My guest this week is Sarah Ward, who holds over 25 years of experience in diagnostic evaluations and treatment of executive dysfunction. She holds a faculty appointment at the Massachusetts General Hospital Institute of Health Professions and is an internationally recognized expert on executive function. She presents seminars and workshops on the programs and strategies she has developed with her Co-Director, Kristen Jacobsen. Their 360 Thinking Executive Function Program received the Innovative Promising Practices Award from the National Organization CHADD. Sarah has presented to and consulted with over 1200 public and private schools in the United States, Canada, and Europe.
In this episode, Sarah and I discuss the importance of independent executive function skills and how parents can better approach teaching them to their children. Key concepts like planning and prioritizing, self-control, focussing, emotional control, organization and following directions have all become more difficult for those struggling with executive functions skills especially children with behavioral disorders such as ADD and ADHD. Sarah helps parents and children who struggle with executive functions by providing practical and impactful lessons to help improve their skills. To learn more about Sarah and 360 Thinking click here.
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Episode Highlights
Executive Function Skills
- Organization, time management, decision-making, memory
- The ability to pre-imagine the future is a developmental skill and is at the core of what executive function is
- Our digital age has greatly affected the teaching of these skills
Teaching Time Management
- Using an analog clock to show that time is visible and passing through space
- The curriculum in schools teaching time used to last on average around 6 months, nowadays they may last around two weeks
- This skill is critical for children and adults to understand and function on their daily lives at work and in school
- especially for teens before they enter university
- See 360 Thinking’s resources
Where to learn more about Sarah Ward…
Episode Timestamps
Episode Intro … 00:00:30
Sarah’s Story … 00:02:50
Executive Function … 00:05:29
Teaching Time Management … 00:16:30
Resources … 00:34:55
Episode Wrap Up … 00:38:00
Episode Transcript
Dr. Nicole Beurkens:
Hi everyone, welcome to the show. I am Dr. Nicole and on today’s episode, we’re talking about executive function skills and how they impact learning, behavior and just general life functioning for our kids. If you’ve got a child who tends to forget things, can’t stay organized, doesn’t get things done on time, or maybe struggles to complete tasks independently, you’re going to love the info and tips that we’re going to share on this episode. My guest today is Sarah Ward, a specialist in helping children and teens develop executive function skills. Her resources, strategies, trainings are things that we use at our clinic here in Michigan on a daily basis, and so I’m really excited to have her here to share them with all of you. Let me tell you a little bit more about Sarah.
Sarah Ward is a certified speech language pathologist with over 25 years of experience in diagnostic evaluations and treatment of executive dysfunction. Ms.Ward holds a faculty appointment at the Massachusetts General Hospital Institute of Health Professions. Sarah is an internationally recognised expert on executive function and presents seminars and workshops on the programs and strategies she has developed with her Co-Director Kristen Jacobsen. Their 360 Thinking Executive Function Program received the Innovative Promising Practices Award from the National Organisation CHADD. She has presented to and consulted with over 1200 public and private schools in the United States, Canada and Europe. Really impressive. So excited to have you here, welcome, Sarah.
Sarah Ward:
Thank you for the invitation, I’m excited to be here today!
Dr. Nicole Beurkens:
So, I think that the things we’re going to talk about are things that virtually every parent listener can relate to in terms of things that they just have challenges with or frustrations with their child on a regular basis. But before we dive into strategies, I’m always curious to know from my guests: How did you end up specializing in the work that you’re doing today? Was that something you started out with right away as a speech language pathologist? Was it something that developed over time?
