Smart but Scattered Kids

Peg Dawson, Ed.D., NCSP
Invited Address
National Association of School Psychologists Annual Convention, February 2018

When my colleague and I started talking and writing about executive skills, somewhere back in the late 80’s and early 90’s, we felt like we were voices in the wilderness. People didn’t know what we were talking about—heck, I didn’t even know what I was talking about. When I introduce myself at workshops, I tell people I got interested in executive skills through working with kids with ADHD when I transitioned out of the public schools to working in a clinic setting. As I started working with that population more extensively, I began to realize that the American Psychiatric Association’s diagnostic criteria for ADHD—which, as you well know, includes problems with attention or hyperactivity/ impulsivity, or both, really didn’t begin to describe the problems I saw these kids having in school. I saw huge problems with things like time management, planning, organization, etc., as well. And I remember talking with my colleague Dick (Dr. Guare) about them. Dick and I both did our doctoral work at the University of Virginia, but he went on to do a post-doc in neuropsychology at Children’s Hospital in Boston, and as I was describing these issues, he said, “Peg, those are executive skills.”

And then he and I decided we wanted to know more about them—how they develop across childhood, what’s going on in the brain, how do they impact school performance, and most important, because he and I are both school psychologists by training: How do you help kids with weak executive skills become more successful students.

Then we began writing books, and our goal was to make both the books and the information in them accessible to as wide an audience as possible. Which is why we’ve written books directed at both parents and professionals and that address executive skill challenges in childhood, adolescence, and adulthood. And after a while, we weren’t having to stop and explain what we meant when we used the term.

This wider recognition of executive skills can’t be attributed to our books, although I admit to smiling with pleasure and surprise the first time a parent said, in answer to my question about what brought her to my office, “I’ve been reading Smart but Scattered, and you’ve described my child.” At the same time, we were doing our work, people like Peter Isquith and his colleagues were creating norm-referenced rating scales that enabled us to capture these skills and to distinguish kids who were on target in their executive skill development from those who were lagging. And the technology available to measure what’s happening in the brain became way more sophisticated, so now we could see in the brain images how executive skills develop over time. And now, unlike when we started, neuroscientists have come to recognize that executive skills take a minimum of 25 years to reach full maturation—and longer in individuals with neurodevelopmental problems such as ADHD or Autism Spectrum.

In case you’ve never been to one of my workshops, here’s the evidence I show for how long it takes for executive skills to develop:

http://www.nytimes.com/interactive/2008/09/15/health/20080915-brain-development.html

And the research on executive skill development began to explode. Which has given us a much better understanding of how and when these skills emerge and what influences their development across childhood. All of this has opened up opportunities to incorporate this knowledge into education policy and practice.

So, let me start by summarizing what I see as the most positive aspects of our current state of understanding with respect to executive skills and their relationship to school performance. Then I’ll move on to talk about my concerns about the current status of the field, and finally, I’ll end with the trends for the future that I would like to see as we refine our understanding of executive skills and our techniques for identifying and treating executive skill challenges.

Here are some of the leaps forward I’ve seen the field take since I first started thinking and writing about executive skills:

First of all, it has become fairly well-established knowledge that there is a significant link between executive skills and school achievement. There is good research to support this link, especially when we use “real world” assessment and outcome tools. For instance, a 4-year longitudinal study published in 2014 (Samuels, Tournaki, Blackman, & Zilinski) showed that scores on the BRIEF completed during middle school were robust enough to predict GPA into high school. This study, by the way, used a very different approach than studies collected in a meta-analysis published a couple of years ago that got a great deal of attention at the time (Jacob & Parkinson, 2015). That one compared scores on tests of executive skills that can be administered in a laboratory setting, such as the Go-No Go task, to scores on standardized achievement tests. The authors of that meta-analysis were much more cautious in their conclusions about the link between executive skills and achievement, but I’ll return to this article later to explain the concerns I have with it.

Secondly, I’ve begun to see that the concepts and vocabulary associated with executive skills are beginning to replace more pejorative terms such as “lazy,” “unmotivated,” or “not working to potential.” In fact, a few years ago, the last time I was invited by NASP to give a talk on executive skills, I titled it, Beyond Lazy and Unmotivated. And here’s a portion of a rating scale completed by a teacher for an evaluation I did on a high school student that served as the impetus for that title. View Slide. There are two problems with using these terms to describe a student’s academic problems. First of all, it makes them sound like character flaws over which the individual student has little or no control. And when we start using words to describe students, before you know they’re describing themselves that way, and then it becomes an excuse to free them from making an effort to become better students.

