2018 Diamonds in the Rough Conference welcomes our featured speaker, Dr. Joyce Cooper-Kahn, author of the ground-breaking Late, Lost, and Unprepared: A Parents’ Guide to Helping Children with Executive Functioning. WEG is proud to present a conversation with Dr. Cooper-Kahn on current understanding of these critical life skills, the schools’ role in addressing them, and the obstacles that children and teens still face.
Q. Dr. Cooper-Kahn, I’d like to start with a simple question. What are executive functioning skills and how do they impact children and teens?
It’s easier to describe than to truly understand, but executive functioning is an umbrella term for the processes and skills that allow us to manage ourselves and our resources in the service of a goal. Executive functioning is critical to the development of mental control, as well as emotional and behavioral regulation.
Q. You are serving a dual role this year at the Diamonds in the Rough Conference, providing an in-depth training on March 9 and serving as the conference keynote speaker on March 10. What can attendees look forward to in both of these presentations?
The Saturday keynote will focus on what we know that helps kids with executive functioning and what gets in the way of good intervention. The focus will be on the sorts of interventions that can easily be incorporated into the general education classroom and that meet the needs of most of the kids with executive functioning delays. With just a little bit of tweaking of the typical classroom, we can meet the needs of about80 percent of the kids with executive functioning delays.
We’re also going to talk about what gets in the way of intervention and why this happens. I am planning on staying for the whole day, because the Diamonds Conference has so many great speakers that I want to hear too. So, I’ll be around to answer questions later in the day.
The three-hour workshop on Friday gives us time to dig in a little deeper. We will talk about interventions for the general education classroom, but also look at more intensive interventions for those that need more. We’ll talk about the principles of intervention, and then we’ll look at specific strategies for how you apply the information in the classroom and at home. These longer workshops are always really fun because there is time for interaction—time for participants to share their expertise and their questions. There are always great questions, because most people come with a whole backlog of experience, and we learn from each other.
Q. It’s been ten years since Late, Lost, and Unprepared was first published. How has our understanding of executive functioning skills changed in the last decade?
It’s a very exciting time for people who are interested in executive functioning. There have been huge changes in our understanding. There’s been rapid growth of data on executive functioning, so on a neurological level we have better brain imaging techniques as the years go on, and we have the advantage of having these super large databases. Researchers can now share data digitally and have these cooperative agreements to share data around the world. So instead of studies with 150 subjects, we have some studies with 20,000 subjects. That allows us to see patterns with confidence that we might never have seen otherwise.
There used to be a primary focus on the prefrontal cortex of the brain, and even when we wrote that book, that had already started to change. Now, we have more and more data about executive functioning and how it operates based on new understandings of neurological development. We know that executive functioning depends on structures, connections, and communications within the brain. It is really a much more complex process.
We have seen new data in the area of neurological functions that affect executive functioning development, and we’ve also seen increased research in specific diagnoses, and how they seem to affect the patterns of weaknesses. There are new findings in the way that executive functioning unfolds in typical development. That’s something we need as a yardstick for atypical development, and we haven’t had that in the past.
Clinically, there’s been an explosion in research on interventions.
But in some ways, the current situation mirrors the situation we had when we wrote that book. There’s no absence of data to guide us in addressing the problem, the problem is getting it into the hands of the people on the front lines. It’s important that we distill that information down so it is useful to people who are trying to help kids on a daily basis. The goal is to put this new information in the hands of parents and teachers. Being able to bring research and theory to practice is one reason the Diamonds in the Rough Conference is so tremendously important.
Q. What do you think is the schools’ obligation to work on these skills with their students?
Schools definitely have an obligation to work on these skills if you work from the legal requirements. There was a clarification letter from the Office of Civil Rights in Education in 2016 that defined ADHD more specifically in order to give guidance to schools. In it, they stated that one of the symptoms of ADHD is that students often have difficulties organizing tasks and activities. That may not seem like much, but it is. And the last iteration of IDEA specifically talked about preparing students for independent success post-high school. So, how can you do that if you cannot organize your effort?