Sarah Ward:
Yes and no. So as a speech pathologist, my first job was at Mass General Hospital and I worked on the inpatient and outpatient traumatic brain injury unit. So certainly individuals who have traumatic brain injury, they’re always having difficulties in the executive function and I started providing outpatient treatment and rehabilitation. At the same time, I also have a daughter, and my daughter has a lot of executive function challenges. She has ADHD and dyslexia, and if you’re familiar with Ross Greene’s work on The Explosive Child, she was an explosive child because she had lagging development of executive skills. So I was sort of working in the field of brain injury, I knew what executive function was, but then I had this beautiful daughter who wasn’t developing her executive function skills, so that sort of started me down the track of, “Well, how do you develop them?”, and many people also know my story that my husband was riding his bicycle, he got hit by an 18-wheel mack truck and sustained a very severe traumatic brain injury and he lost his executive function skills. While I was sort of familiar with it and doing it, then all of a sudden it really became such an integral part of my life, supporting both my husband and my daughter, and really, that took me down the path of executive function because, especially being a wife and a mother and an educator and a clinician, I always wanted to know — well what do you do about it? It’d make me crazy when I’d go somewhere and they’d tell me what executive function was, but then no one really gave me strategies that I could use to really remediate it, so my real focus is all about the practical. What can we just do everyday to truly support children and adults because often times I lecture, inevitable, every single time a teacher, a parent, a husband, a wife will approach me and go, “Oh my gosh, this is me you’re talking about it? How can I help my child if I’m struggling with these executive skills myself?”
Dr. Nicole Beurkens:
Absolutely, I think that’s so true, what we see in our practice too. I love what you’re saying about really developing strategies for this because you’re so right that as we do evaluations on kids or adults, it’s like, “Oh, these are the problems you’re having.” And it’s like, “Well, what do I do about them?” “Well, here’s something to read.” It’s like, “No, really, what do I do to help my child or myself improve these?” And that’s what I think is so wonderful about your work is you’ve really been in the trenches and you’re like here’s what you do because these skills are so vitally important, not just for getting kids through school, but for life beyond that and you and I were talking before we started the interview about the top 10 most important predictors of success beyond school and none of them are academic, right? They’re all these abilities to manage life and manage the kinds of things we’re talking about, so these are really life skills that we all need. I’d love to have you start — for people who aren’t very familiar with the term “executive function” or “executive function skills”, let’s define those terms and talk about how we use them or what kinds of struggles people have when these aren’t working well for them.
Sarah Ward:
Sure. So typically when I go to a school or you talk with parents, what they’ll describe as being sort of the challenges of executive function are things like organization, management of your materials in your backpack — so the kids who have sort of the exploding bedroom or they open up the backpack and there are crumpled papers and the sandwich that is three weeks old, those kinds of things, and as they mature through the academics, you’ll often hear trouble with recording homework, remembering to turn in the homework, remembering to bring home the materials that are required for a specific homework assignment, being able to manage long term projects. It’s also in addition to an organization of materials, it’s a time management skill. So it’s being able to sense “What time is it now? How much time do I have to be able to complete that task? Am I using my time efficiently and effectively? Am I managing to self-regulate or ignore distractions and to stay on task?” And typically, we’ll hear parents say things such as “Oh my gosh, the morning routine, he’s late getting out the door in the morning.” or “If I don’t cue her to every single individual step, then she really can’t independently get from upstairs to downstairs and be dressed and with the backpack and ready to go out the door.” It’s being able to manage and get everything that you need to be out the door to your soccer or to your dance rehearsals or whatever it is. But then at a very even higher level, it’s all around decision-making and problem-solving and being able to break a task down, so it’s being able to plan simple things like chores, taking out the trash, managing the laundry — and then academically, it’s being able to take a complex assignment and break it down and know, “How am I going to get started? What are the materials that I need?”
What I find fascinating though, I guess two things. One is that from a perspective, all of those, we typically describe them as sort of being your managerial — or people will say executive function. It’s like your self-executive in your frontal lobe that manages all that. I guess the thing that I think is really interesting is that all of those things that I mentioned: organizing, being on time, managing your backpack — those are actually products of the executive system. It’s not the process of how we do it itself, and really understanding the process of what you go through to be able to organize your backpack or to be able to be on time, I think it’s what is most eye-opening to parents, and it’s really where our practical strategies lie. And I think that’s the critical thing to share, which I’m happy to share what that is. So the thing about it is, is that for example, you and I are chatting here and any person listening, and even though you’re talking to me, i guarantee, you have a little movie going through your head. Now the little movie going through your head says, “Okay, well, I’ll finish talking with Sarah this morning, then I’ve got to hop online, I absolutely have to send three critical emails, I’ve got to go into my home office, I have to gather that document because I’ve got the house leave the house and be across town by 1pm, but boy, there could be traffic and I’m going to have to find parking, so, I’m going to grab a protein bar on the way, I’ll get gas before I go, because if I leave downtown at 5, I don’t want to get stuck in traffic and have to get gas on the way home.” And the list goes on.
