiz.”
look like if you turned it upside down.”

Executive Functions
Gauge Anticipate Estimate Time

§ Gauge cues one to identify the demands § Foresee/Plan cues the anticipation of § Estimate Time cues the use of time
(perceptual, emotional, mental, physical) of conditions or events in the very near future, estimation routines (e.g., cueing the
a task or situation and cues the activation such as the consequences of one’s own engagement of mental functions that enable
of the resources needed to effectively perceptions, feelings, thoughts and/or a person to have an internal sense of how
engage the task or situation. actions.
long something will take to complete, or how
much time is still left in a specific period of
§ Prompt example: “Consider what it’s going § Prompt example: “If you keep erasing in
to take to get this job done right.” that same spot, what do you think will time).
happen to the paper?”
§ Prompt example: “Tell me how long you
think this will take you to do.”
Analyze Compare/Evaluate Generate

§ Analyze cues the realization of the need to § Compare/Evaluate cues the realization of the need § Generate cues the realization that novel, fluid
examine more closely perceptions, feelings, to make comparisons among, or evaluate the problem-solving efforts are required and cues
thoughts or actions to obtain a greater adequacy of, perceptions, feelings, thoughts or the activation of the resources needed to carry
understanding of a problem or situation. actions. out problem-solving routines.
§ Prompt examples: “Make a list of the positives § Prompt examples: “Did you complete all the § Prompt example: “We haven’t tried to solve a
and negatives and then compare them.” steps?”
problem like this one before.”
“Are there additional factors that need to be “Does yours look like the model?”
“This problem will require some novel thinking if
considered?” “Why do you think what you said was a good you are going to find a solution.”
explanation?”

Executive Functions
Associate Organize Plan (Short-term)

§ Plan cues the engagement of the capacities
§ Associate cues the realization that associations § Organize cues the use of routines for required to identify a series of perception,
need to be made, and cues the activation of the sorting, sequencing, or otherwise arranging feelings, thoughts, and/or actions that, if carried
resources needed to attempt to make the perceptions, feelings, thoughts, and/or out, would be most likely to produce a desired
necessary associations. actions, to enhance or improve the outcome in the very near future (within minutes to
within several hours).
efficiency of experience, learning, or
§ Prompt examples: “Have you heard anything like performance. § Prompt example: “Write down what you will do
that before?” over the weekend and when you will do it so that
“This problem is very similar to one you worked on you will be ready for the test on Monday.”
§ Prompt example: “Let’s establish the order
last week.” in which you need to do things to get this
task done.”
Choose/Decide Prioritize External Control Strategies

§ Prioritize cues the use of routines for
ordering perceptions, feelings, thoughts, Provide time management
• Choose cues the need to achieve closure, and/or actions, according to their relevance,
i.e., to make a choice among alternatives importance, or urgency.
aids, such as calendars,
now.
§ Prompt example: “Make a choice now.”
clocks, timers, schedules,
“Pick one now.” “Choose now.” § Prompt example: “Think about how
important each of these tasks is, and then
peer leaders and coaches,
• The Choose cue often must be preceded
by the Stop/Interrupt cue. list them in order of importance so the most work teams, etc.
• Prompt example: “You need to stop important ones get done first.”
thinking about it and make a choice now.”

Executive Functions
Key Concept Bridging Strategies Reflective Questioning

Repeat the individual’s question back to
Bridging strategies them instead of providing an answer.
effect the gradual Encourage the In situations where the client seems
engagement of unaware of the need to be asking
transition from questions for adequate engagement,
external control to executive functions reflective questioning involves the
self-regulated through the use of mediator asking the client a question
internal control. that is intended to make the client aware
reflective questioning of the need to engage executive
265
functions.
Bridging Strategies Feedback About Accuracy Bridging Strategies

Provide immediate and frequent feedback When providing feedback, be sure to
about the effectiveness of attempts to emphasize the importance of effort; Model appropriate use of
make sure the individual realizes that
engage self-regulation executive
self-regulation is not simply something self-regulation executive
functions. Providing individuals with
feedback about their performance you have or don’t have – it can be function capacities
enables them to engage executive increased by applying techniques and
capacities more effectively to learn from strategies; the more effort placed into
their mistakes and improve future applying the techniques, the more likely
performance. the improvements.

Executive Functions
Bridging Strategies Five Stages of Strategy Instruction Five Stages of Strategy Instruction
Teach self-regulation capacities 1. Explain the purpose of 2. Model the use of the
with specific skill routines using self-regulation strategies
Cognitive Strategy Instruction strategy using
in general and describe language and
approaches (e.g. Graham & Harris
Self-Regulated Strategy and discuss the specific
examples that connect
Development approach for steps of the strategy that
Written Expression). will be taught. with the students.
Strategies Strategies
272 273
Five Stages of Strategy Instruction Five Stages of Strategy Instruction Five Stages of Strategy Instruction
3. Students memorize the 4. Teacher supports the 5. Students independently apply

implementation of the the self-regulated strategy
steps in the strategy as strategy by the students, covertly (in their own minds).
well as any mnemonics scaffolding as necessary Students and teacher
collaboratively evaluate the
that are used as part of to help the students to
effectiveness of student self-
the strategy. master the use of the directed strategy application.
strategy. Strategies
Strategies
Strategies
274 275 276

Executive Functions
EF Involvement in Reading EF Involvement in Reading EF Involvement in Reading
Behavior indicating EF difficulties: Attention to Orthography EFs Likely to be involved in