To me, it is inherent in the legal requirements for schools. However, the problem has been how we approach this with the schools. Schools are designed to educate kids, and they are designed to do that according to the unfolding of typical development. Special education was introduced into the content areas, but until recently there was little talk about delays in these processes of learning So, when we began to include executive functioning in educational plans, we sort of tried to create a separate category.
But in fact, I think the way that it works better is to focus on the content areas, what schools know best, and use them to teach executive skills. Because you cannot teach executive functioning in the abstract, you need content. The school content and the curriculum goals give you the way to work with them. Many of us have to shift what we are asking of the schools.
If you look at the Common Core standards, embedded into those standards are executive skills and assumptions about what students can do. There are all sorts of ways that you can build goals and objectives, using the curriculum standards as they exist. That way, you are helping the child and you are speaking a language that the schools understand. I have had much better success with that, then telling a school, “This kid does not organize well. So, my goal is for him to get better at organization.”
I think good special ed teachers have been helping kids with executive functioning for ages. And if you look particularly at first and second grade teachers, their whole skill set involves teaching kids how to be students. They are great at teaching routines and habits. So, now the next step is, how do you systematically build a plan of support in order to move the child forward in his or her development of executive skills? How do you monitor their current level of functioning and help them according to their own readiness and timetable, to get to that next, more independent level? We don’t want to be in the business of just supporting kids, we also need to teach them to manage their demands when they are their own.
Q. What’s the biggest obstacle you see right now for young people when it comes to improving these critical life skills?
There are many challenges in helping kids with executive functioning, but I really think that the biggest obstacle I am seeing right now is a failure of compassion and understanding. The kids can be way behind in their ability to meet expectations, and being that far out of sync means that adults can get frustrated and impatient. They may make the mistake of interpreting a lack of success in the child for a lack of caring. And when they do that, they lose the child.
I once had a therapy supervisor that said to me, “Children can forgive a mistake of the head, it’s a mistake of the heart that they have trouble letting go of.” It’s so important that we truly understand the long course of development of executive functioning, and how delays will make that more extended and put kids out of sync. If we can continue to teach and support them, despite the extended length of time it takes for development to take hold, then we can remove so many obstacles for them.
Executive functioning extends into so many aspects of daily expectations for our kids, and it sometimes seems really hard to work with the child instead of in opposition to them. Once adults start feeling helpless, then they want to make that feeling to go away, and the easiest way is to blame the child.
Teachers will diligently teach a way to do a task, and then they will even repeat this a second time, and on the third time that child has that sort of project, they are like, “We’ve already been over this, how come you don’t know it yet?” We can succeed with students when we teach these step-by-step skills while sitting next to a child instead of across from them, and with an understanding of the pain and the demoralization the child can be feeling. We need to teach students these skills, while accepting that they need the neurological readiness as well as the teaching and support, and that we have no way of predicting when they will be independent.
Q. How do ADHD and ASD impact executive functioning skills?
We know that among the population of youth with delays in executive functioning, two of the largest sub-groups are those with ADHD and those on the autism spectrum---as well as kids with both of those disorders. We also know that there are somewhat different patterns between those groups, as well as within those groups.
The complexity of working with kids who are on the spectrum is that you may have more anxiety. There are problems with flexibility and shifting that you don’t always have with students that have ADHD, although you do with some. However, there’s also a huge amount of overlap in the executive functioning problems and symptoms that you see in the two groups.
We know that cognitive flexibility is more of an issue for folks on the spectrum, and you have a speaker coming to the conference who is one of the leading experts, Dr. Lauren Kenworthy. She is the author of a program called Unstuck and On Target that addresses both executive functioning and cognitive flexibility in the populations of kids who have autism spectrum disorder, and I understand she’s also extended that program to ADHD populations too.
As far as ADHD, that’s more my expertise, particularly in this area of cognitive control. Organization and planning, working memory, initiating tasks, and task monitoring, those are the things that are so often out of whack in kids with ADHD. They need a lot of support and teaching.
No one can tell us with any of these populations how much change will happen because of teaching compensatory techniques verses how much change will happen because of fundamental changes in the neurological underpinnings of executive functioning. We are always in the business of working on both. We work with short-term strategies that help a child to meet the daily demands, and at the same time we are planning our long-term interventions. Those meta cognitive skills are critically important – we need to help children and teens to think not only about what is the task, but also how will I monitor my progress, and how will I adapt my efforts along the way to reach my goals.