But the whole time that you’re running that movie through your head, what you’re doing is you’re pre-imagining that future and saying, “Okay, what am I going to look like in that moment in time?” and you are anticipating the obstacles and things that go around it. That ability to pre-imagine the future is a developmental skill and is at the core of what executive function is. So, if you think about it as a mom and I’ll kind of give you two examples of this: If your child is downstairs, eating breakfast, you as a mom are thinking, “Oh, okay, I have this meeting today, I know it’s with somebody important, so I could wear the black or the blue dress, but gee, we’ve got to get out the door, I don’t have time to iron the blue, so I think I’ll wear the black dress.” And you’ve made that decision in the kitchen, so that the minute you go upstairs and you go to your closet, you’ve grabbed the black dress. Children who don’t do this for a variety of reasons, whether it’s due to a disorder like a learning-based disability or whether it’s just developmental, you’re downstairs and you say “Time for school, go upstairs, go upstairs! We need to get dressed!” and this is the child who after multiple prompts gets upstairs and you pass their bedroom and they’re playing with legos or painting their nails and you’re like “What are you doing? We’ve got to get out the door!”
Dr. Nicole Beurkens:
“What is happening!”
Sarah Ward:
And then you say, “You need to get dressed!” and this is the child who opens the closet and then they take one pair of pants and then they grab a different shirt and then they go and they go — and before you know it, the clothes are all over the floor and you’re racing to try to get the child out the door in the morning, and so — those are the kids that we chronically describe as being what we say “A beat behind”. They really aren’t developing that mental model and that self-movie in their head of planning. And so, there’s this fascinating — I just think it’s the coolest statement at all, it says that 90% of the time, task-planning happens in a different space from where you execute the plan. I have to say that again, it’s so important. So if you think about it, 90% of the time, we plan what we’re going to do in one space. So you’re down in the kitchen and you’re planning what you’re going to wear, so that the minute you get in that space, you just carry out that plan. Children who don’t do this, you say, “Go brush your teeth, go brush your teeth!”, we’re expecting them to have this little mental movie in their head as they walk through the house and upstairs, “I’m going to brush my teeth”, so the moment they get in their bedroom, they grab their toothbrush. But if kids don’t do that, then all of a sudden, they get in there and they’re like, “Oh, shiny object!” And off they are distracted by the thing that is there. So, that processing skill of the pre-imagination of the future is actually where that true self-regulatory skill is that we have to as parents really foster and improve to support a student in being more independent with executive skills.
Dr. Nicole Beurkens:
I think that’s so important to understand that background, that underlying stuff that you’re talking about because so often, kids with these challenges just get labeled as being a behavior problem, right? They’re naughty, they don’t do what they’re told to do, they’re resistive, they’re belligerent, when really, the root of so much of that is not being able to do this pre-planning, not having this mental movie, being off-task of not being able to complete things, not because they’re intentionally doing it but just because they don’t have the skills to do it the way that we want them to do it, and I think that’s such an important distinction, but I just see that so often, both in patients at the clinic and when I do work in schools. The root of so much of what gets labelled as being a behavior problem is really weak or lacking executive function skills.
Sarah Ward:
Hugely so, the part too about where I often find kids get diagnosed as having kind of behavior challenges, and I think this is really interesting is that distance between where you are in a moment in time and how far into the future you can see and plan is called the spatial temporal window. So I’m going to use my video here for a minute…but it’s this idea that if you’re downstairs, you’re thinking, “Okay, I have to go down the hall, up the stairs and into my bedroom, that’s the distance.” But if you’re at home and you have all of your homework on your desk and let’s say that you’re in middle school, you have to think, “Okay, I need to put that homework into my backpack”, but then you have to imagine yourself going to bed, getting up in the morning, getting to school then going into your locker, then you have to imagine going from the locker down the hall, up the stairs and into the science classroom, turning it in. So all of a sudden, even though you’re at your desk at home, the distance and the space with which you’re imagining turning something in is six miles and 12 hours from now.