§ Quick but inaccurate offerings for § Cueing/directing/coordinating directing orthographic processing
individual words with no recognition immediate and sustained during word reading and
of the errors being made; words
offered are highly similar in visual
attention to orthography for decoding:
configuration to the correct word or accurate letter/word perception § Perceive, Focus, Monitor,
start with the same letter or letter and discrimination Correct
combination as the correct word or
the nonsense word when performing
decoding tests.
Intervention for Orthographic Intervention for Difficulties with Intervention for Difficulties with
Direction of Attention to Orthography Directing Attention to Orthography
Awareness Difficulties
§ Should be addressed directly in early § Typically not addressed specifically Interventions for executive functions
intervention (Pre-K-1) in intervention programs difficulties with word reading
§ Intervention involves transfer of visual § Intervention involves focusing miscues:
images to long-term storage, usually attention on characteristic visual
through repetition drills 1) Increase awareness of and use of
features of letters; learning to attend all of the steps in the word
§ Unremediated difficulties result in chronic carefully and quickly to
illiteracy recognition process.
all the letters of every
§ Typically not the primary factor
word
in most reading problems
281
280 282

Executive Functions
Intervention for Difficulties with Intervention for Difficulties with Intervention for Difficulties with
Directing Attention to Orthography Directing Attention to Orthography Directing Attention to Orthography
• For a student who appears to be • Script for increasing awareness • “See the letters and words that are on
having a lot of difficulty with substituting and use: the page, not the letters and words you
visually similar highly familiar words, believe to be on the page.” (Inhibit
talk with the student about how words • “Look” (Perceive cue) cue)
can be illusions in that they can fool us • “at each word” (Focus cue) • “Quickly” (Pace cue)
into believing that they look like other • “figure out if you know the word or
words we know. • “carefully.” (Monitor cue)
don’t know the word.” (Gauge cue)
283 284 285
• “Quickly” (Pace cue) • “and quickly” (Pace cue) • “Use your decoding skills again if
• “say the word if you know it.” • “use your decoding skills to sound you don’t recognize what you
(Retrieve cue) out the word.” (Retrieve cue) sounded out or if the word
• “Pause if you don’t know it.” • “Ask yourself if what you sounded doesn’t make sense in the
(Interrupt cue) out matches a word you’ve heard sentence.” (Correct cue)
• “Shift to decoding before.” (Monitor &
mode.” (Shift cue) Retrieve cues)
286 287 288

Executive Functions
Intervention for Difficulties with Intervention for Difficulties with

Directing Attention to Orthography Directing Attention to Orthography
• Follow the discussion with word • Attention to orthography

recognition drills and oral reading of difficulties also should be
passages that emphasize the use of addressed in conjunction with
the first four cues in the sequence monster
most
mast
muster
mister
master
must
mist fluency instruction.
(“Look / at each word / carefully./ See
the letters and words that are on the • The following strategy can be
page, not the letters and used:
words you believe to be
on the page.”) 290
289 291
• Note the words that are mispronounced • On a copy of the practice passage, • Instruct the student as follows: “When you
during a “cold” read of a fluency underline every mispronounced word see an underlined word, that means that
practice passage. that had been pronounced correctly this is a word that you don’t always read
correctly but that you know how to decode.
• Identify those words that have been during decoding instruction.
The underline is there to remind you to
read correctly in word decoding use your decoding skills to sound out that
lessons but that were mispronounced word so that you will be sure to read it
during the cold read. correctly..”
292 293 294

Executive Functions
Intervention for Difficulties with Intervention for Difficulties with Source Acknowledgements
Directing Attention to Orthography Directing Attention to Orthography
• Computer-based interventions that • Many programs available today, such

emphasize attention to orthographic as Read 180 and Lexia, have the
regularity have demonstrated reading with orthographic and
improvements in students’ decoding speech support components that
skill application and overall reading have been shown to improve
achievement levels. decoding skills.
295 296 297
Writing as a Holarchically Organized Process Executive Functions and Writing Executive Functions and Writing
PLAN ORGANIZE
• What Evan wrote for me: • What Evan told me:
Reviewing/Revising
My favorite game is … “mabul “My favorite game is rolling marbles. I
Text Generation roling it is think it is fun. I just learned it yesterday. It
can be pretty hard at times. It can be fun
PLAN
fun. I like making and it’s interesting if you make it
Text Transcription the box to role in challenging. I like making the boxes to roll
to. Iam prety gode as the marbles into. You probably need to be
Language Representation well. It is rell inters pretty skilled with eye hand coordination to
do it. To get up the ramp you need to roll it
ing. It is so fun really fast.”
Idea Generation 298

Executive Functions
Executive Functions and Writing The Report Writing Strategy
§ What Evan wrote for me: • What Evan told me: 1. Select a topic.
My favorite game
“My favorite game is rolling
marbles. I think it is fun. I
2. Brainstorm what you know
is…“mabul
roling it is
just learned it yesterday. It
can be pretty hard at times. It
and what you want to learn.
fun. I like making
the box to role in
can be fun and it’s interesting
if you make it challenging. I 3. Organize your information
like making the boxes to roll
to. Iam prety gode as the marbles into. You using a visual web.
well. It is rell inters probably need to be pretty Steve Graham
ing. It is so fun skilled with eye hand
coordination to do it. To get
Self-Regulated 4. Review your visual web and
Strategy Development
up the ramp you need to roll it
really fast.”
(SRSD) identify any holes or
302
disconnects. 303
Web for what I know and what I want to learn The Report Writing Strategy The Report Writing Strategy
Habits Looks 5. Gather new information and 8. Check the visual web; did
Active at night Large eyes revise your visual web. you write what you wanted to
___________ Long tails
Lemurs
___________
___________
Rings on tail
___________ 6. Use the visual web to help write?
construct an outline for the 9. Add information that is
Live Pets? Eat? report or to begin writing. missing; fix sentences that
jungle
trees Can they be pets?
What do they eat?
___________ 7. Review, plan and revise as don’t say what you want
Country???
zoos
___________
___________
___________
___________
you write. to say.
___________
305 306

