Archives for executive functioning

Weekly Planning Part One: The Set-Up

Weekly Planning Part One: The Set-Up | http://www.speechykeenslp.com

Last week I posted about  how to print on sticky notes. In that post I mentioned how sticky notes can help with time management and planning. I received some wonderful feedback from that post and I decided to give you some examples of how I help my clients do weekly planning using those printed sticky notes!

The first step is the “set-up” – creating our “Days of the Week” papers. I print out 8 1/2 x 11 sheets of paper with the day of the week printed at the top. Important: each day of the week is on a different colored sheet of paper. This is the beginning of a color coded system for my clients, so we pick the colors VERY specifically. It really is whatever makes since to each client, so I have to keep a note in my file as to what color system each client uses. TIP: if you are short on colors for printer paper, you can print on construction paper. Just make sure to carefully trim it down to 81/2 x 11 and feed it in one piece at a time.

Next I laminate these sheets. I do this for two reasons: durability and to create a work surface.These sheets will be getting a LOT of use, so laminating means they will hold up and not have to be recreated over and over again. It also creates a good surface for the sticky notes to adhere to each week without coating them in paper residue – you’ll see why this is important in the upcoming posts. Did you know laminating creates a dry erase surface as well? (hint hint)

BTW, This is my favorite laminator!

Tune in next week for the next post in this series …

– Tara, the Speechy Keen SLP

Minecraft Gingerbread Houses: Week 2

Minecraft Gingerbread Houses - Week 2! | speechykeenslp.com

This week we continued to work on our Gingerbread house. My husband has begun complaining that my office smells like Willy Wonka’s Chocolate Factory with the completion of my chocolate bar “landscape”. This week we addressed: problem solving, planning, flexibility, more executive functioning and brainstorming.

Progress and Problem Solving

We first checked in on each other’s “landscapes” to see how we’d done with our goal for the week. We also discussed unexpected problems that arose. The main issue we both were running into was adhesive. Have you ever tried to use royal icing to make candy stick together? Those cake shows make it look much easier than it is. My client was stuck on how to fix this. Particularly because he was stuck on “edible” answers. I had the answer, but really wanted him to reach it on his own. So we put on our “future glasses”[Sarah Ward] to talk about our plans for the houses once finished. Once we’d both agreed that we would NOT be eating our gingerbread houses, he was able to brainstorm “non-edible” options. Our conclusion? Tacky Glue!

Brainstorming and Flexibility

When we first began this project, we’d “warmed-up” by brainstorming everything Minecraft and organizing it visually (see here). So, we had already practiced brainstorming once. Now we needed to brainstorm candies to use for the next step – the siding. We’d decided ahead of time that we were going with “bricks”. So we used Google Image to look through pictures of red candy. We went down a few rabbit trails until we made our choice – can’t wait to show you next week! My client became a little “stuck” the “mortar” you see between bricks. He wanted to dye icing grey and filling in the spaces between the candies. Oy! After some talk on time limits and flexibility, he decided to eliminate it from our plan and just use “bricks”. *phew*

Shopping List

Because my client had no prior knowledge about some of our choices today, a written shopping list was fraught with danger. Have you been in the candy aisle? Completely overwhelming, even when you know what you are looking for! With executive functioning delays, it can often be difficult to remember what something looks like when transitioning from a 2D picture to a 3D object. This means my client would most likely ended up trying to read EVERY package. Which also means mom probably would lose patience, step in, grab the package and the learning moment would have fallen to the wayside. So, for our shopping list this week, we copied pictures from the web and created a “visual shopping list”. This took less than 5 minutes and helped my client “keep a “mental picture” of what he was searching for.

Personal Note

My client did not have his project finished before group tonight. That resulted in a HUGE meltdown on his part, which I was able to view via webcam. As much as my heart broke for him, it was good for me to see so we could discuss why this happened. I really appreciate his parent’s honesty in saying “It was completely my fault. I dropped the ball and didn’t support his executive functioning skills.” I’m putting together a webinar soon for parents and executive functioning as I’ve discovered a lot of them need help supporting their child. Stay tuned for more information soon!

Here is a picture of the progress:

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Join us next week for more lessons and another step closer to our finished gingerbread house!

– Tara Roehl, SpeechyKeenSLP

Thanksgiving Comic

thanksgiving comic

Seeing as today is the day before Thanksgiving, it always feels better to work that into therapy somehow. So, when this comic came up on my Facebook feed, I quickly saved it to use in my sessions today!