To illustrate this, a couple of summers ago, I saw a 14-year old who was struggling in school. His parents had placed him in a charter school because they thought he might be more successful there than in a traditional public school setting, but he was still not doing a whole lot of homework and his grades were suffering as a result. When I interviewed his mother, she reported that the boy’s father, who had a degree from MIT, called his son lazy and frequently reminded him, “You’d never be able to get into MIT because you’re so lazy.” The youngster breezed through my cognitive measures and then I interviewed him about school. “What’s going on with homework?” I asked. He shrugged and said, “Basically, I’m just lazy.” And then he told me the same story about his father that his mother had told me.

The second problem with using terms such as “lazy,” to describe students is that terms like these don’t encourage problem solving. No one has ever asked me, “So, what’s the intervention for lazy?” And that’s sad—because we have interventions for executive skill weaknesses such as task initiation and sustained attention. So the fact that educators are moving toward using executive skills as a way to describe the underperforming students in their classes is heartening to me.

I’ve also found that more parents and professionals are making the link between these skills that underlie school success and brain development. Over the years, I’ve seen experts on learning and child development give various labels to the set of cognitive skills that support academic achievement. Sometimes they talk about “soft skills.” Here’s how Wikipedia defines soft skills:

Soft skills are a combination of people skills, social skills, communication skills, character traits, attitudes, career attributes,^[1] social intelligence and emotional intelligence quotients among others that enable people to navigate their environment, work well with others, perform well, and achieve their goals with complementing hard skills. View Slide

Ross Greene has another way of characterizing these skills. He talks about “lagging skills” that make it hard for behaviorally challenging students to do well in school. Here’s a partial list of what he calls “lagging skills”. View Slide

 

Another term that has become popular is “non-cognitive skills.” That one particularly annoys me, because what does that even mean? Here’s one list of what’s included under those skills that I pulled down off the web. View Slide

More recently, educators have begun to talk about “grit,” based on Angela Duckworth’s work. She defines grit as “perseverance and passion for long-term goals.” View Slide

These terms are all perfectly fine. They have a great deal of overlap—both with each other and with executive skills. Let me tell you why I prefer to use the term executive skills. Because my audiences seem to really respond to the notion that these skills are situated in specific regions of the brain (the frontal lobes) and they’re tied to a set of brain processes that help people both understand how they develop and why it takes 25 years to reach full maturation. When I explain pruning and myelination and can show slides that depict these processes View Slide, people understand that there’s a brain-based explanation for why these skills take time to develop. And I can talk about how the skills are strengthened and refined through practice, and they can see why that is. And I’ve found when parents understand that these skills are tied to brain development, they are not only less likely to blame their kid, they’re also less likely to blame themselves for their child’s developmental lag. These gives them more hope and therefore more energy to focus on constructive solutions. Just yesterday, I got an email from a woman in Hong Kong who attended a training I did there in November. She wrote, “Introducing your model to parents, it facilitated an ‘empathetic shift!’ Parents no longer just blame the children for their laziness and lack of willpower. Now they could expand their view and try to see the child’s functional impairment from the lens of developmental EF deficits…Your method provides a step-by-step systematic guideline for us to walk through the problem, brainstorming ways to accommodate for the children’s deficits as well as to help them develop new skills.”

Another plus to the current state of affairs is that we have a better understanding of the factors that impact executive skills. Again, part of this is related to knowing more about brain development. We know, for instance, that the frontal lobes of the brain are the last part of the brain to reach full maturation. Which means if infants are born premature, there’s a greater likelihood that executive skills will be impacted than any other aspect of cognitive functioning. And there are birth complications that are also associated with executive skill challenges, such as the umbilical cord being wrapped around the infant’s neck to the point where the infant is blue at birth.

And the frontal lobes are the last part of the brain to reach full maturation so kids continue to be at risk throughout the developmental period. And because of where frontal lobes are situated means kids are at risk from the most common types of head injuries, including sports injuries. And then there’s impact of toxic stress. View Slide The Center on the Developing Child at Harvard University has done some very good work focused on this population of students—and on helping their parents, particularly mothers, learn better ways to help their children overcome the negative impact that toxic stress has on executive skill development.