Executive Functions
Scaffolding Step 9 Scaffolding Step 9 Bridging Strategies

A. Read the sentence silently D. What’s missing? What Practice and rehearsal of the use
and/or aloud. doesn’t make sense? of executive functions. This is
B. Does the sentence make E. Restate what you want to the single best way to increase
sense to you? What does it write. Repeat it to yourself. engagement and efficiency of the
mean? F. Write what you just said. use of executive functions.
C. Is that what you meant to G. Read what you wrote; go
say? through steps A-F if needed.
307 308
Bridging Strategies Simon Says

Pay Attention:
Whenever possible, use game Help for
formats and game strategies to Children with
ADHD
practice the use of executive
functions. Daniel Yeager &
Marcie Yeager
311 312

Executive Functions
Bridging Strategies Bridging Strategies

Align external demands with internal Develop a common vocabulary
desires to maximize motivation. and set of nonverbal symbols for
§ Allow self-selection or choice of describing or signifying self-
assignments whenever possible regulation capacities and signaling
§ Use high interest material to their use (e.g., cueing
illustrate application of new flexibility with “The
knowledge and skills Coconut Story”)
314
Internal Control Strategies Key Concept Internal Control Strategy
Once learned, the child can use

Once learned and internalized “self-talk” as a means of
practiced, Internal increasing awareness of executive
Control Strategies functions and of when and how to use
enable students to them (e.g., modified Berninger mantra
effectively “run their for writing: “What I can think I can say.
What I can say I can write.
own shows.” What I can write I can revise.”)
317

Executive Functions
Internal Control Strategy Internal Control Strategy Cognitive Strategy Instruction
Model and teach the use of self-

administered reward routines to Teach the use self-monitoring Case
increase the use of self-regulation routines. These routines can be
executive functions (e.g., teach the used to monitor and correct Example:
child how to “bargain with yourself” perceptions, feelings, thoughts
to get homework accomplished). and actions. Zach
Motivational Interviews with Zach Goal Setting with Zach

Chapter 21
Motivational
Interviewing with “I’m here to help you get what Zach’s self-selected long-
Adolescents you want, but in order to do term goals:
and Young Adults § Pass all classes in 8th
that I need to know what it is
John S. Baer and that you want.” grade
Peggy L. Peterson § Get promoted to 9th grade
and attend 9th grade at the
Page 320 - 332
district Senior High School
322

Executive Functions
Collaborative Problem-Solving with Zach Collaborative Problem-Solving with Zach

Ross Greene’s
Collaborative
When asked specifically about his
Problem-Solving “When I was observing you in refusal to do classwork that day in
Science class, I saw that you Science class (as observed by the
just put your head down on psychologist), Zach offered that he
the desk and stayed that way was not purposefully refusing to do
the work, but that he was unable to
for most of the class. What
get himself to do it, stating: “It feels
happened?” like I am hitting a wall and the harder
I try, the more it hurts.”
325
Collaborative Problem-Solving with Zach Goal Setting with Zach Cognitive Behavior Therapy
Using Zeke’s own descriptive metaphor, It was also explained to Zach that
Goals developed through discussion
the psychologist explained to Zach that it is possible to improve the
with Zach about how to achieve his
he was going to teach Zach strategies long-term goals: capacity to respond on demand,
that would enable him to stop hitting the
§ Improve my mood; get engaged especially if he were to have a
wall, step back and find the door in the
wall, open the door and go through it; with class strategy worked out that he could
“Once inside the door, you are now in the § Pay attention in class use in situations where demands
control room of the brain and you can were being made of him, such as
§ Complete class work and home
take control and make your brain do the
work
the demands for participating in
things you want to achieve your goals.” class and doing homework.

Executive Functions
Cognitive Strategy Instruction Cognitive Strategy Instruction Cognitive Strategy Instruction
The Psychologist met with The Powerpoint file was used

Zach and his mother to come to teach Zach how to use the Zach’s
up with strategies that he strategies and used with
could use to achieve his school staff to help them Cognitive Strategy
understand how Zach was
immediate goals. After the
strategies were developed, going to work on improving
Powerpoint
the psychologist summarized his behavior.
them in a powerpoint file.
Long-term Goals Ask: How am I doing right now?

Do I feel good?
Get passing grades in all subjects Am I doing what I need to do for class?
Get promoted to 9th grade
Immediate Goals
Improve my mood; get engaged with class
Pay attention in class

Say: I need to use the
Purple Elephants Strategy
Complete class work and home work

Executive Functions
Ask: What should I be doing for class?
Say: OK, I’m on it.

or
Say: I’m not sure.
I will ask for help.
Take a deep breath and relax.

Say: I need to adjust my attitude Say: I am in control now!
so I can have a good day. Say: I feel better.
I’m ready to do what
Say: Looking at my Purple Elephants file
I need to do for class.
will help me feel better.
How am I doing right now?

Do I feel good?
Am I doing what I need to do for class?
Ask: Am I paying attention right now?
I need to use the
Purple Elephants Strategy
I need to adjust my attitude

so I can have a good day.
Looking at my Purple Elephants file

will help me feel better.
I am in control now!
OK, I feel better.
I’m ready to do what
I need to do for class.
What should I be doing for class?
Say: I need to use
I’m not sure.
the Focus Strategy
OK, I’m on it.

Executive Functions
Say: What should I be doing for class?

or
Say: I am in control now!
Say: I am energized and ready

Yawn and Stretch.
to pay attention!
Am I paying attention right now?

Ask: Am I doing my class work?
I need to use the Focus Strategy
Yawn and Stretch.
I am energized and ready
To pay attention!
What should I be doing for class? Say: I need to use the

I’m not sure.
Just Do It Strategy
OK, I’m on it.