The thing that’s really critical about this is we have developmental norms for this. So what happens is, if you think about — if your child is young, they’re two or three years old, you get your child dressed in the morning — really, your only goal is for that child to see themselves with their socks and their jeans and their shirt on. But around four, five, you suddenly get your child dressed in their bedroom and you say, “Okay, go in the bathroom and brush your teeth.” And you’re expecting that child to be able to vision “I can go across the hall and I am brushing my teeth.” And then, as they get a little older, you say “Okay, I’m going to go downstairs and get breakfast, come downstairs and meet me”, you’re now expecting that child to be able to go from upstairs to the bathroom and then down the stairs and into the kitchen. And again, the older — and this is one of the key things to understand: It’s not that academics get harder that make the executive system more difficult, it’s that the demands on how far into the future and how much planning you have to do changes. Because at the time that I’m at sophomore junior and high school and maybe I have my drivers’ license, now, not only am I just thinking, “Okay, get to the bathroom and get dressed.”, but I have to think, “I need to get dressed, I need to get myself breakfast, I need to drive to school, I have to allow enough time to park the car and walk into the school, I then have to go to my first block, I have chemistry first block and then I have English and then I have a free block, and during my free block, I need to see myself studying for that English quiz because that’s this afternoon.”
Dr. Nicole Beurkens:
Well, I think that does really become clear when kids get to — especially at middle school age and certainly by high school, it’s like you just see this gap widening between what the expectations are and what they’re able to do. I find that a lot of the supports that kids end up having written on their IEPs or in their plans are really to kind of crop up and try to support these lagging executive function skills much more so than the actual academic content.
Sarah Ward:
And we know that diagnostically, I think it’s fascinating. There is a huge push right now to actually change the diagnostic label of ADHD to EFDD, which is Executive Function Developmental Delay because it has absolutely been proven through the research that children with ADHD demonstrate a 30%-35% developmental delay in the skill.
Dr. Nicole Beurkens:
We’ve talked about what these skills are, how they can prevent problems for kids and for adults. Let’s jump into some practical strategies. And I’d love to start with time management because, as you’ve been talking about, there are so many practical areas in life where this comes up and it’s a big one that I see kids struggling with and parents getting frustrated with, so what are some of the strategies that you teach your clients and the professionals that you work with to help with the time management aspect of this?
Sarah Ward:
So actually, there is a very simple one, and it relates again back to this idea of having this mental thought bubble of what something will look like, and we always describe that executive function starts with that mental imagery. The problem is that when a parent or a teacher says, “Okay, we’re going to go to science in 10 minutes.” Or mom says, “It’s 3:20 and we’re leaving at 3:30 for soccer practice.” When you say the words “3:20 to 3:30”, a lot of kids hear 3:20 or 3:30 or they see the digital 3.20, which is not actually what time looks like. So our favorite strategy is to really make time visible, but specific to the actual time that it is. So our favorite thing to do, and I’m going to use my video here, is we use really analog clocks and it’s important with an analog clock that you do use the clock’s help. We’ll use a dry erase marker and we really make time truly visible so that students can see the volume of time. And remember this is a time and space skill. So now, the student can begin to visualize “What will I look like in a space in that given amount of time.” So I’m going to keep my clock to what it is, and you even see here that it says it’s like 10:40.