And finally, I’m encouraged that more and more schools have begun to tackle the challenge of the variability in executive skills of kids at every grade level, including significant weaknesses in some students. And they are thinking about ways to teach these skills. Sesame Street, for instance, hired Walter Mischel a few years ago to help them figure out how to teach delayed gratification to 4-year olds. Mischel, of course, was the research psychologist who created the Marshmallow Test as a way to determine if 4-year olds were able to delay eating a proffered marshmallow until the experimenter returned to the room. His longitudinal studies based on that original population have shown that early ability to delay gratification is associated with better life outcomes. He maintained that you could look at the strategies that the successful 4-year olds were using to wait the full 15 minutes the experimenter was out of the room and you could probably teach those skills. Sesame Street hired him to do just that. And then researchers used the Sesame Street videos for training purposes and found, yes, you can teach strategies. View Slide

I have been particularly encouraged by the efforts some educators have made to embed executive skills deeply into the school’s curriculum. Two that have been particularly well thought out are the Montcrest School in Toronto, Canada, a K-8 school and Mountain View School in Fairfax, Virginia, an alternative high school. Teachers at the Montcrest School created a set of Super Heroes as a way to help students understand what executive skills are and how they can use strategies to overcome obstacles associated with weak skills. View Slide Mountain View created a 12-week series of mini-lessons that teach these skills to struggling high school students. Their format is to use a funny YouTube video (or a game) to introduce the skill, have the students wrestle with discussion questions associated with the video to help them understand the message of the video and to connect the video with the specific executive skill being discussed that week. And then all week long, teachers point out during their regular classroom lessons where the specific executive skill comes into play. They post descriptors and “catch” phrases for each skill on the wall which they leave up over the course of the 12 weeks so students over time are getting a lot of practice applying each executive skill to their regular classroom View Slide

More personally, for more years than I can remember, I’ve been running a study group for the New Hampshire Association of School Psychologist on the topic of executive skills. In the beginning, we spent a lot of time “admiring the problem,” but in the last 3 years or so, people have begun to try out interventions and see how they work. I think of it as a laboratory for innovative practices. Group members have come and gone over the years, but I have a group of loyalists who have hung in there. And every year I decide I’m going to stop, but when I ask if people want to keep going, the answer is always yes.

One other strategy I’m beginning to see get some traction is our coaching model. We created coaching as a vehicle to help students learn and practice strategies that help them build their weak executive skills. We published our first coaching manual in the late 90’s, and I was so convinced that it was the perfect strategy for training executive skills that I was a little surprised when schools, teachers, and school psychologists didn’t jump on it right away. When they didn’t I decided something must not be right about it—and then in the last two years I’ve been asked to teach 5 coaching seminars, and through that process I’ve become more convinced than ever that this can be a very powerful intervention. Look at the results of our pilot study, working with novice coaches and only half-formed ideas about what we were doing. View Slide  Through teaching these seminars, my faith in the process has only been reinforced, although I now have a little more appreciation about how even though it’s only based on a 5-minute daily conversation between a coach and a student, it’s not as easy to implement as I thought it should be. Still worth working for though.

Okay, those are all the things I feel good about with respect to the current status of the field of executive skills. But this isn’t just a feel-good talk. There are still some problems that need to be solved, and that’s where I want to turn now.

First of all, there are some significant assessment issues. For those accustomed to using standardized measures to assess processing disorders or learning disabilities, the assessment of executive functions presents a challenge. It is possible to assess language-based learning disorders, nonverbal learning disabilities, and dyslexia using instruments such as tests of intelligence, achievement, language, memory, and phonological processing—tests that are normed on a typical population of students—with a diagnosis deriving from a distinct cognitive profile.

Although efforts have been made to develop formal measures of executive functioning in children, many have argued that these efforts have fallen short for a number of reasons. For one thing, the tests that are most available for assessing executive skills in children were developed originally for use with a clinically impaired adult population. Since they were designed for use with a clinical population (e.g., head injury), they fail to take into account the normal developmental progression of executive skills in childhood.

Furthermore, the tasks developed often require the child to use other skills, such as language, memory, and motor functioning, that confound the test results—does the child have difficulty copying a complex visual design because of weak planning or organization (two executive skills) or because of weak motor control, for instance. Others have raised questions about the ecological validity of clinic measures of executive skills. Peter Isquith and his colleagues, the developers of the BRIEF, have pointed out that when performance-based tests are designed to ensure internal validity, the result is tests that “assess more narrow, situationally constrained processes in contrast to real-world adaptive executive functions.”