Q. You wrote in Late, Lost and Unprepared that it can be difficult to distinguish between kids with specific learning disabilities in content areas (reading, writing) and those that struggle with the process of learning. Have we gotten better in making those distinctions? How can we help teachers understand these differences?
The problem is separating the content from the process. Executive functioning is a process, it has no content, it is a function. To reach a goal, we run data through our executive functioning processes. You can run math, you can run getting your chores done, through the executive functioning processes. To separate the two out, requires that you look at the content separate from the process and the only way to do that is very fine-tuned evaluations. And that doesn’t mean only formal psychoeducational testing, it also means fine-tuned observations.
I’ve heard a lot of kids say that they dislike reading, and when I ask them what it is they dislike, they say, they have to answer all of those comprehension questions. Some of them dislike writing and others will say, “I can’t remember what I’ve read.” This indicates to me that it is not the ability to read that is the primary problem, it is a matter of being able to hold on to the information long enough to answer the questions, or perhaps to organize the information in a way that will allow them to meet the demands.
The testing really does help, if it is comprehensive, but it’s not the only thing we have to go on. We also have lots of information based on teacher and parent observations. Further, if we ask the kids, they can often describe to us the areas with which they are having trouble.
Q. Can students struggle with executive functioning skills and not have any significant diagnosis at all? If so, how can any parent help their child improve these skills?
Yes, of course. My best example of this, although there’s a chance that in this day he’d be diagnosed with ADHD, is the “absent-minded professor.” He’s the guy who is a brilliant scientist but fails to show up at his own wedding because he lost track of time.
All of the characteristics of executive functioning exist along a continuum. There is a point when a person is unable to meet their demands and where it is limiting their success, and that is the place where we call it a pathology. There are lots of people hovering around that border between prepared and unprepared, successful and unsuccessful, and they are going about their lives without a diagnosis.
The way we teach people to function better is applicable to all kids and applicable in a general classroom. We focus on personal best, rather than perfection. We celebrate each movement toward better functioning. We teach habits and routines; that is always the cornerstone of intervention, because once something becomes a habit, it no longer lives in the part of the brain that is responsible for executive functioning. And we focus on helping youth to think about how they will accomplish tasks, teach them strategies for planning and organization, guide them and support them until they perform these strategies independently.
A conversation with Ned Johnson about stress, student achievement, and how to give kids more autonomy
2018 Diamonds in the Rough Conference speakers Ned Johnson and Dr. William Stixrud have a new book, The Self-Driven Child: The Science and Sense of Giving Your Kids More Control Over Their Lives.
Here’s a conversation with Ned Johnson about stress, student achievement, and how to give kids more autonomy.
Q. There is a lot of interest in your new book The Self-Driven Child, co-authored with clinical neuropsychologist Dr. William Stixrud. Dr. Madeline Levine said, “This is one of the most radical and important books on raising healthy, resilient, purpose-driven kids.” That’s high praise. So, why might the book be considered radical?
To Bill and me, it’s not radical at all. To us, it’s common sense. As Bill would say, “You should make peace with reality.” And a huge chunk of that is, you really cannot control your kid.
The “radical” language is because, it’s almost a complete 180 in what most of us as parents have been led to believe we should be doing. We are overwhelmed because we think that we are responsible for our kids’ success, happiness, safety - everything. It ultimately doesn’t lead to better outcomes. It looks good in the short term, but in the long-term it is a hot mess.
This idea that your kids are going to be more successful and less stressed, by you doing less strikes some people as insane. In part because, we think, “I will feel better when I feel more in control.” So, the parent may want to jump in there, fix things and take control of their kids. But by definition it is a bit of a zero-sum game. The more control I try to exert, the less there will be left for my kid.
There’s been a thousand books written about “letting your kids fail.” We’re taking a different tack. This is not “let your kids fail.” Instead we’re saying, you just cannot be the manager of your kid’s life. We encourage parents to see themselves as consultants to their kids, rather than task masters.
Q. Parents with children that struggle with attention and executive functioning deficits spend a good deal of time helping their children navigate school. The idea of giving your child more autonomy may be terrifying to these parents. How can we help both the parents and children in this scenario?
