Do you have Speech Pathology crushes? I do! I want to share my latest.
Celebrating the work of Sarah Ward and Kristen Jacobsen
As a Speechie was I was a little late coming to the idea of executive function and my role in supporting it in sessions. However, over the last ten years my knowledge has grown, and my use of strategies has increased.
I attended a professional development session by Sarah Ward, a Speech Pathologist from the United States, 18 months ago and my knowledge has increased significantly. It makes so much more sense.
Here are my big takeaways…
Executive function is a set of mental skills that include working memory, flexible thinking, and self-control. We use these skills every day to learn, work and manage daily life. Trouble with executive function can make it hard to focus, follow directions and handle emotions just to name a few.
Executive function skills are mediated by language. Even students with strong language skills who suffer from executive function problems have difficulties using their language to set goals, reason, problem solve and mediate completion of tasks. Students with executive function difficulties need to develop metacognitive skills to organise their language skills in order to benefit from tools that suit their particular learning styles. Students develop the language skills for understanding, analysing and applying more efficient strategies that help them become more efficient and independent learners. You can see how this would have a huge impact on students with language difficulties and disorders.
The other thing which has a huge impact is the ability to visualise. We use episodic memories of our experiences to form schemas and routines. Our ability to record memories and visualise ourselves in them allows us to rehearse our goals, monitor time and use of strategies for the desired outcome. These cognitive skills develop from young childhood through young adulthood.
Executive function starts with nonverbal working memory. We think about what will happen. From here it moves to verbal working memory. This is where the language piece comes in. Our verbal working memory includes self-talk and stated intention – such as I will … I am going to. We start to run through how we are going to do it. Many of our children have problems with this because they don’t have self-talk. This is all about working out the plan before it is time to start.
To be able to do this, children need to have orientation to where they are. This is called situation awareness or situation intelligence. Sarah and Kristen call it Situational IQ (I like this! ). They need to read the room.
Children need to think about Space, Time, Objects and People.
Space – navigate the room, what’s in the room, what’s happening?
Time – get on the timeline, what schedule is being followed?
Object – organisation and what objects do I need?
People – what’s my role in the situation?
Imagine morning time in a classroom. Jenny is sitting on the floor, she is looking at the teacher and knows that the routine will start with the attendance roll and instructions for the first activity of the day. Contrast this with James, who is on the floor but focused on last week’s experiment that is sitting on a side table. Jenny who has great situation intelligence is set up well for the day, whereas James is not orientated in time, objects or people in the room.
Kids who can’t pick up on these don’t have situational intelligence and are often distracted by objects or memory. They struggle to pull all the clues together to one meaning.
When I was learning this, my immediate thought was social thinking. I work with many kids on the Autism Spectrum. Children on the spectrum often have executive function difficulties. This difficulty with situational awareness impacts signficiantly on their executive function as well as their social skills.
When you combine nonverbal working memory with situational awareness you get a particular skill which is crucial to executive function. This processing is called mimetic-ideational information processing. Essentially what you do is make a mime in your head. A movie if you well. This is a mental simulation of how the future will play out. It is a mental dress rehearsal where through trial and error without any real risk of error you can play it out. It can be reviewed and adjusted to achieve the desired outcome.
To be able to do this we need to teach our students four key things – If they can’t do this, they won’t be successful. Children need to be able to Mime so that they can then move it over into verbal memory (if then) so that they can use self-talk. Mime it!
M – Future scene thinking – Make an image – stop – what will it look like?
I – Episodic future thinking – What do I look like? Self-projection into the future.
M – Mental time travel – Temporal – spatial – how am I moving to achieve this
E – The future emotion – How will feel? – emotional psychological state
I – If then
T – Self Talk
We are teaching them to have a mental dress rehearsal, so they are efficient and successful.
For example, if you send a child up to their room – it’s 7.15 we need to get ready for school. If the child isn’t mime mapping, they go up to their room and get distracted. The parent comes up and says come on. This is external prompting. If the child has executive functions skills – the child mimes the future. They self-project themselves to their bedroom and go through the tasks before they even get to their room. When they get to their room, they execute the plan.
This big point is that planning, most of the time, happens in a different space to where it is executed. Let’s think about kids at school. They collect their things from their locker before they get to the classroom or before they go home to do their homework. They plan in a different place to where they execute.
If kids are not doing the planning and we are always prompting, they are not learning new skills.
So how do we support kids? We teach them to plan backwards to execute forwards.
1. Done – What does it look like when I am done?
2. Do – What do I need to do to get to the picture?
3. Get ready – What materials will I need?
When we get home – we execute forwards
4. Start – gather materials
5. Check – create time markers – set a halfway point
6. Stop – done – stop clean up review
Many programs don’t teach this plan backwards, instead starting at the “Get Ready” point. With this approach kids become prompt dependent instead of learning to plan.
For example, when a parent says to their child, “Get ready for school”, this creates a problem. The child is starting with verbal memory, whereas to be successful executive function starts with non-verbal memory.
In another example, if a parent says “go upstairs and get your hair done”, the parent is the one who has done the spatial and temporal travel rather than the child.
In the past we have given a checklist to kids – but these don’t always work, because check lists are verbal memory whereas we know that executive function starts with non-verbal memory.
Gesture is a key part of miming – Kids on the autism spectrum don’t gesture. Gestures give life to our mental scratch pads – allowing us to perform actions with our hands before we have to do them in real life. Gesture helps infuse memories with an emotional charge that make them last.
One of the first strategies Sarah talks about is driving that nonverbal working memory with photos so that kids can move from the if to the then which is verbal working memory – self talk. She often takes photos of what kids look like when they go to school. She then supports them to plan in reverse – “Tell me your plan to look like this!” Walk me through your plan so that we can get there.
When you use walk me through the plan – it helps kids to gesture.
Executive function is all about being a mind mime.
This is where the get ready, go and done plan comes into play. It’s a great way to set out the plan visually and makes the student the planner.
Children today are growing up in a digital world. Digital clocks sit on the side of verbal memory. Using an analogue clock, we can make the passage of time visual. Using a clock face, time can be coloured in for Get ready, do and done – using the corresponding colours. When you draw on the clock you are planning and experiencing time.
Other interesting facts about time
Check out more awesome on their website – https://efpractice.com/
360 app is a great resource for sessions. 360 Thinking time tracker