More recently, Russell Barkley has offered a multi-pronged critique of psychometric tests as measures of executive functioning. He argues that these tests have been shown to have only low to moderate reliability, noting, for instance, “that only a minority of patients experiencing frontal lobe injuries or those with ADHD known to have a frontal lobe disorder score in the impaired range on these measures.” Furthermore, these same patients exhibit executive function deficiencies both on rating scales and when observed in natural settings.

The implications of this are not benign when considering the impact of weak executive skills on school performance. Many school districts (especially those employing a traditional assessment model for determining special education eligibility) expect the student to show significant weaknesses both on formal measures of cognitive processing and on standardized achievement tests in order to determine that the processing disorder (in this case, executive dysfunction) is having a negative impact on school performance. This is problematic for two reasons: 1) formal measures of executive skills are not measuring the same set of skills that are required in the classroom; and 2) the way standardized achievement tests are constructed eliminates or reduces the demand on executive functioning.

Standardized achievement tests may be good measures of the acquisition of factual knowledge and reading and math proficiency, but they cannot be said to assess the way we expect students to apply that knowledge on the kinds of assignments that teachers typically give students. In short, standardized tests—of any kind—remove the need for the student to draw on executive skills to perform the tasks at hand. In my experience, this is a significant source of frustration for anyone involved in the assessment process who understand the mismatch between the way we measure academic achievement on standardized tests and the way we expect students to demonstrate academic achievement in the classroom. And the differing demands on executive functions in those two instances have a lot to do with that mismatch.

Secondly, there are some issues around the special education identification process. People often ask me how you make a determination that a student with executive skill challenges requires special education. I have a “quick and dirty” answer to that question, but it’s full of holes. My quick and dirty answer is that if a student is failing classes or grades due to weak executive skills, that qualifies as a disability. And I’m basing this on the ADA’s definition of a disability, which is “a significant impairment in one or more major areas of life functioning.” Well, “failing” qualifies as evidence of impairment and school is a major area of life functioning.

But there are students who fall through the cracks with that definition—most obviously kids who aren’t failing. But they’re also not doing well—and certainly not performing up to their ability. Two groups of kids come to mind in particular. Gifted kids, for one. Not every gifted kid, of course, but the “smart but scattered “ones. They’re not failing because they could almost pass tests with their eyes closed because they’re that bright. But their executive skills don’t match their other cognitive strengths and no one feels compelled to help them close that gap. Furthermore, by the time they reach high school, we’re keeping them out of AP and honors classes because everyone says, “They’re not going to do the work. They don’t belong in those classes.” They would have no trouble grasping the course content—but we don’t say, “Ok, we’ll figure out a way to help you be successful in these classes.”

The second group of kids who fall through the cracks because they’re not failing is kids whose parents are working overtime to make sure they don’t fail. And I get that—because failure comes with a whole set of side effects no parent would wish on their kid—discouragement, depression, low self-esteem, a lack of a high school diploma and restricted employment options for the rest of the student’s life. The problem with leaving it to parents to make sure their kids don’t fail is that it’s a very sophisticated parent who understands the difference between ensuring their child doesn’t fail and ensuring that their child becomes an independent learner who can go onto the next level of schooling and be successful.

With this as backdrop, I think the best solution to the assessment/special ed identification process is to implement a well thought-out MTSS model that incorporates executive skills into the process. Because this ensures that there are Tier I interventions taking place in the regular classroom that support not only the student at risk for failure but that helps all students improve their executive skills. Here’s the Triangle I created to outline the steps in a good MTSS process as it applies to executive skills. View Slide

Okay, so those are my assessment and identification concerns. Now let’s look at the intervention side. Here’s my biggest concern: that people are looking for “quick fixes.” I understand this. In the grand scheme of things, executive skill weaknesses look pretty mild—especially compared to the impact of child abuse or other kinds of trauma or more severe psychological disorders such as bipolar disorder or major depression. But executive skills are best thought of as habits of mind, and we know that habits are built over years. We say to parents and teachers all the time, “Progress is measured in years and not months with these kids.”

