Developmental Executive Functions, 5400-001 Class 10, 10/25/05

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Developmental Executive Functions, 5400-001Class
10, 10/25/05

• Principles of Assessment,
• Open-book quiz

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Principles of Assessment

• Concepts for tonight
• Do not build yourself in as the childs PFC
• EF skills are tertiary processing
• Provide a profile of strengths weaknesses
• Differentiate discreet EF components
• Consider developmental expectations
• Crystallized v. fluid intelligence
• Process v. product
• Neuropsych, speech, formal, and informal

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Where is the problem?
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What we usually do

• Traditional tests
• Account for every variable
• Provide scripted instructions
• Eliminate distractions
• Allow for very little novel thinking
• Eliminate opportunity for errors in planning,
  sequencing,
• Examiner controls order of things
• Examiner establishes goals, objectives

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Why this doesnt work to evaluate executive
function skills.

• Traditional tests prevent us from identifying
• How well child can recognize need to DO something
• Whether or not child can initiate efforts
• If child can establish a plan, find needed
  materials, sequence, and predict outcome
• If child can manage distractions, impulsivity,
• If child can adapt to changes, manage unfamiliar
  problems

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Let the child do the thinking

• In any assessment of EF skills, look for PROCESS
  first, OUTCOME second
• If YOU become the process, how can you identify
  deficits?
• Learn how to step back
• Learn how to watch someone fail
• Learn how to wait

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EF skills are tertiary processing

• Rule out other primary or secondary processing
  problems
• Garbage ingarbage out
• Decision-making is based on quality of input

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Profile strengths weaknesses

• No 2 profiles are the same
• Build on strengths
• Compensate for weaknesses
• Know where to step in and promote development
• Ask WHY they are failing
• Begin to see profiles as you observe children..

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Deficits in underlying cognitive processes.

• (Attention, Inhibition, Working Memory)
• Result in variety of EF deficits
• In reports, group these under EF umbrella for
  simplicity
• But, must be addressed as foundational skills
  upon which everything else is built

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Inattention leads to.

• Poor working memory
• Does not identify relevant information
• Poor goal selection, decision-making
• Overlooks steps, sequences
• Disorganization
• Impaired flexibility, shifting of attention
• Minimal self-awareness, self-correction

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Lack of inhibition contributes to..

• Very poor self-regulation (awareness, monitoring,
  judgment, correction)
• Ineffective planning, or lack of planning
• Poor selection of behaviors to meet environment
• Poor execution of good intentions
• Behavioral and social disruptions
• Poor emotional control, expression

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Deficits in working memory contribute to

• Ineffective, incomplete storage of info for later
  retrieval (poor long term recall)
• Ineffective, incomplete immediate reactions and
  responses
• Inefficient planning, organization
• Disrupted execution of intentions
• Inconsistent initiation of plans
• Poor shifting of set with changes in requirements

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EF-specific deficits

• Foundations of Attention, Inhibition, and Working
  Memory allow for EF skills
• If these 3 are intact, follow hierarchy of EFs
  to help identify breakdown
• Hierarchy is relativeskills are simultaneous yet
  domino-effect may apply

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Hierarchy of EF skills

• What should I do?
• How should I do this?
• Now I should start
• I should keep working.
• Oh, something has changed!
• Have I done what I intended?
• How is this going, overall?
• Do I need to fix anything?

• Goal selection
• Planning, organization
• Initiation
• Persistence
• Flexibility, shifting
• Execution
• Self-regulation

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How do these children look?

• Look, observe, listen, watch
• These kids can show you a lot with only their
  social interactions
• Give them a task to execute, or a problem to
  solve,
• Then watch what happens

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Deficits in Goal Selection (what should I
do/say?)

• Inappropriate behavior
• Poor problem-solving
• May not recognize need to act, say, do
• May not foresee consequences, cannot predict
• May choose poorly, or not at all (relevance)
• Perhaps cannot apply prior experience
• May not be able to regulate emotions well

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Deficits in Planning, Organization (how should I
do this?)

• May not be able to identify what is needed to
  accomplish chores, homework, assignments, simple
  tasks
• May be easily distracted, disorganized,
  disorderly,
• May be unable to create any plans, or relevant
  plans
• May demonstrate poor sequencing
• (put butter/jam on bread, THEN in toaster)

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Deficits in initiation, persistence (I must
start, and keep going)

• May tell you what they intend or should do
• May have excellent plans but cannot start
• May shut down entirely, w/no response
• May require physical prompts
• May need specific verb phrases to start
• May need forced choices
• May appear frustrated, silent, angry
• May require frequent prompts to continue

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Deficits in flexibility, shifting(Oh! Something
has changed!)

• May perseverate with unsuccessful strats
• May fail to notice new information
• Trouble adapting, transitioning
• Anger and frustration with imposed changes
• May demonstrate obsessive tendencies
• May fail to recognize environmental cues
• May demonstrate emotional extremes

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Deficits in execution(Did I finish? Is it done?
Is this what Im supposed to do?

• May not realize when they have successfully
  completed a task
• Likely have impaired self-monitoring
• May be inattentive to task at hand
• May lack time awareness, be unable to adjust
  efforts accordingly
• May require external motivation to continue,
  speed up, stop, etc

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Deficits in Self-Regulation(How is it going
overall?)

• May demonstrate poor self-control, emotional
  outbursts, impulsivity, inflexibility
• Social, behavioral problems
• Difficulty adapting, fitting in
• May argue deficits with you, or excuse them
• May require constant feedback, proof
• May not know why theyre here

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Deficits in self-regulation, contd

• ORmay identify errors but may not KNOW HOW to
  adapt, change, correct
• May recognize deficits but may not BE ABLE to
  control or minimize behaviors
• May even be frustrated with poor self-control
• May not generalize or learn new information well

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So. back to assessment principles

• Profiles will be different
• Show strengths and weaknesses
• Differentiate within EF skills
• Consider developmental expectations
• IQ does not equal EQ
• Combine formal evals, informal observations, and
  interviews

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IQ v. EQ

• IQ
• Crystallized intelligence
• World knowledge
• Fund of knowledge
• Often assessed via verbal, vocab
• May also be assessed via visual, non-verbal
• Static demonstration

• EQ
• Fluid intelligence
• Performance
• Use and application
• Planning
• Strategic thinking
• Anticipation, monitoring
• Draw conclusions
• Learn and adapt

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Cattell-Horn-Cattell (CHC) Theory of Intellectual
Processing

• Gc repertoire of educational, cultural
  knowledge
• Gf fluid, inductive, deductive and novel
  reasoning integrates verbal nonverbal
• Interpretation of scores is critical
• Process of how scores achieved critical
• Reflects a learning capacity, or style
• Gf-Gc pattern can relate to occupational,
  achievement outcomes

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WJ-III (Woodcock, McGrew, Mather, 2001)

• Fluid Reasoning Cluster (Analysis-Synthesis,
  Concept Formation)
• Planning, application of strategic efforts
• Ability to anticipate outcomes
• Ability to monitor, adapt, inhibit
• Capacity to identify changing rules
• Provides SS, AE, severity levels, iles

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Test options

• Formal assessment tools
• Informal observations
• Interviews
• Rating Scales

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Two areas to assess

• Problem Solving
• EF deficits impact
• novel PSing
• reasoning
• adaptation
• learning/thinking
• overall independence

• Social Interactions
• EF deficits impact
• behavior
• pragmatics
• normal-ness
• conversation
• explanations