So, if I say to my child, and it’s a Saturday, “Okay, we’re going to leave for your soccer game in 20 minutes”, I don’t want to just say “20 minutes” because the kid is going to hear “20 minutes”, they’re not really going to see the planning. But if I take a marker and I draw with the dry erase marker and show, “Okay, we’re going to leave in 5, 10, 15, 20 minutes”, and I really shade in that actually volume of time, this is super helpful because now the student can see the volume of time. But we actually call this a working clock, not because it has a battery but because it helps us to do our work. And remember that time is going to pass, so that as time is passing, the student can now visually see, “Okay, I’ve got this much more time left here”, but more importantly, they have the ability to also look back and do that metacognitive thinking about thinking skill to say, “Well, what was I doing during this time? Was I using my time effectively?” And as a parent, you can really — or a teacher, you can gauge what you want that student to be doing during space and time. So if I come back to this and I say, “Okay, we’ve got to go upstairs and braid your hair for soccer, we’ve got to change into your outfit, you need to come downstairs and get your bag with your shin guards and your soccer ball, and then that will give us a minute or two to grab a water bottle, maybe pee and get out the door.” And that is so much more effective to saying, “We have 20 minutes” than to saying “We’re out the door in 20 minutes.” The other thing that’s kind of cool about this is you also have some flexibility to really plan the time and show the time. So if you have a student, let’s say, and it’s — I don’t know, we’ll call it 3 o’clock and they’re working on homework, you can actually write out what that’s going to look like. So you can say on a clock — and I’m drawing on a clock, actually, with the dry erase marker, so if it’s 3 o’clock, I’m going to shade on the clock from 3, to say, 3:20 to show that time for homework. So 3:05, 3:10, 3:15, 3:20, and I can shade in — okay, we’ve got about 5-10 minutes for spelling. And you can actually write with a dry erase marker right on the clock spelling, and then that will give us about 5 and 10 minutes to do our math.
One thing that’s kind of nice about that is, the student can now see spelling and math, but the thing is that a lot of times, kids too will think, “Ah, I’ve got to get ready!” Or “Oh, I have homework!” And suddenly when you show it’s 20 minutes or it’s 30 minutes — it makes the time seem doable. And it really helps them to control for distractions. Because if I see that this is the time that I’ve got blocked, and then I’m going to get a chance to go outside and play with my friends or ride my bike or whatever it is, I mean even the encouragement — I think that we struggle with this idea of technology, but we want students to be able to regulate their task before they go to the video games or before they go to the iPad, and this is kind of a cool way for them to say, “Okay, well gosh, time is passing and now I’ve been distracted. If I haven’t gotten my spelling done, I can really see how that’s going to eat into my other time that I want.” It really makes time truly visible, but I think what’s important about the fact that it’s an analog clock is, you’re not just showing a pie of time like 20 minutes, you’re showing it actually on the clock itself and learning that passage of time is critical, because first of all, we have more students who can’t read an analog clock. I heard the most fascinating statistic that you and I as a generation, the typical clock curriculum was on average six months. So you’ve got three months at the end of first grade and three months of time curriculum at the beginning of second grade. Do you know that the average clock curriculum is two weeks now? They just say, “Well, kids are going to go to the watch, or kids will use the cellphone and it’s digital. That is the worst ever, because again, digital time doesn’t show you volume.
The part that’s about it is that you really want kids to see that sweep of time. So when you’re doing this is a parent, and again, I know if you’re listening and you can’t see it on a screen, I am putting my marker in the middle of the clock and I’m drawing up the minute hand and I’m counting by fives. So we’re going to go to bed in 5, 10, 15, 20, 25 minutes. And I really then go back and I shade in exactly what that volume of time is going to look like. The counting by fives is critical because for most students who aren’t efficient and aren’t fluent with a clock — if it’s 3:40 and you say we’re leaving in 20 minutes, most kids will picture the location of the 20 on the clock, not 20 minutes from now. So, the part that’s critical about it is you must draw up the minute hand and count out, “We’re going to work for 5, 10, 20 minutes from now” so that they’re learning to predictively see that volume and sweep of time, and I think the second key kind of time management strategy is that a lot of kids when they are in elementary school and then merging into middle and high school, we ask them to use an agenda book, and it’s not that I don’t think an agenda book is an important, I think that it’s terribly important. But it’s also critical to understand that an agenda book is actually a to-do list. It’s listing the homework that you need to do. It’s not visually showing you the schedule of the hours of what your day will look like. And what we find is that a lot of students, they know — “Oh, I’ve got math and reading and science tonight”, but what they’re not picturing is that block of time. “So I leave school at 3, I should be home by 3:30, I am home from 3:30 to 4:15, that’s the time to do a little homework. From 4:15, I leave to get to soccer, I’m at soccer from 4:30 to 5:30, maybe we’ll go out for pizza afterwards, I should be home by 6, I need to shower, that gives me from 7-8 to wrap up a little bit of homework.” We’re expecting kids to figure that out and visualize that and yet, it’s not taught in school.