When we talk about interventions, we talk about a progression from external to internal. View Slide So we argue that before you think about changing the child, you should be thinking about how to modify the environment to make it either more supportive or less punishing for the student with executive skill challenges. And when we decide we’re going to focus on changing the child we recognize that we are going to spend a long time externally cuing the child before we expect them to self-cue. And in my clinical experience this is where it all falls apart. Because people either don’t recognize or don’t believe that it takes a long time before kids are able to self-cue. This where people start using terms like “babying,” “coddling,” or “enabling.” If the kid is relying on an adult for a cue how will they ever achieve independence.

This fails to take into account a couple of things about self-cuing. First of all, our executive skills are at their weakest in the context of things we don’t care about. That explains why that same kid who fairly routinely forgets to put his math book in his backpack on nights he has math homework never forgets his soccer equipment. But secondly, when you think about it, a self-cue is an incredibly sophisticated metacognitive strategy. Because you have to be aware you have a problem for one thing. That alone requires metacognition. And then you have to design a self-cue that you think would address the problem. And then you have to remember to use the self-cue. And if you forget to use the cue or the cue doesn’t work, you have to cycle through that problem-solving process all over again. In the executive skill scheme that my colleague and I came up with, metacognition is the last skill to emerge. And it tends to coincide with a brain process called pruning—a process that doesn’t kick in until the early stages of adolescence.

When people look to quick fixes, not only do they tend to give up on strategies too quickly, but they also tend to focus on brief, time-limited interventions. Research studies typically run interventions for 8-10 weeks and then assess change. Well, if progress is measured in years and not months, here’s another glaring mismatch—that between the length of typical intervention studies and the length of time it takes for executive skill strategies to take hold.

When we believe that an 8 to 10-week intervention is viable, then the next thing we do is look for off-the-shelf intervention packages that come with scripts, activities, lesson plans and protocols. I do believe there are some good ones out there—I’m particularly impressed with the elementary school version of Second Step, which is a broad social-emotional learning curriculum and with the Unstuck and On Target curriculum, but I think it’s difficult to achieve measurable results on a group basis. I think more frequently they work for some kids under some circumstances when treatment integrity is achieved.

This leads me to worry about what happens when the intervention doesn’t work. Do we say—as a review article published in a major research publication did a couple of years ago—that there is “no compelling evidence” that there is a causal association between executive skills and achievement or that efforts to improve executive skills leads to improved achievement.

And I am worried that when we draw these conclusions, we create a case for abandoning efforts to refine both our interventions and our research methodology. This same research article made this point: Given the severe budget constraints faced by many schools today, it is critical that school leadership invest in programs that have the greatest promise for improving outcomes for children. Although investing in interventions that target executive functions as a way to boost academic achievement has strong intuitive appeal, a more critical assessment of the benefits of such interventions is needed before substantial investments are made.

Who could disagree with that? Unfortunately, the meta-analysis that the authors employed to make this critical assessment created parameters that substantially limited the value of the results of that meta-analysis and therefore the conclusions that the authors came to. Here’s why: The authors chose to “only included studies in which the outcome of interest was achievement on a standardized assessment.”

The examples of those measures include the WIAT and the Woodcock-Johnson. And as I stated earlier, the way standardized tests of any kind, including tests of achievement, are constructed minimizes the need for the child to use executive skills to perform the task. That means that our intervention may do a great job of teaching executive skills—and even applying those skills to performance on classroom tasks and homework assignments—but when we come to measure achievement, those executive skills are not required. I use these examples all the time in my seminars View Slide. Standardized achievement tests extract the executive skill demands, supposedly as a way to purify our measures of achievement. But if students can’t apply what they’ve learned to “real world” demands—which invariably requires executive functioning—what good is that?

This article clarifies the kinds of published studies excluded from their meta-analysis: “Studies in which GPA, homework completion, or teachers’ reports of academic performance were the outcome of interest were not included in the sample, because such measures generally assess both scholastic achievement and behavior and the two cannot be disentangled. Although the association between academic behavior and executive function may be important, it is not the direct focus of this article.”

Excuse me? I have to pause here and remind the audience that I am not a researcher, so I tend to overlook or disregard the constraints under which researchers are forced to operate. But I would argue that the association between scholastic achievement and academic behavior is way more important to most teachers and parents than is the relationship between executive skills and scores on achievement tests. In the real world, GPA, homework completion and teachers’ reports of academic performance have much more to do with how kids progress through school—what classes they get assigned to, whether they’re allowed into AP or honors classes, what college they get into, and even whether they graduate from high school or not, than scores on the WIAT or the Woodcock Johnson.