Executive Functions
Say: I can complete my class work if I

know what I need to do and how to do it.
Ask: Do I know how to do this work?”
or
Say: I need to do my class work Say: I am in control now!

so I can earn a passing grade
and go on to 9th grade next year. Say: I am energized and
ready to work!
Am I doing my class work? Cognitive Behavior Therapy Cognitive Distortion Cognitive Correction
Dichotomous Thinking: Contextual Thinking:
“I’m either a good student or a “Sometimes I perform poorly but
I need to use the
Just Do It Strategy
The psychologist created a list of failure.” many times I perform well.”
cognitive distortions and related Overgeneralizing: Specifying:

I need to do my class work “I hit the wall in class today and “I hit the wall today and couldn’t
so I can earn a passing grade
and go on to 9th grade next year.
cognitive corrections that was couldn’t find the door. I have no find the door. The next time I hit
used with Zach to discuss how control over my emotions.” the wall, I will use my Purple
Elephant strategy and find the
I am energized and
he could change his thinking door.
ready to work!
about school and academic Mindreading:
“I didn’t do all of the assigned
Mindsharing:
“I didn’t do all my work. I’ll let the
I can complete my class work if I know what I
need to do and how to do it.
Do I know how to do this work?”
tasks. The list was shared with work. I know the teacher is teacher know that I plan to finish
disappointed with me.” all of it if that is ok with him/her.”
I’m not sure.
Zach’s counselor who also
worked with Zach on cognitive
OK, I’m on it.
354
corrections.

Executive Functions
YOU ARE IN CONTROL!

Cognitive Distortions and
Teacher Training Teacher Training
Counteracting Cognitive Corrections Worksheet
Developed by George McCloskey, Ph.D. Philadelphia College of Osteopathic Medicine
Zach’s teacher’s met with the § Deliver 1-3 prompts during
Cognitive Distortion Cognitive Correction
psychologist for 90 minutes to class
receive training on how to use a § Provide daily ratings of
series of prompts to cue Zach to engagement, attention and work
use the strategies he was completion based on need for
learning to improve his and response to prompts
engagement, attention and work
completion during classes.
355
Teacher Training Cognitive Strategy Implementation Progress Monitoring Form for Zach T Date: __________________
Goal 1: Managing Frustration and Engagement
§ Prompt 1: Self-awareness § Zach self-cues engagement, 3 Fully engaged Maintained positive engagement throughout
cueing (Zach, you seem to be attention and work completion without frustration class and no frustration was apparent.
having some trouble with…) § If prompt 1 is used: Zach realizes 2 Frustration managed Frustration was apparent but was effectively
the need to use his strategies with self cued strategy managed and positive engagement occurred
§ Prompt 2: Zach, you need to likely due to self-cued use of strategies.
use your _ strategy. § If prompt 2 is used: Zach, uses his

strategy as suggested by teacher 1 Frustration managed Frustration was apparent but was effectively
§ Prompt 3: Zach you need to § If prompt 3 is used: Zach leaves

with teacher cue managed and positive engagement occurred
after teacher provided a cue for strategy use.
use your reset strategy. the room and uses his reset 0 Frustration not Frustration was apparent and strategy use was
strategy. managed cued by teacher but positive engagement did not
occur and student left class.
360

Executive Functions
Staff Collaboration/Consultation
Class: _____________________
Frustration 3 2 1 0 Work Comments: § Staff requested to have the

Management Modified: psychologist meet with Zach on
Yes No
a regular basis to reinforce the
Attention 3 2 1 0 Work strategies and consult with
Work 3 2 1 0
completed
teachers and staff.
with
Completion extended
time?
Yes No
361 362
Progress Monitoring
DAILY PROGRESS BY CLASS ATTENTION 4-Feb 5-Feb 6-Feb 7-Feb 8-Feb 11-Feb 12-Feb 13-Feb 14-Feb 15-Feb 19-Feb 20-Feb 21-Feb 22-Feb 23-Feb 25-Feb 26-Feb 27-Feb 28-Feb 1-Mar
WEEK 1 WEEK 2 WEEK 3 WEEK 4 Math 2 2 3 3 2 0 2 0 0 0 1 0 2 0 3 2 2 3
ENGAGEMENT 4-Feb 5-Feb 6-Feb 7-Feb 8-Feb 11-Feb 12-Feb 13-Feb 14-Feb 15-Feb 19-Feb 20-Feb 21-Feb 22-Feb 23-Feb 25-Feb 26-Feb 27-Feb 28-Feb 1-Mar Science 3 3 3 1 3 0 0 0 0 2 1 2 2 0 2
Math 3 3 3 3 2 0 2 0 0 1 1 0 3 0 3 2 2 3 Social Studies 3 3 3 3 3 0 3 3 3 3 3 3 3 3 1
Science 3 3 3 0 2 0 0 0 0 3 0 2 2 0 2 English 3 3 2 2 0 3 3 0 3 0 0 0 3 2 3 3 3
Social Studies 3 3 3 3 2 0 3 2 3 3 3 3 2 3 1 Reading 3 3 3 1 0 0 3 3 3 0 3 3 3 3 3 3 3
§ Weekly ratings were

English 3 2 3 3 0 3 3 0 3 0 0 0 3 3 3 3 3 Math Facts 0 3 3 3 0 3 0 3 0 2 2 0 3 3 2
Reading 3 3 3 3 0 0 3 3 3 0 3 3 3 3 3 3 3
Math Facts 0 3 3 3 0 3 0 3 0 3 3 0 3 3 3
summarized to help school staff

ATTENTION 4-Mar 5-Mar 6-Mar 7-Mar 8-Mar 11-Mar 12-Mar 13-Mar 14-Mar 15-Mar 18-Mar 19-Mar 20-Mar 21-Mar 22-Mar 25-Mar 26-Mar 27-Mar 28-Mar 29-Mar
Math 3 2 2 1 3 3 1 1 0 0 1 0 0 1 0
WEEK 5 WEEK 6 WEEEK 7 WEEK 8 Science 0 3 1 3 3 0 0 0 1 0 3 1 3
ENGAGEMENT 4-Mar 5-Mar 6-Mar 7-Mar 8-Mar 11-Mar 12-Mar 13-Mar 14-Mar 15-Mar 18-Mar 19-Mar 20-Mar 21-Mar 22-Mar 25-Mar 26-Mar 27-Mar 28-Mar 29-Mar Social Studies 3 2 2 1 3 3 3 3 3 3 2 3 3
monitor progress and provide