I’d say, take the long view. You only grow by a challenge. If we clear all the obstacles from a kid’s glide path, he’ll end up at a place that will look successful but he will have no idea how he got there.
(Here Ned goes into a very detailed and fascinating story about studies with stress and baby rats. Researchers found that baby rats who are stressed and then return to a nurturing mother, over and over, are conditioned to tolerate stressors. The rats, which were actually dubbed “California laid back rats” were more likely to take risks. Which, in the rat world, would be exploring an open space instead of hiding. If the rats were stressed and then returned to a stressed-out mom, they became the most screwed up, neurotic rats ever. And the rats that lived life without stressors? They did not develop the courage to take risks at all.)
So, this is what we want for our kids. We don’t want to shield them from stressors that they can handle. You want your child to experience mild or moderate stress and you can say, “It’s okay, I’m right here with you.” You would of course step in and protect them from an overwhelming stress, but we don’t want to shield them from mild or moderate stress.
Now, how do you get your child to do that thing that might be stressful? Well, if you child is tough, rigid, mentally inflexible, these are all signs of being anxious. He wants to have more control. We’re trying to develop all those executive functions, and mental flexibility is a big one there.
The pre-frontal cortex is sort of like #igotthis and the amygdala is #ohcrap. Under stress, that #ohcrap seems to metastasize over everything. So, what we want is for the pre-frontal cortex to be in charge.
The problem is, if he is sensitive and that amygdala fires off, you are not engaging the rational part of his brain. And you think you are, you’re giving him facts and reasons, but his amygdala says, “Don’t listen.”
So, what I suggest to parents is to just simply say, “May I offer you some advice?”
Because that gives your child a sense of agency. You can relax a bit, let him take charge a little. (And why would you want to give your child advice at that moment if he doesn’t want it anyway?) Let your child come back to you when he wants. If this calms his amygdala, then you are engaging the rational part of the brain again, and your child is able to hear facts and logic and not just respond emotionally.
Is the stress we’re seeing with our kids and achievement unique to the DC area?
Yes and no. This thing with stress is, it’s not any one thing, it’s everything. So, part of the way I feel about students and achievement stress is cumulative – a percentage of it is your temperament, part of it is how much stress your parents are under, part might be trying to compete with an older sibling, and so on. You start adding it all up.
I think what’s probably the case in places like DC, the ambient stress is higher, because it’s expensive, there’s too much traffic, there’s this sense of endless competition. My best friend and former business partner lives in Portland, and they are much less likely to think about test prep in the 9th grade. So, I think geography is part of it.
There’s also something in the DSM (Diagnostic and Statistical Manual of Mental Disorders) called shared delusional disorder. Imagine growing up with an entire family where there is a sense that, if you don’t go to an Ivy League school, you’ll never be successful. Their kids trot into kindergarten wearing Yale and Dartmouth t-shirts. You’ll start to absorb that from your family or your culture, and you’ll start to believe it. In fact, despite evidence to the contrary, a lot of people believe this. As much as it is a stereotype, it’s a confirmation bias, and what happens is you ignore contradicting information.
But I do think part of it is that DC feels more competitive, people are more sleep deprived, and people are more stressed, than if, say, we were living in Albuquerque or something.
You and Dr. Stixrud have been doing talks together for a few years. What is it that you enjoy about working together?
Our knowledge and experiences complement each other well. Bill and I started working together on this book in 2014, but we’ve been thinking, talking and lecturing together for about ten years. It’s interesting going through this as a road show. The introductions can be like, “Dr. William Stixrud, a highly respected neuropsychologist, etc. etc.” - and then it’s “Ned Johnson is a tutor geek.”
But the advantage I do have is that I’ve probably spent more time one-on-one with more 16 and 17-year-olds in the country than anyone. There are lots of teachers and there are lots of therapists, but most people don’t see ten adolescents a day during the most stressful period of their development. I have such an opportunity to sit there and watch children’s eyes light up in a test prep session. My whole thing is, how can I best deliver the research and what I’ve learned to help other kids and parents.
What should we look forward to in your presentation at the upcoming Diamonds in the Rough Conference?