So moving forward, here’s my plea. Let’s begin with some common sense. Look at the executive skills that my colleague and I have targeted over the years in our writing and clinical work View Slide  These were selected because we thought that of all the skills there are out there—and some have identified as many as 40—these have the biggest impact on school performance. If we can all agree that these skills play a huge role in school success, then doesn’t it make sense to figure out ways to embed these skills in what we’re asking kids to learn? And I don’t mean through discrete lessons, I mean by incorporating these concepts into our daily conversations with kids.

Here’s what this would look like. A few years ago, I was invited by a private school in LA to spend the day at the school talking about executive skills. They asked me to do a 1-hour keynote for teachers first thing in the morning and then spend the day meeting with teachers by grade level, talking about how they might address executive skills at individual grade levels, kindergarten through 8^th grade. By the end of the day, teachers were saying, “You need to come back and talk to our parents.” So just about a year later I returned to the school. This time, I did a 1-hour keynote for parents first thing in the morning and then spent the day with teachers, again meeting with them by grade level to see what they’d been up to in the year since I’d first visited. They gave me tours of classrooms to show how they’d incorporated executive skills into classroom design—checklists on the wall for instance, and good evidence of organizational strategies being put to use. But my favorite story was told by a 2^nd grade teacher. She described having a fun event planned for the class. It had been planned for weeks, and the excitement was building as the day grew closer. Unfortunately, the very day the event was planned for, it fell through. So this poor teacher had to stand up in front of the class first thing in the morning and say, “Remember that fun thing we were going to do today? Well, we can’t do it.” She delivers the bad news, and a little girl in the class sighs and says, “I guess we’ll have to be flexible.”

Why is that such a great story? Think of Bloom’s Taxonomy. View Slide. This clearly shows that that teacher was successful in teaching the vocabulary term flexibility and explaining the concept well enough so that that student not only remembered and understood it but she was able to apply it successfully in a novel situation. This is my favorite way to teach executive skills and I’ve seen kids as young as first grade be able to use, understand, and apply these concepts accurately.

If we adopt this approach, then we quite naturally move away from the idea that improving executive skills can be done in 8-10 week interventions. That alone would be something to cheer about. Because, remember, executive skill development is all about habit formation. And how are habits formed? Through continual practice, day in and day out, until they become automatic. Think about teeth brushing. How long does that take to become habitual? Given the number of cavities I had when I was a child, I suspect my parents stopped supervising me with my daily teeth-brushing far sooner than they should have.

We need to impress upon parents and teachers that progress may be slow, and that just because an intervention didn’t work in 2 weeks doesn’t mean it’s not a good intervention. I remember a mom in one of my workshops saying to me, “I’ve been using the same getting-ready-for-school checklist” for 245 days and it’s still not working. So, what do I do?” My short answer was, “Keep using it.” Now others in the audience suggested she might want to look at what was on the checklist, suggesting it could be adapted so the kid would be more successful, but I still stick to my original answer.

The best interventions are not ones that work in 8-10 weeks. This is not only because that’s not enough time to see results but it’s also because those interventions tend to be complex and labor intensive. What I’ve started telling my audiences now is that, at least as far as executive skill development is concerned, the best intervention is one that takes no more than 5 or 10 minutes a day but that you are willing to do forever—or at least as long as it takes. When I first shared this with audiences in my seminars, I thought of it as somewhat whimsical, and maybe, while not in and of itself realistic, it might get people thinking differently about how we design interventions.

But in the months I’ve been sharing this, I’ve started gathering evidence to suggest it may be a realistic recommendation. With my own son, who was diagnosed with an attention disorder at the age of 14, I spent more than 3 of his 4 years in high school asking him every day when he got home from school, “What do you have to do? When are you going to do it?” Those two questions tackled a number of executive skill challenges he presented with—task initiation, planning, time management, and maybe even goal-directed persistence. The conversation rarely took more than 5 minutes, but we did it just about every day.

Over the last few months I had one mom in one my seminars tell me that she introduced a checklist for getting ready for school when her son was in kindergarten. Now, in 7^th grade, finally, he was following the checklist on his own. And I had another mom who told me that every day the first thing she asks her son to do is “Check your planner,” because that tells him what he needs to know about the upcoming day. It took him 4 years before he began checking his planner without a prompt from her.