The Goal

I love using comics in therapy. There are so many areas comics can address in therapy! Today’s session focused on social cognition and executive functioning.The client’s I used this with have difficulty:

  • Describing facial expressing when given a picture with contextual cues but blocked out facial features.
  • Figuring out the emotions of everyone in a scene based on contextual cues
  • Making connections between what they see as expected/unexpected and how that can help them make social inferences
  • Seeing organization in a space – most of them see “chaos” in pictures and the real world
  • Problem Solving within the areas of Executive Functioning and Social Cognition

 

Our Session
  • Social Cognition
    • I covered the face of the mother, working with my client to “put yourself in her shoes” and “read the clues”. We talked about how she was stirring with her feet, how many pots were on the stove, etc.
    • We used Social Thinking’s™ “Expected/Unexpected” language to talk about mom’s actions
    • We used Mindwing Concepts™ Story Grammar Marker to talk about the important clues in the room (Who, Setting, Kickoff, Feelings, Plan). We then made “Smart Guesses” (Social Thinking™) to predict what would happen and fill in the rest of our Story Grammar Marker.
    • We then had to draw the important clues we thought we might see on mom’s face to know how she was feeling. They had to describe her face to me, and I attempted to draw it. (Funny side note: When I asked one of my clients why they thought I covered her face, he whispered “because she’s drinking something?”)
  • Executive Functioning
    • We looked at the kitchen space and had to figure out if mom had “Getting Ready, Doing, and Done” (GRDD/Sarah Ward) spaces (Hint: She does!)
    • We discussed the “TIME”  – was this a fast moment or a slow moment for mom?
    • We pretended we’d been hired to be her “GRDD” consultants – how could we help mom? The conclusion was that she was “too zoomed out”! Her “GRDD” Plan was too general. Instead, we needed to “zoom in” and make a “GRDD” for the Turkey, the mashed potatoes …. (this also showed me how many clients didn’t categorize Thanksgiving foods! I got all types of wacky guesses as to what was on the stove!)

Here is a pdf from one of the lessons – to give you a “picture”. We worked together on this document during our session, using screen sharing!

Happy Thanksgiving!

– Tara Roehl, the Speechy Keen SLP


Minecraft Gingerbread Houses: Week 1

Minecraft Gingerbread Houses: Week 1 | via SpeechyKeenSLP.com

This week we’ve begun our Minecraft gingerbread houses! This activity addresses a lot of therapy goals. Especially one of my favorites – executive functioning. All of my therapy is now via telepractice, so it requires extra planning/executive functioning skills to make sure we are ready on BOTH sides of webcam.

Our Kits

For this activity, I bought gingerbread house kits and had my clients gingerbreadhouse_kitbuy some as well. This cuts out on a lot of the “cooking”, which is quite difficult (but not impossible!) via telepractice. Most kits include similar products, but making sure everyone has the same kit helps with clients who struggle with “flexibility”. I buy mine at the end of each season from Michaels – because they are a chain, I can have my clients pick up the same ones at their local store!

Getting Ready, Doing, Done (GRDD)

We use Sarah Ward’s GRDD framework to prepare for our sessions. We fill out a table together via screen share – always beginning with the “DONE”. We GRDDneed a mental picture of the finished product before we begin making a “GETTING READY” list! We also create a visual of the “DONE” so we can make sure we are all “seeing” the same things in our brains! Then we make our “GETTING READY” list – which often now includes a shopping list as well!

Setting a Goal

We set a “DOING” goal for each week. But many individuals with Executive weeklycalendarFunctioning Delays struggle with “weekly goals”. This type of “general” goal doesn’t give them an actual timeline. We break our “weekly” goal” into daily goals, and put them on a calendar. When you do this, you see there are a LOT of little goals going into that weekly goal. A few we included were: grocery shopping for items, asking mom where our “waiting spot” is for the house in progress and covering the house after each step with plastic wrap!

Tech Support

When doing this via webcam, it’s helpful for me to have two webcams. I useHP-Elite-Webcam the one built into my laptop for my face, but have another one I can aim at the desk. This has helped with looking at items in our kits, planning a layout on our cardboard “base” and even discussing how to apply the icing!

Personal Note

We decided to start this week with our “landscape”. We chose a “snow” scene, seeing as it is winter currently. We searched Google Images and found this minecraft__wonderful_snow_by_arriii-d4m72d4image as our “inspiration”. We’re going to try to make our landscapes using chocolate bars and icing. I love that my client picked chocolate bars. They are square, similar to the pixilated look of the game!

Tune in next week for our progress and more examples of how we worked on our therapy goals!

– Tara Roehl, the Speechy Keen SLP

Gingerbread Image Source


A Free Seminar – Executive Functioning: Strategies to Keep Your Child Organized and Yourself Sane

I will be putting on a free seminar at the end of the month related to Executive Functioning and wanted to invite my readers, and ask you to spread the word to those who you think could benefit from this information:

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Executive Functioning:  Strategies to Keep Your Child Organized and Yourself Sane                  

Do you have a child or student who struggles with impulse control, getting started on homework/projects, organization of their things and/or knowing when their behavior is getting out of control?  Do you hear yourself repeating “please just start working on____” or “that is not a clean bedroom/backpack/desk!” or even   “What do you mean you lost___?”   You know they are smart, but does the child or student often appear to be “lazy” or “lacking motivation”?   They may be struggling with Executive Functioning, a higher order brain process that may not be developed in many individuals including, but not limited to, those with Asperger’s, High Functioning Autism, ADHD and OCD diagnoses.  But don’t be discouraged!  Come learn what to look for, why these individuals do the things they do and how you can help them!  This FREE Seminar will explain the science behind Executive Functioning skills and will introduce practical concepts and techniques to help your child or student to be successful across environments.