I know Bill has been to the Diamonds Conference before, but this will be my first time, and I’m really excited. I think the first thing is, we’ll be approaching the audience with the understanding that parenting kids is hard. And parenting kids who fall outside the narrowly defined scope of what “normal” is, is even harder. These are kids whose reactions are likely to be more intense, whose needs are broader. Parenting can really go from a full-time job to an over-time job.
I work with lots of kids who have anxiety. Bill says almost by definition the kid who has learning difficulties has anxiety, because all day long they are feeling like they are not measuring up. What I say to kids is, “Your reactions are totally normal, because you have a human brain, right? But what’s happening, is that your reactions are just more intense.”
There’s a line we have in the book, that “this is chemical, it’s not character.” We are all born with a temperament. Some people are really sunny, right out of the womb, and others are more like Eeyore from Winne the Pooh. If we know that these things are chemical, rather than character, the question is how do we take that into consideration, and what can we do to bend that a bit. We can focus on the things that can increase a kids’ sense of control, and ways we know improve well-being like meditation, sleep and exercise.
What is the biggest takeaway for attendees?
I want people to understand that growth is not linear. We can see this so clearly with bodies, and its ten times more so with brains. While how tall you grow is limited by your genes, we have so much more control over how we help our brains develop in healthy ways.
Ned Johnson is President and Tutor-Geek for PrepMatters, an organization that provides academic tutoring, one-on-one test preparation and college counseling services.
The holidays are a hectic time for many adults. Add the factors of travel, anticipation and parties and you may have some stressed out kids too. Mary Elliott, WEG Communications consultant, talks with Dr. Lisi Levisohn about practical tips that can help any family enjoy a more peaceful winter break.
Dr. Levisohn, does everyone feel stress around the holidays? Is it natural?
What I sense from the media and discussions with others over the years is that it is indeed common to feel stress around the holidays—there is pressure to make everything great, to find the perfect present for everyone, or sometimes the stress is around complicated relationships with extended family. But in my practice, thinking of the kids I’ve worked with, I’d have to say they are really looking forward to the holidays – whether it is Christmas or Hanukkah. In fact, I suspect most kids don’t see the holidays as a stressor. They see it as a welcome release from what they are experiencing in school or throughout the rest of the year. And they are excited about the specialness of the holidays—and all kinds of good associations they have.
That said, there are still aspects of the holidays which could be stressful for children, especially for a kid who might have anxiety, be twice exceptional, or have some processing issues. One potential source of stress relates to uncertainty. For example, if your child feels anxious when they don’t know what to expect, whether it is a change in routine or they are not sure what the expectations for them are going to be, or whether they will be able to handle those expectations, that can be a source of stress. Sometimes, if they know something big is coming, even though it might be something they look forward to, it can be a source of underlying stress. Their mind and their body are getting ready for something unusual and something big, so they are getting signals that they are supposed to be on high alert. The other source of potential anxiety would a social one for a child who might have more trouble interacting with a big group. So, with the holidays, there can be uncertainty with travel plans, lots of anticipation, and plenty of social interactions like parties - all of which can be challenging for many kids.
Although most kids are looking forward to the holidays and would say it is a happy time, sometimes when parents themselves are filled with anticipation or stress, that can translate into their interactions with their children. Through their body language and intonation, parents can be expressing their own holiday stress. Kids can pick up on that.
How can the holidays be less stressful for children who have ADHD, anxiety or other challenges?
One thing is just to pay attention to your own feelings. Reassure yourself, as the parent, that it is a time of joy. Take a little time to center yourself, especially in your interactions with your kids. If there is something big coming up, it can be helpful to talk about the event a few days beforehand in a very relaxing way.
Talking through an event in advance, describing the place, even looking at pictures online of the venue is a relaxed, preparatory walk thru. This way, things won’t seem so uncertain or unpredictable and the child can start to visualize and imagine the place or the event.
A parent might use a schedule, even if it is going to a party, and help their child by breaking up the evening into parts. This way, you give the event a structure and it doesn’t seem so overwhelming. And perhaps most importantly, the child knows this party is not endless.