This sounds like a strategy that is more applicable to parents than teachers, but I think it can be adapted to teachers as well. Teachers can’t devote 5-10 minutes a day to every student in their class, but can they devote 5-10 minutes to a classroom routine that supports executive skill development? Years ago, I was doing an ADHD workshop to a K-8 school in my state and I was beginning to realize at the time that rather than developing personal accommodations for each student with an attention disorder, it might be possible to develop a whole-class routine that would meet the needs of a bunch of students. So I suggested this to the staff. “Is there anyone in here who has routine for homework collection? Or is there anyone who has an end-of-day routine to ensure that students have written down their homework assignments and have everything they need in their backpack?” Two 5^th grade teachers raised their hands. One had a homework collection routine and the other had put in place an end of day routine. I asked, “How long do those routines take? 10 minutes?” They each said, “No, 5 minutes.”

These routines shouldn’t be seen as eating into instructional time. They can be framed as part of the instruction, especially if the teacher is explicit with the class about which executive skills are being addressed. Here’s the cartoon I use to try to persuade teachers that the time they spend on explicitly teaching executive skills is not wasted time but, in my opinion, as important as the time they spend on teaching content. View Slide

To wend my way toward closing, let me at this point talk about a few issues that I’m passionate about pursuing at the moment. These are the things that keep me pushing back my retirement date. I’ll try to be brief.

First of all, I’m excited about helping people see the value of involving students/children in generating their own coping strategies for improving executive skills or working around challenges. Personal goal-setting is a central feature of our coaching model, which we developed over 20 years ago. The importance of placing the student in the driver’s seat in coaching was reinforced for me in the last couple of coaching seminars I’ve taught. When I teach coaching, seminar participants have to find a student to coach and come to class each month prepared to talk about the experience. Usually, these novice coaches meet with amazing success, but I had a couple of coaches last year who admitted the process hadn’t work. When I explored why, in both cases the coaches told me, “The mom changed the goal.” I was sorry that the coaches hadn’t had a positive experience, but It was nice for me to get some validation that the student really does need to be given permission to set their own goal.

We’ve now extended that concept out to classroom-based intervention strategies. We’ve developed a process that we call student-centered interventions. I’ve created a whole folder full of materials that includes examples as well as forms that could be part of a teacher assistance team or pre-referral team process, instructions for the use of those forms, a set of instructions that could be used with parents to help them work with their kids in a similar fashion in the home. If anyone here would like access to that folder, email me and I’ll send you a Dropbox link to it.

Second of all, I want to focus more on how to fade supports. We know a lot about this, but I want to be able to describe it so parents and teachers understand. One of pieces of advice we share with both groups when setting up supports is this: Provide the minimum support necessary for the child to be successful. I’ve always explained this by stressing that this advice includes two co-equal parts: provide the minimum support and for the child to be successful. If you provide too much support, the child will be successful but not through his or her own efforts. If you don’t provide enough support, the child won’t be successful. This is hard advice to operationalize. And I recently realized it’s particularly hard because we’re talking about a moving target. The minimum support the kid needs now may be less than he needed two months ago. And we have to bear this in mind.

The reason explaining fading supports is so important is because when we leave out this stage, kids are falling off cliffs. Think about the transition from elementary to middle school, from middle school to high school, and from high school to college or the workplace. Each of those environments requires students to take giant steps. Typical students adjust to each of these new environments. There’s a learning curve, for sure, but they eventually catch on. Kids with more significant executive skill challenges are more likely to fall off the cliff.

Finally, I want to see the research on executive skills and their relationship to school performance focus more on ecological validity. When we just use standardized rating scales and standardized achievement tests to measure intervention outcomes, we’re likely to be missing some really significant effects. Sometimes I equate the current research process to that old metaphor of the drunk looking for his lost keys under the lamppost because that’s where the light is best. But the keys aren’t there—just as the true benefits of teaching students about executive skills aren’t captured in norm-referenced tests and rating scales, at least as currently constructed.

