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Executive Functioning. Stephanie Nelson, Ph.D., ABPdN, ABPP Pediatric Neuropsychologist Child Development Network Lexington, MA (781) 861-6655, www.cdnkids.com. How Students Succeed. What Is Executive Functioning?. One Name, Many Functions. Testing Executive Function. Requires:

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executive functioning

Executive Functioning

Stephanie Nelson, Ph.D., ABPdN, ABPP

Pediatric Neuropsychologist

Child Development Network

Lexington, MA

(781) 861-6655,www.cdnkids.com

testing executive function
Testing Executive Function




Working memory

Processing speed

Cognitive flexibility


Emotional control

Instructions: Start with the center number (7). Follow the lines to collect 4 additional numbers, adding all 5 numbers together

Goal: Lowest total possible

where are efs located
Where Are EFs Located?

Prefrontal Cortex

Last Part of the Brain to Fully Develop

Continues Developing into early/mid 20s

Fragile to Disruption

prefrontal lobe connects to brain regions that control
Prefrontal Lobe Connects to Brain Regions that Control:
  • Habits
  • Timing
  • Arousal/Awareness
  • Emotions
  • Memory
  • Language
  • Motor Planning
  • Eye Movements
how do efs develop
How Do EFs Develop?
  • “He gets there, but in his own, unique way”
  • “She did it yesterday, why can’t she do it today?”
  • “Why can you remember your iPod, but not your school books?”
a period of refinement
A Period of “Refinement”
  • Scientists talk about the “development” of the prefrontal cortex
  • However, these regions are not growing, they are refining
a period of refinement1
A Period of “Refinement”
  • Some pathways are dead ends
  • Some pathways are inefficient
  • Pathways that work are strengthened during maturation
Age 5: Lots of potential brain connections. Potential is unlimited, but pathways are inefficient.

Ages 5-20: Pathways that are used regularly are becoming strengthened. Pathways that are not used are pruned away.

Age 20: Brain pathways are more compact, more efficient.

how efs develop
How EFs Develop


What We Expect

how efs really develop
How EFs really Develop


What Actually Happens

ef resources
EF Resources


Too Much

Too Time-Consuming

Not Teen’s Idea

What if I have EF weaknesses too?


Tons of specific suggestions

Great overview of EF

What is “Normal”?

start with a healthy foundation
Start With A Healthy Foundation
  • Sleep
  • Exercise
  • Nutrition
  • Stress Management

A House Built On Sand…

game plan shine a spotlight
Game Plan: Shine A Spotlight
  • Spotlight the neuronal connections you want to develop
  • Brains learn what you teach them
spotlighting 5 key techniques
Spotlighting: 5 Key Techniques
  • Start with Strengths
  • Make It Manageable
  • Make It Personal
  • Build a Scaffold
  • Take Advantage of Habits and Routines
make it personal
Invite her into the problem-solving process

Adolescence involves intensive levels of self-awareness

How does this relate to my life and interests?

Make It Personal
make it manageable
Make It Manageable
  • Pick one thing
  • Be a scientist

“I Can Do Anything, But Not Everything.” – David Allen

allocation of precious resources
Allocation of Precious Resources

How Adult Brains Respond to Stress

How Teen Brains Respond to Stress

be a scientist

My teen complains that I nag her about studying for upcoming exams, but she is not studying!!!

Be A Scientist
  • Stop reminding
  • Nonverbal reminding
  • Remind more!
  • Had to remind teen only 1 day out of 7
  • Got B on test
  • Nonverbal Cues
  • Calendar
  • Reminder (by text message) if teen fails to check off that day on the calendar
  • Stop Reminding
  • + No nagging!
  • Studying not done
  • Nonverbal Reminding
  • + Quiet
  • Don’t know if it will work
  • Remind More!
  • + Studying gets done
  • - More shouting
scaffolds and safety nets
Scaffolds and Safety Nets
  • Start where he’s at
  • Create a recipe
  • Expect “Extinction Bursts”
start where he s at
Start Where He’s At
  • Zone of “Proximal Development”
extinction bursts
“Extinction Bursts”

Frequency of Unwanted Behavior

habits and routines
Habits and Routines

The 3 R’s of Habit Formation

Planner Resources: www.cognitiveconnections.com


think forwards plan backwards
Think Forwards, Plan Backwards
  • Visualize the Goal
  • What Does It Look Like Right Before the Goal is Met?
  • What About Right Before That?
  • Repeat Until All Steps Between Beginning and End are in Place
spotlighting review
Spotlighting: Review
  • Start with Strengths
  • Make It Manageable
  • Make It Personal
  • Build a Scaffold
  • Take Advantage of Habits and Routines
notes and resources
Notes and Resources

Slide 2

Slides 4 - 14

Slides 4 - 14

Slide 29

Slide 23

Slide 20

Slide 17

executive functions defined
Executive Functions Defined
  • Initiation
    • Getting started on a task
    • Avoiding procrastination
    • Initiating social interactions and asking for help
  • Organization
    • Planning how to work through tasks most effectively
    • Breaking complex tasks down into steps
    • Organizing materials, keeping a room clean, finding objects
  • Attention
    • Sustained Attention: Concentrating over time
    • Selective Attention: Focusing on the right thing (and ignoring distractions!)
  • Working Memory
    • Keeping information in mind while using that information
    • Following multistep directions; remembering a phone number
  • Inhibition
    • Thinking before acting and considering all options before choosing
    • Regulating activity level as needed; not invading personal space or interrupting
  • Fluency
    • Coming up with ideas over time
    • Coming up with a new idea if the first idea does not work
executive functions defined1
Executive Functions Defined
  • Time Management
    • Estimating how long a project will take
    • Balancing speed with accuracy
  • Multitasking
    • Switching between two approaches to complete a task
    • Considering two ideas at once
    • Getting back on track after an interruption
  • Self-Monitoring
    • Noticing errors and going back to correct them
    • Self-awareness and self-regulation (“Am I paying attention?” “Do I need to do more on this project?”)
  • Cognitive Flexibility
    • Adapting to new information or new situations
    • Transitioning between activities or ideas
    • Changing one’s mind and accepting “no”
  • Emotional Control
    • Getting “just the right amount” upset over frustrations and setbacks
    • Using “self talk” to calm down or reframe a situation
  • Perseverance
    • Sticking with a task as long as it takes
    • Effectively managing frustration, boredom, fatigue