Pay attention to your child’s needs. Maybe that holiday party would be great for an hour. You do not have to totally pass, instead you can make it a smaller adventure. Make a plan that you’ll check in with each other at a certain time, and that way you can see how your child is feeling. These are good skills to teach kids anyway. You are modeling a healthy strategy and teaching planned flexibility.
You don’t want to let your kids dictate every plan and decision in your family life—that wouldn’t be good for your kids either! But, including your kids in some decisions can feel reassuring and empowering to them. For a family vacation, you can give your kids some choices, by saying, “Here are the two places we’re thinking about going, which one appeals to you most?” It’s good to allow children to weigh in when planning a special trip, because this gives them some feeling of control along the way.
How might reducing screen time help reduce stress?
It’s best to stick to whatever your house rules are about technology and individual devices during a regular weekend, even as you head into vacation time. For car travel, if your kids have screens in front of them, set a schedule so they take breaks and don’t get overwhelmed by it. Bottom line is to set up routines in advance, make sure your kids know them. Too much screen time can take a toll, so limits can benefit the emotional health of your child.
On the flip side, watching a movie together is different than the kinds of video games that kids might do online or with another kid, and they impact their mood differently. Cuddling up on a couch and watching a movie with your child can be a wonderful positive tradition during the holidays.
What are some tangible ways that all families can slow down and find joy during this hectic time?
Sometimes kids resist a planned activity, but it is okay to say, “We’re just going to do this now for a while.” They usually end up enjoying it. Take a winter walk in the woods or visit your favorite hiking trails. Get out into nature as a family, even in the winter. It’s fun to bundle up and go out. As a parent, I know from experience that following up an activity with hot chocolate or ice cream always makes it more fun and special. Take in interesting holiday displays walking through town, or paint pottery as a group activity (even teenage boys can get into that sort of thing!). Take your child to an arts and crafts store, pick out some new supplies so it is already a treat, and then go home and create. If a child is older, ask her to help you build a fire in the fireplace, and then sit together and enjoy it afterwards.
Do you have any gift giving ideas for students that also promote wellness?
Tap into your child’s strengths. For visual spatial learners, there are a lot of great puzzles out there.
Let’s say you have a child that is dyslexic or dysgraphic, but they are really talented building or solving strategy puzzles. So much of school is language-based and text-based, which can be frustrating and difficult. At home, you can provide toys that highlight their unique strengths and help them feel successful.
Give a gift that can become a happy and peaceful family activity. If your younger child experiences frustration at school, consider a gift like building blocks that can be worked on in the center of the family. As you child is working, give him positive feedback. This tells your child that he is smart and has talents that people admire.
Pretending toys, depending on the age of the kids, can be great. Even a pack of little dinosaurs, can lead in to a pretending activity with your child and many great conversations. Whether your children are good at pretending, or you want to model pretending for them, stuffed animals, dolls, even little cars can be a nice way to lead into pretend play, which is great for all kids’ development.
Consider giving a good book, one that can be read aloud or shared. There are lots of options for younger kids, but even for older kids, large "coffee table books" with photography around an area of interest, cookbooks or books with jokes or funny stories can bring the family together.
If your kid is into music, download a new album that the family can listen to together. Or if your child plays an instrument, consider a gift that can recognize that skill and then enjoy an impromptu concert.
So, a big takeaway here is that parents consider giving gifts that can be enjoyed by the whole family in one way or another. Also, it’s helpful to pick gifts that allow children to show their strengths and lead to greater parent-child engagement.
Any last words for parents, Dr. Levisohn?
If you suspect that your child might be stressed about an upcoming holiday event, just open the conversation. Just ask, “Are you feeling a little anxious? Is there something that’s on your mind?” And if they are, be sure to validate and sympathize with that feeling, and then talk about what’s coming up. Help them understand that feeling, and that it is normal and something can be done about it. And if your child isn’t as verbal, try introducing an activity that is peaceful to help reduce those anxious feelings.
Lisi Levisohn, PhD is a licensed psychologist, a developmental neuropsychologist, and mother of two teenage boys and one teenage daughter in Silver Spring, MD. Dr. Levisohn provides neuropsychological and psychological assessments for WEG. This week, she’ll be enjoying her own family’s peaceful, laid-back Hanukkah traditions.