So I’d like to figure out how to use qualitative or mixed-methods research as alternatives to “the gold standard” of quantitative research with experimental and control groups. I’d also like to get people thinking more about single case study designs as a foundation for an evidence base. I frequently get emails from people asking about the evidence base to support our strategies. I find those requests frustrating mostly because it’s a hard question to answer. My colleague and I feel pretty confident that the strategies we’re describing work, not only because we’ve seen them work but also because they’re built on sound behavioral principles. And when you think about it, when you’re changing executive skills, all you’re really doing is changing behavior. But my response to questions like that is you’ll know if the strategies work because you’ll see a change in behavior. And if you want to know if it’s real, just count the behaviors—number of homework assignments missed, grades on tests improving once students start using a study plan, etc.

In preparing this talk, I reached out to Mark Steege, the author of, along with Rachel Chidsey-Brown, of Response to intervention (2nd edition): Principles and strategies for effective practice. I remembered something he’d said in a presentation to the New Hampshire Association of School Psychologists a few years ago that I resonated to—it went something like this: “Just because an intervention was shown to be effective with students in Portland, Maine, does not mean that the identical intervention will be applicable to and effective with individuals in Waterloo, Iowa.” By which he meant that there are limitations to the conclusions you can draw from any study showing the efficacy of any intervention. As he wrote in his email to me: “Within a problem-solving model we are obliged to a) select evidence-based and/or conceptually sound interventions and b) collect data to determine if the intervention is effective with the referred student.”

[I know there are school psychologists out there involved in an MTSS or RTI model who collect this kind of data all the time. I would love to expand our research base within the field of executive skills to include more single case study designs—in part to counteract studies like the one I cited earlier that used standardized tests to try to show intervention efficacy and came up short.]

I’ve been doing some work in Portsmouth, New Hampshire with some middle and high school teachers this year who have chosen two models to work on improving executive skills in teenagers. One group has chosen to focus on teaching executive skills within a lesson format based on the Mountain View model I described earlier. The second group has chosen to implement a coaching model.

I’ve identified the kinds of outcomes that I would love to see come out of these interventions. It occurs to me now that as they are written they might make reasonable IEP goals—but I would also like to come up with a research design to assess these outcomes in groups of students. Here they are, for what it’s worth. Because this feels like the culmination of all the work I’ve been doing on executive skills for the last 20 years.

By the time students graduate from high school, they will be able to:

1. Describe their own executive skill strengths and challenges and give concrete examples from their daily lives to illustrate them.
2. Identify with specific examples how their executive skill challenges impede academic performance.
3. Make and achieve specific goals to address executive skill challenges within a context and/or setting that is meaningful to the student (e.g., improving organization by following a bedroom cleaning checklist every day; improving metacognition by creating a study plan for every test and quiz that includes specific study strategies and how much time will be spent using each strategy).
4. Create tools (e.g., graph, chart, or checklist) that will allow them to track their progress toward goal attainment.
5. Identify strategies for overcoming obstacles toward goal attainment (e.g., if making a study plan for tests and quizzes doesn’t mean they follow the plan, asking a classmate, coach, or parent to check in with them every day to see if they’re following the plan).
6. Be able independently to set goals and use self-selected coping strategies that lead to measurable improvement in academic performance variables (e.g., grades on tests/assignments, homework handed in on time, report card grades).
7. Explain how they think they will be able to apply what they have learned during the coaching or seminar to future goals at school or home, in leisure activities, or in the workplace.

In my ideal world, executive skills would become part of every school’s curriculum, and when students finish their education they would understand their own executive skills profile and know how to use that knowledge to help them achieve any goal—personal or professional—that was important to them. That still may be a long way off—if not impossible.

But I implore the practicing school psychologists in the room not be deterred by that. You don’t have to change your entire school district. Just see what you can do with one kid, one teacher, or one parent using whatever strategies that make sense. My husband used to tease me about trying to change the world one child at a time. Through my writing and my other professional work, I know I’m reaching more kids than I ever thought possible. But there’s still value—and a great deal of professional satisfaction to be had in changing the world one child at a time.

Only as I say this now do I realize how perfect that fits with this year’s convention theme: The Power of One.

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References

Jacob, R. & Parkinson, J. (2015). The potential for school-based interventions that target executive functioning to improve academic achievement: A review. Review of Educational Research, 20 (10), 1-41.

Samuels, W.E., Tournaki, N., Blackman, S., & Zilinski, C. (2016). Executive functioning predicts academic achievement in middle school: A four-year longitudinal study. Journal of Educational Research, 109, 478-490.

Steege, M. & Chidsey-Brown, R. (2009). Response to intervention: Principles and strategies for effective practice (2nd edition). New York: The Guilford Press.