WHEN:  Thursday, November 29th 2012                                             

TIME:     7:00 p.m. – 8:30 p.m.  – Charis Table Room

WHERE:   Home Church 1799 Winchester Blvd Campbell, CA 95008

 

About the Speaker:  Tara Roehl is a nationally certified Speech Language Pathologist.  She owns and operates a private practice clinic focusing on the social/pragmatic and executive functioning needs of students with ADHD, High Functioning Autism, Aspergers and related disorders.  At the same time, Tara runs a Special Needs Program at her church to improve the inclusion of individuals with special needs and their families into the religious community.

Earlier in her career, Tara worked as a speech therapist in the public school systems in Illinois and California.   Most recently, she worked as the lead speech therapist on the Autism diagnostic team for a Bay Area public preschool. While in this role, she designed and launched the district’s “Speech/Social Group” program for children with speech delays and /or High Functioning Autism diagnoses.  In recent years, Tara has extended her practice by working with individuals with disabilities outside of the United States, including developing long distance remote speech therapy approaches with individuals in Rwanda and the Philippines. Tara holds a Bachelors of Science and Masters of Science in Speech-Language Pathology from Indiana University of Pennsylvania.
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A flyer can be downloaded here:

Executive Functioning[22]

 

– Tara Roehl

Executive Functioning – Part 1

Anyone who has done therapy with me (as a client or co-worker) knows that I have a HUGE passion for the area of executive functioning (EF). I never really knew anything about it until I ended up in an amazing talk at #ASHA10 by Sarah Ward. Now, don’t get me wrong. I had heard about EF, but I had never really understood the who, what and whys of it as it related to my students. Since that #ASHA10 talk, I have consumed everything EF related I can find and have pushed it into every session with my students. And the results have been fantastic! Recently a lot of parents and professionals have wanted more information on my lessons and techniques, as well as a deeper understanding of what exactly EF is – so here we go!

What Is It?

Executive Functioning Skills are theorized to be based in the frontal lobe, acting as part of the executive system. It is a higher order process that involves connecting past experiences to present novel experiences to control and regulate one’s abilities and behaviors. This allows one to anticipate outcomes and adapt to changing situations in order to manage oneself and one’s resources to complete a task and/or achieve a goal.

What Skills Are Considered A Part of “Executive Functioning”?

A few areas (with brief description) that are impacted by difficulties in the area of EF:

  • Inhibition – ability to control impulsivity and stop one’s inappropriate behaviors (Actions and thoughts) at the appropriate time
  • Shift the ability to switch focus between tasks fluidly
  • Emotional Control: controlling emotional reactions based on the reality of a situation
  • Initiation the ability to begin actions in regards to activities or tasks
  • Working memory retaining information while doing something with it. For example: remembering details to complete a task
  • Planning/Organization the ability to plan and organize tasks related to projects (current and future)
  • Organization of Materials: the ability to “see and create” order related to the individual’s areas of domain. Examples: desk, room, backpack
  • Self-Monitoring – the ability to evaluate and monitore one’s own manage time and attention

 

Who Does It Impact?

Anyone, and at times it feels like everyone! I have had many parents listen to me explain the “what we did and why” of a lesson, only to say “wow, I could have used this lesson too!” Often students with poor EF skills (but strong capabilities for their development!) are intellectually gifted. This means they are often labeled as “lazy” or “lacking motivation”. These terms can be VERY frustrating to parents, who know their child is fully capable, but they just can’t demonstrate their IQ because of their poor EF skills. Poor EF skills also translate into a client’s social behaviors, sometimes resulting in “poor social skills” and/or difficulty using social skills/concepts that have been taught to them. EF difficulties are often observed in clients labeled with Asperger’s, High Functioning Autism, ADHD, ADD and OCD, but are in no way limited to these diagnosis.

What does it look like?

  • This is the student who is unprepared when they get to class – they can’t find their homework papers, a pencil or quite literally ANYTHING inside their backpack.
  • This is the student who cannot control his impulses to touch other’s thing, throw something randomly, speak out of turn, or even lash our verbally and/or physically at perceived injustices.
  • This student has extreme difficulty getting started on a task – whether working independently or in a group setting. Once started they MAY be able to continue and finish, but not always.
  • They begin a project without all of the materials needed and lack the understanding of how their own unpreparedness has created their predicament (often blaming adults or others for the situation).
  • They cannot follow a series of instructions to complete a task. They may forget important steps, become convinced they are incapable of completing the task, or both.
  • They cannot predict how much time it will take to complete a task, cannot monitor the amount of time it is taking them currently, or change their speed to complete a task relative to the speed of those around him.
  • This student may become stuck on one-way to perceive an idea or task, making problem solving and shifting between ideas very difficult for them without significant help and scaffolding.

Over the next few months I will begin posting explainations of what I have learned from the gurus of EF and how I have adapted their geniuses to become an entricle part of my daily therapy sessions.

What would you MOST like to learn about EF over the next few months?

–          Tara Roehl, Speechy Keen SLP