Math 3 3 3 1 3 3 2 1 0 0 1 0 3 1 0 English 3 2 2 1 3 3 2 1 3 1 2 2 2 3
Science 0 2 1 3 3 0 0 0 0 0 3 1 3 Reading 2 3 1 3 3 2 2 3 3 2 1 0 2 3
Social Studies 3 3 2 1 3 3 3 3 3 3 3 3 3 Math Facts 0 3 0 3 3 3 3 3 3 3 3 0 3 3
English 2 2 3 1 3 3 3 3 3 0 3 3 3 3
Zach with feedback about his Reading

Math Facts 0
3
3
3
0
2
3
3
3 3
3
3
3
3
3
3
3
3
3 3
3
3
0
3
3
3 3
3
performance.
ATTENTION 1-Apr 2-Apr 3-Apr 4-Apr 5-Apr 15-Apr 16-Apr 17-Apr 18-Apr 19-Apr 22-Apr 23-Apr 24-Apr 25-Apr 26-Apr 29-Apr 30-Apr 1-May 2-May 3-May
WEEK 9 WEEK 10 WEEK 11 WEEK 12 Math 2 2 3 0 0 3 0 0 0 0 0 3
ENGAGEMENT 1-Apr 2-Apr 3-Apr 4-Apr 5-Apr 15-Apr 16-Apr 17-Apr 18-Apr 19-Apr 22-Apr 23-Apr 24-Apr 25-Apr 26-Apr 29-Apr 30-Apr 1-May 2-May 3-May Science 3 2 3 0 0 1 3 3 3 2 2 0
Math 2 2 3 0 0 3 0 0 3 0 0 3 Social Studies 3 3 0 3 3 3 3 3 2 2 2 0
Science 3 3 3 0 0 0 3 3 3 3 2 2 English 2 3 2 0 2 3 3 1 3 2 3 3 1
Social Studies 3 3 1 3 3 3 3 3 1 2 2 0 Reading 2 3 2 1 2 3 3 1 3 3 3 3 3 2
English 3 3 2 0 1 3 3 0 3 3 0 3 3 Math Facts 3 3 0 1 3 3 1 2 2 3 3
Reading 3 3 3 2 3 3 3 1 3 3 3 3 3 3
Math Facts 3 3 0 3 3 3 1 3 2 3 3
WEEK 13 WEEK 14
ATTENTION 6-May 7-May 8-May 9-May 10-May 13-May 14-May 15-May 16-May 17-May
WEEK 13 WEEK 14 Math 0 1 1 1 2 0 1 1
ENGAGEMENT 6-May 7-May 8-May 9-May 10-May 13-May 14-May 15-May 16-May 17-May
Science 2 3 2 3 1 2 1 1 0
Math 0 1 0 1 2 0 1 1
Science 2 3 2 3 2 2 1 1 0
English 3 0 1 2 0 2 2 1
Reading 1 3 3 3 1 3 2 3
English 3 3 3 3 0 3 2 0
Math Facts 3 3 3
Reading 3 3 3 3 2 3 2 3 365 366
Math Facts 3 3 3

Executive Functions
WEEK 1
WORK CONPLETION4-Feb 5-Feb 6-Feb 7-Feb 8-Feb
WEEK 2
11-Feb 12-Feb 13-Feb 14-Feb 15-Feb
WEEK 3
19-Feb 20-Feb 21-Feb 22-Feb 23-Feb
WEEK 4
25-Feb 26-Feb 27-Feb 28-Feb 1-Mar
END OF YEAR SUMMARY ALL CLASSES 8th Grade Outcomes
Math 3 3 3 3 2 0 2 0 0 0 1 0 2 0 3 2 0 3
Science 3 3 3 0 2 0 0 0 0 3 0 2 0 0 1
Social Studies 3 3 3 3 0 0 3 3 2 0 2 0 0 1 1
English 3 3 0 3 0 3 3 0 3 0 0 0 3 2 3 3 3
ENGAGEMENT % § Zach passed all of his classes.

Reading 3 3 3 3 0 0 3 3 3 0 3 3 3 3 3 3 3
Math Facts 0 3 3 3 0 3 0 3 0 2 3 0 3 3 3

Rated 3, 2, or 1 78%
§ Zach’s progress toward
WORK COMPLETION4-Mar 5-Mar 6-Mar 7-Mar 8-Mar 11-Mar 12-Mar 13-Mar 14-Mar 15-Mar 18-Mar 19-Mar 20-Mar 21-Mar 22-Mar 25-Mar 26-Mar 27-Mar 28-Mar 29-Mar
Math 3 1 2 1 3 3 0 0 0 0 0 0 0 1 0
Rated 0 22%
Science 0 2 1 3 0 0 0 0 0 0 3 0 3
behavior goals were judged as

Social Studies 2 1 0 0 2 2 3 3 3 3 2 1 3
English 3 2 2 1 3 3 2 1 3 0 2 1 2 3
Reading 2 3 1 3 3 1 2 3 1 2 1 0 2 3
Math Facts 0 3 0 2 2 3 3 3 3 3 3 0 3 3
ATTENTION %
reflecting adequate
Rated 3, 2, or 1 78%
WORK COMPLETION1-Apr 2-Apr 3-Apr 4-Apr 5-Apr 15-Apr 16-Apr 17-Apr 18-Apr 19-Apr 22-Apr 23-Apr 24-Apr 25-Apr 26-Apr 29-Apr 30-Apr 1-May 2-May 3-May
improvement
Math 2 1 3 0 0 3 0 0 0 0 0 3
Science 3 2 3 0 0 1 3 3 3 2 2 0
Social Studies 2 2 0 3 2 1 3 2 2 2 1 0
Rated 0 22%
English 2 3 1 0 2 3 3 0 3 2 3 3 1
Reading 3 3 2 1 2 3 3 2 3 3 3 3 3 3
§ Zach was promoted to 9th grade

