help the child bridge the executive functioning skills of appraising, evaluating

[Guest guest]

Why, Why, Why!

The most popular question I get from parents of teens and young adults on the

spectrum, is " Why does my son struggle so much in simple, real life, judgment

and reasoning? Why can he know what he is supposed to do, but stumble so much

during the act of doing it? " " We can preview what to do before he leaves, but

he forgets to do it once there! " Another popular question is " Why can't he see

the effects his behavior is having on others, and not see when he is out of sync

with everyone else? "

The answers to these questions lie in the " executive functioning " center of the

brain (frontal lobes). This area of the brain gives us the ability to appraise a

situation, plan a course of action, and monitor how we are doing as we are

carrying out the action. To effectively carry out a course of action that

matches the expectations of the demands, you have to engage in multi-tasking

(which is a brain function difficult for people on the spectrum.) To match your

behavior to the situation you have to be (1) continually appraising the

situation, (2) assessing what is needed, (3) planning how to respond, (4)

monitoring how you are doing as you are " doing " , and (5) evaluating how

effective your response is. You have to perform all the these five functions

simultaneously to stay coordinated with the needs of the demands. It requires

the abilities of (1) processing multiple information simultaneously and (2)

multi-tasking the five functions above. This is where the person on the spectrum

has difficulty with any social situations that demands them to perform. Plus,

when you add the " anxiety " over performing under such conditions, what ability

they have to multitask crumbles. In essence, most daily responding, that doesn't

involve acting out of " habit " , requires us to " think about " what we are doing,

while we are doing it. We step back and monitor what we are doing as we are

doing it. We are constantly appraising, evaluating, and adjusting or actions

based on the monitoring. This is very difficult for people on the spectrum.

At best, most kids on the spectrum can learn to appraise what is needed before

acting, and even plan out a course of action based on that appraisal. However,

once they decide to act, they have difficulty " monitoring " their actions while

doing them. They have difficulty continually appraising, evaluating, and

adjusting their actions in the mist of doing them. So, if their actions are not

in sync with what is needed, they often have no clue, or if they feel that they

are off course, do not know why and what to do about it.

1. Prepare the child before entering a situation about (1) what he can expect,

and (2) what is expected of him. Lay out any rules and expectations, on what to

do and what not to do, very literally. If possible role play and practice any

known behavior expectations, and how to handle possible snags.

2. We often fail, by telling them what is expected (previewing), and then

throwing them into action without a " path " to follow. We think that the mental

map from " telling " them will provide the path. However, they often have a hard

time maintaining this information in their " working (short term) memory " , and

referencing back and forth between this memory and their behavior to keep their

actions in sync with the mental map. So, often the map needs to be a concrete

visual path to follow (following someone else, or visual boundaries that outline

the path, or a model to follow). This can be provide is several ways:

a. Concrete visual roles and rules. For example, when taking a young child

grocery shopping, you have to provide very concrete rules that provide a path

for correct behavior (otherwise they are all over the place, and getting into

everything). We need to give the child a role to play (push the cart) and

concrete boundaries (path), such as " hands always on the cart, and walk

alongside mom " . These two visual boundaries provides a " map " to keep the child

on the correct " path. " When they don't have a clear path, they are left to

wonder haphazardly, and get into trouble.

b. Another tool that can help is tying their actions to the sequential steps of

the task, providing visual cues to each step. When this happens, you do this,

then when this happens, you do that, etc. Then the visual cues of each step of

the task can cue them what to do. Scrap the plate, then rinse the plate, then

place it in the dishwasher.

c. Another tool for bridging the weak " working memory " is to provide written

instructions as a path to follow. At each step of the task, the child can

reference the directions as needed, just like we navigate a map, street signs,

etc. while driving. This often works well for school tasks, writing down the

steps and directions.

3. Once the child starts into action, since he cannot monitor (appraise,

evaluate, and adjust) what he is doing as he is doing it, he has to learn to

break the task/event down into sequential steps, then at each step stop and

appraise, act, and evaluate. So the tasks result is sequential steps of

appraise-act-evaluate, appraise-act-evaluate, etc. Since he cannot do these

functions simultaneously, he has to learn to do them sequentially. The child is

going to need some coaching to learn how to appraise and evaluate. This can be

very taxing and mentally draining for the person. However, if it going to be a

situation that will occur frequently, and the child can learn it " habitually " ,

then it is worth doing.

4. Until the child becomes old enough to doing the " self monitoring " in step 3,

he will need someone coaching him during the action. This is where " guided

participation " is a good technique. With guided participation, the coach and

child do the action together, with the child learning by following the lead of

the coach. The coach teaches by showing and using assistance to keep the child

on the right " path. " Guided participation provides a very clear path, along with

assistance to pattern the actions to stay on the right path. Once the child

understands what is needed, the guide fades the assistance.

5. Another good strategy used in guided participation is teaching the child what

to reference when monitoring how he is doing. Frequently through the action, the

coach stops and evaluates how well their action is (if they are on the right

track). This teaches the child to (1) stop and check, as well as " what to

check. "

6. Once the action/task is completed, then help the child evaluate how their

performance was in regards to the " path " that was laid out. If they got off the

path, discuss what the break down was and how we can tighten up on the path.

So, to help the child bridge the executive functioning skills of appraising,

evaluating, and adjusting actions to expectations, then provide the following

sequences of supports.

Preview --- map --- coach --- evaluate