Math Facts 3 2 0 0 3 3 3 2 2 3 3
Zach T. WEEK 13 WEEK 14 WORK

WORK COMPLETION
Math
6-May 7-May 8-May 9-May 10-May
0 0 0 0 1
13-May 14-May
0
15-May 16-May
0
17-May
1 COMPLETION % at the high school instead of
Science
Social Studies
English
1
0
2
0
3
2
0
0
3
0
0
1
2
0
0
0
1
2
1
0
3
0
0
1 Rated 3, 2, or 1 70% being transferred to an
Reading
Math Facts
2
3
3 3 3
3
1 3 2 3
3 Rated 0 30% alternative program
367 368
Key Concept Executive Functions Interventions Key Concept

Some specific Specific Programs and Tools of the Mind
educational programs Approaches to Improving (Bodrova & Leong) is
are designed, either Clients’ Executive an effective preschool
explicitly or implicitly, to Functions include the /kindergarten
improve students’ curriculum that helps
following:
executive functions. young children improve
370 371 372

Executive Functions
Bronson & Key Concept

Merryman
discuss their Cognitive Strategy
observations of
the Tools of the
Instruction is an
Mind evidence-based
Tools of the
curriculum in methodology that
Chapter 8
Mind Can Self- improves students’ use
Elena Bodrova Control Be of executive functions
& Deborah Taught?
Leong to improve academic
373 374
production. 375
Evidence Based Intervention: Evidence Based Intervention: Evidence Based Intervention:

Cognitive Strategy Instruction Cognitive Strategy Instruction Cognitive Strategy Instruction
Cognitive Strategy Instruction (CSI) CSI techniques employ Lynn Meltzer (2010) employs
emphasizes the development of thinking
skills to increase learning and production.
metacognition and focus on CSI techniques in the Drive
CSIs help students to become more modeling and teaching students
strategic, self-reliant, flexible, and productive strategies for completing tasks
to Thrive classroom program
in their learning endeavors (Scheid, 1993). and routines and then modeling and the BrainCogs and
Use of these strategies have been Essay Express software
associated with increased academic
and teaching methods for self-
production (Borkowski, Carr, & Pressley, cueing the use of the strategies. programs.
1987; Garner, 1990).

Executive Functions
Evidence Based Intervention: Executive Functions Interventions

Cognitive Strategy Instruction
Drive to Thrive and BrainCogs both address five Rueven Feuerstein’s approach to
general areas of self-regulation: improving cognitive functioning
§ Goal Setting, Planning and Prioritizing through instrumental enrichment,
§ Organizing mediated learning and dynamic
assessment, all focused on
§ Remembering
increasing self-regulation through
§ Shifting and Flexible Problem-Solving increased self-awareness and
§ Self-Monitoring and Self-Checking strategy use.
379 381
Key Concept
The language of
Cognitive Behavior
Therapy is being used
to help teachers
improve their ability to
engage specific brains
areas during classroom
382 383
instruction. 384

Executive Functions
Executive Functions Interventions Evidence Based Intervention: Evidence Based Intervention:

Cognitive Behavior Therapy Cognitive Behavior Therapy
Cognitive Behavior Therapy (CBT).
CBT teaches strategies for improving the Cognitive Behavioral Therapy Outcomes of CBT with children and
(CBT) emphasizes collaborative adolescents:
use of executive functions to cue and
direct effective perceiving, feeling, thinking § Increased ability to monitor perceptions,
reality-testing and the monitoring
and acting. Techniques have shown good feelings, thoughts and actions
and modification of automatic
results at the adult and adolescent levels § Increased engagement in positive problem-
and some early indications that the perceptions, feelings, thoughts, solving strategies
techniques can be applied effectively with and actions that cause difficulties § Increased capacity for self-regulating
children in the elementary grades. for the child. perceptions, feelings, thoughts and actions
385
Executive Functions Interventions Evidence Based Intervention:

Dialectical Behavior Therapy
CBT variants such as Jeffrey Schwartz’s
“Dialectical behavior therapy (DBT) focuses on the treatment
“Brain-Lock: Free Yourself from mood disorders and on changing patterns of behavior that are not
Obsessive-Compulsive Behavior; subtitled helpful, such as suicidal ideation and substance abuse. DBT
improves modulation of perceptions, feelings, thoughts and actions
as “a four-step self-treatment method to by helping clients learn about the triggers that lead to reactive
states and learn coping skills in order to avoid undesired reactions.
change your brain chemistry.” This DBT is a modified form of CBT developed by Marsha Linehan to
method uses CBT oriented techniques to treat individuals diagnosed with borderline personality disorder and
chronically suicidal individuals. DBT use has expanded to the
strengthen self-regulation capacities and treatment of traumatic brain injuries (TBI), eating disorders, and
decrease unproductive perceptions, mood disorders, self-injury, sexual abuse survivors, and chemical
dependency. DBT combines standard cognitive behavioral
feelings, thoughts and actions. techniques for emotion regulation (modulation) and
reality-testing with concepts of distress tolerance,
acceptance, and mindful awareness largely derived from
meditative practice.
388

Executive Functions
Executive Functions Interventions

Key Concept Ross Greene’s
Ross Greene’s Collaborative Problem- Collaborative
Problem-solving solving approach featured in his books Problem-Solving
approaches are on Treating Explosive Kids. Although
Greene does not specifically use the
intended to increase concept of executive functions, his
students’ use of intervention approach teaches parents
executive functions to techniques for improving both external
control and building internal self-
find better solutions to regulation capacities.
personal difficulties.
391 392 393
Executive Functions Interventions Executive Functions Interventions
Myrna B. Shure’s I Can Michelle Garcia Winner’s Social

Thinking Curriculum Superflex.
Problem-Solve techniques for Uses cartoon characters to teach
teaching young children about self-regulation concepts (e.g.,
increased self-control and Rock Brain represents inflexible
improved cueing of appropriate thinking). Intended for upper
problem-solving routines. elementary age children diagnosed
with Asperger’s, but the techniques
and ideas appear to have wider
394 395
application. 396

Executive Functions

Key Concept
Computer-based cognitive training
Computer-based programs such as CogMed and
technologies are neurofeedback programs are being
beginning to show closely studied to determine the
promise as techniques extent to which they can be used to
for improving students’ improve self-regulation in settings
other than the “computer lab.”
capacities for executive
functions use.
397 398 399

Key Concept
Use of Meditation, especially
Meditation is one of witnessing meditation techniques.
the most effective Improving all forms of self-control,
ways to increase especially Self-Awareness,
through “quieting of the mind.”
access to and use of
400 401 402

Executive Functions

Key Concept
Mindfulness-based Physical Because so many
Exercise Programs such as Yoga
and Thai Chi are likely to have executive functions
generalized effects on a number of problems are related
self-regulation executive functions. to maturational
delays, time is an
effective intervention
in itself.
403 404 405
Executive Functions Interventions Executive Functions Interventions

Key Concept
Time - Natural maturational Pharmacological - Medications help
processes affect executive functions Some medications increase executive functions use in
at all levels; time-related help individuals with conditions such as ADHD, mood
expectations for EF development severe ADHD gain disorders, and OCD. In most cases,
often need to be adjusted (e.g., greater access to the medication does not directly
enhance EFs but rather reduces the
recall the 30% developmental delay some specific disrupting effect of less than optimal
often found with individuals with executive functions. function of other neural circuitry.
ADHD)
406 407 408

Executive Functions
Key Concept Executive Functions Interventions Executive Functions Interventions
Executive Skills Engage the Services of a Cognitive Encourage Symbiotic Relationships

coaching is a growing Coach (i.e., Rent-a-Lobe) Make and Support Networks. Enter into
area. When done well, extensive use of an external relationships where there is a
it can be used to executive function substitutes where mutual interdependence that
appropriate, e.g., ADHD and Life enables reduction of the effect
implement all four
Coaches. of EF deficiencies
strategies for improving
executive functions. (e.g., Marry-a-lobe).
409 410 411
Strategies for Improving

Key Concept Key Concept Assessment Methods
Teachers can implement Alternately, teachers can
specific techniques to take on the challenge of 1) Offer bonus points for handing in
reduce the likelihood of teaching students how to homework and assignments on
executive functions adjust to increased time instead of taking points
difficulties affecting demands for the use of away
assessment of academic executive functions in 2) Point out minor errors and offer
production. assessment situations. students a chance to correct
them before assigning a grade
412 413

Executive Functions
Strategies for Improving Strategies for Improving Strategies for Improving

Assessment Methods Assessment Methods Assessment Methods
3) Offer feedback and 5) Offer credit for all efforts to 7) Offer multiple ways to
opportunities to revise writing correct work; offer participate in classroom
assignments before grading opportunities to retake failed activities, not just oral
them tests expression
4) Offer students choices for 6) Deduct no more than 5-10% of 8) Use pop quizzes only as a
ways to demonstrate content total points for minor detail diagnostic tool rather than a
knowledge errors graded performance measure
Strategies for Improving Strategies for Improving Cognitive Strategy Instruction

Assessment Methods Assessment Methods
9) Offer response choices 11) Avoid placing constraints on Case

(word banks) for open-ended response modes as much
question formats as possible Example:
10) Provide guidelines and 12) Teach note-taking, memory
progress checks for long- strategies, and study skills Billy
term projects when necessary
Lack of Inhibition?

Executive Functions
Billy’s Intervention: Orienting Phase

Billy: Case Conceptualization Billy: Case Conceptualization
§ The psychologist described what he saw in the
classroom and listened to Billy’s explanation of what was
It is critical that the actual problem behavior and § Teacher only used a Stop prompt happening in the classroom.
associated EF difficulties be specified clearly and
accurately : when voice or activity levels were in § The psychologist helped Billy to think through why his
§ Teacher used the terms Lack of Inhibition and the unacceptable range. behavior was viewed as disruptive by the teacher.
Impulsivity to describe Billy’s behavior, but her § Billy was not aware of why he was § The psychologist asked Billy to help find a solution to the
behavioral descriptions of problem situations classroom problems that resulted when he was unable to
were really examples of lack of effective being told to stop. monitor and adjust his voice and activity levels.
monitoring and modulating. § Without awareness of the problem § Billy and the psychologist concluded that Billy needed
§ Classroom observation confirmed that Billy’s and help in finding a strategy to help learning how to monitor and modulate his voice and
difficulties resulted from a lack of monitoring of
voice and activity levels and a lack of adjusting change voice and activity levels on activity levels.
of the intensity of voice and activity levels. command, Billy was unable to § The psychologist and Billy met with the guidance
counselor to identify strategies that could be used to help
change his behavior. Billy learn how to improve his ability to monitor and adjust
421 422
his voice and activity levels. 423
Billy’s Intervention: Orienting Phase Billy’s Intervention: External Control Phase Billy’s Intervention: Skill Bridging Phase
§ The guidance counselor and Billy played a game that Billy
§The team (Billy, the psychologist § Billy and the counselor talked about the named “the Sounding Good Game.”
different voice levels (library, indoor and § In the first part of the sounding good game, Billy got to
and the guidance counselor) outdoor) and the best times to use each choose a song to dance to while playing the game.
decided to use an activity similar one. § As Billy danced to the music, the counselor held up a card
§ The counselor and Billy practiced using with a short sentence and a symbol for a specific voice level
to those used in the Tools of the different voice levels; Billy would try to printed on it.
Mind curriculum to help Billy learn repeat what the counselor said in the § Billy would continue to dance while reading the sentence to
same voice level used by the counselor himself and while thinking about saying the sentence out
how to monitor and adjust his and would receive feedback about the loud in the voice level that was shown on the card.
voice level. accuracy of his use of different voice § When the counselor stopped the music, Billy had to say the
sentence in the voice level indicated on the card.
levels.
§ The counselor would give Billy feedback about the accuracy
424 425 of his use of voice level. 426

Executive Functions
Billy’s Intervention: Bridging Phase Billy’s Intervention: Function Bridging Phase Billy’s Intervention: Progress Monitoring
§ Billy and the counselor discussed how he could
use what he was learning about voice level control § In the second part of the sounding good § The counselor kept track of Billy’s
in the classroom.
game Billy and the counselor also played a progress informally by checking in
modified version of the game; the counselor with the teacher at least weekly.
§ They decided that Billy’s teacher could cue him showed Billy a card with the description of
about the right voice level to use in a classroom an activity or a location in the school and a § Over the course of three months,
activity by saying to Billy: “Billy, what voice level sentence about the activity or location and
Billy would read the description in the voice Billy’s teacher usually reported that
do you think we should be using now?”
level appropriate for the activity or location. Billy was able to adjust his voice
§ Billy’s teacher would also give him feedback about
the accuracy of his response.
§ The counselor would give Billy feedback level in class, but most often only
about the accuracy of the voice level he after being given the reflective
§ The counselor explained to Billy that the teacher’s used when reading.
question and feedback would be his cue to be question prompt.
sure to use the right voice level.
427 428 429
Billy’s Intervention: Progress Monitoring Billy’s Intervention: Self-Regulation Phase Billy’s Intervention: Carry-Over to
Activity Level
§ Because Billy was still being § Reflective questioning was used with
provided with reflective questions at Billy through September and § Although no specific teaching was provided to help Billy adjust
his activity level, the psychologist and the counselor discussed
the end of the school year to get him October. During November, the with Billy how he could use what he was learning about voice
control to monitor and adjust his activity level.
to adjust his voice level, he played teacher needed to use reflective § The counselor provided Billy with examples of how he could
the sounding good games with the questioning only twice. think about a classroom activity and then think about how
active he should be during that activity (using the same level
counselor a few times at the § Billy was able to self-regulate the names as voice – library, indoor, outdoor).
beginning of the next school year monitoring and adjusting of his voice § Billy’s teacher was asked to use the reflective question
technique with Billy when his activity level was not appropriate
and his new teacher was asked to level for the rest of the school year for an activity and give him feedback about the accuracy of his
response.
provide the reflective question without requiring reflective § Billy was coached by the counselor to recognize the teacher’s
prompt when Billy’s voice level was questioning. reflective question as a prompt to monitor his activity level and
adjust it.
inappropriate for the situation.
430 431 432

Executive Functions
Billy’s Intervention: Progress Monitoring

§ The counselor kept track of Billy’s progress
informally by checking in with the teacher at
least weekly.
§ Over the course of four months, Billy’s
teacher reported that Billy was able to adjust
his activity level in class, but usually only
after being given the reflective question
prompt.
§ By the end of the school year, Billy was still
requiring the use of the reflective question
prompt, but usually not more than 1-2 times
per week.
433

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Executive Functions

Essentials of Executive Frontal-subcortical Circuits

Motor Circuit Oculomotor Circuit Behaviorally Relevant FSC Circuits

McCloskey – Executive Functions 1

Frontal-subcortical Circuits Orbitofrontal Lateral and Medial Regions Orbitofrontal Circuit

Orbitofrontal Cortex Frontal-subcortical Circuits Dorsolateral Circuit

McCloskey – Executive Functions 2

Frontal-Subcortical Circuits Anterior Cingulate Cortex Anterior Cingulate Cortex

McCloskey – Executive Functions 3

Anterior Cingulate Circuit Anterior Cingulate Circuit Anterior cingulate circuit

Frontal Lobe Pathways Frontal Lobe Pathways

McCloskey – Executive Functions 4

It is important to distinguish Management Structure within a

McCloskey – Executive Functions 5

Today’s Discussion Draws on Years of Painstaking

Behavior Observation and

McCloskey – Executive Functions 6

Ability Deficits From Ability to Skill

From Ability to Skill From Ability to Skill

2) implementing and refining Marzano, Pickering & Pollock

McCloskey – Executive Functions 7

From Ability to Skill From Ability to Skill

Strategies discussed include:

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Key Concept Key Concept 504 Accommodation Plans

Functional Behavior Assessment Functional Behavior Assessment FBA: Is A-B-C Enough?

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The EF Driven FBA A Key Concept EF- Driven FBA

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Thoughts The Management Structure within a Holarchical

§ Cue the use of other mental Self-Regulation

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Self Regulation Executive Function “Clusters” Executive Functions Interventions

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Cognitive Strategy Instruction Self Regulation Executive Function “Clusters”

Key Concept Bronson &

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Engagement of Self-Regulation Engagement of Self-Regulation

Internal Command Pathway: Internal Command Pathway:

The neural circuits for executive Because internally driven production

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Internal versus External Control Holarchy vs Hierarchy Holoarchy vs Hierarchy

The on-demand deficiencies Hierarchy § Within a hierarchy, the next stage of

EF Tiers within the Holarchical Model of Executive

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John S. Baer and

100 101 102

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EF Tiers within the Holarchical Model of Executive

Self-Generation § Directs the posing of speculative questions Self-Generation

Self-Realization Self-Determination Self-Realization Self-Determination

used to guide self-awareness, self-realization

Trans-Self Integration EF Key Concept Executive Function Development

§ Directs the engagement of mental

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by continuous equal intervals Math

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Key Concept Key Concept Producing versus Learning

Intervention efforts require a Producing difficulties