So one of the most effective things that you can do as a parent is create a visual schedule with those 15-minute blocks of time. From, let’s say, 3:00-3:15, 3:15-3:30, 3:30-4:00 and what I recommend because hey, I’m a busy mom, I don’t have a time to do a schedule for my child, so what I recommend is: Make a copy of 7 days and fill out what is your child’s usual schedule. School, after school blocks and then maybe practices. But only put the usual things on it. Then what you can do is you can take that schedule and you can put it in a plastic sleeve protector. It becomes a write on/wipe off surface with a dry erase marker. The coolest thing about that is, then you can show your child without having to copiously rework it every morning, “Hey, it’s Monday, this is what our Monday looks like. You have school, you’re home for an hour, then we leave for soccer practice, then you’re home and you have this block of time, then there’s a nice two-hour block of time of free time.” Except, if it’s in a dry-erase marker, you can then, say, show them what their Tuesday looks like and say, “But actually, today is different. You have a dentist appointment today, so I’m going to pick you up at school at 3, you’re not going to take the bus home and you can go ahead and shade in on top of the usual schedule, I’m going to pick you up from school, we’ll drive to the dentist and then you’ll be home. So today looks the same, but different.”
But starting as early as fifth grade, you really want students to begin to visually see blocks of daily time because we don’t teach that in school and they’re not going to get it, and then all of a sudden, we expect them to go off to college and to visually see and manage a schedule. So I think that’s a critical early time management tool to teach.
Dr. Nicole Beurkens:
I find that these strategies that you’re talking about right now are just such game-changers, not only for me with my own child who tends to struggle with these things, but also just for so many kids we see at the clinic — that idea, taking this abstract concept of time and making it tangible and visual so they can see that and whether you’re using — I love the example of the clock that you can just use a dry erase marker and write on the face, or I know that they make visual timers and things now, whatever tool you’re using, that just is a powerful strategy that I really encourage you if you are listening and you have a child who struggles with this — because we see so many kids at our clinic who have gotten through all the higher level maths that they’re required to do at the high school level for graduation — they’ve gotten through algebra one and two, geometry, precalculus, and they lack a basic awareness and sense of time and how long 20 minutes is. And if you say to them, “It takes you 30 minutes to get to work, what time do you need to leave in order to get there in time?” And they really struggle with the basics of that, that’s right! So I think these are game-changers, the idea of starting to use the planner and not just the agenda that the school gives, but actually blocking that out and I find that as kids get older and more familiar with that, they can take on more responsibility for mapping that out themselves, right?
Sarah Ward:
Absolutely. And then, you can eventually shift it to something like a Google calendar. But the reason why you and I are proficient with Google calendar is because we had the experience of writing on paper and blocking out our schedule. And two things that are sort of our favorite phrases: We love to teach our middle and high school students a phrase called “the go’s withs” and “the maybes” and what we really teach kids is, “Okay, so yes, you’re going to soccer practice, but what goes with that is planning that block of time to get dressed and to drive to the field and to actually be dressed and prepared by the time practice starts. Maybe there will be traffic on the way.” Because a lot of our kids think, “Oh, I just have soccer at 3 and I have my tutor appointment at 6.” They’re not thinking ahead of “Oh, and what goes with that is we have to drive and maybe afterwards, yes it ends at 7, but maybe mom will talk with the tutor for a little bit.” So they don’t incorporate that to really visualize their day.
I think the other thing that is sort of an important strategy that parents can really be thinking about is, if you do shade on the clock when a child is doing homework, it does help them to regulate, because they can be creating what we call time markers. And this idea of a time a marker is, “Okay, if I’m reading 10 pages and I’m answering two comprehensions and I’ve blocked a half hour, then around — let’s say if I’m working from 6:00 to 6:30, then around 6:15, I should probably be within the range of about five pages read and have answered about one question. And so when students set that little sort of midpoint goal, they suddenly have the ability to self check-in and say, “Well, gee, am I on track to complete this within time?” And if I’m off-track, then why am I off-track? Do I have any —” what we call time-robbers, “What’s kind of stealing my time?” And again, sort of looping it back together, big picture, remember that this is a time and space skill. We’re always imagining in what space, where will I be at what time and what will I look like? So, if you’ve shaded on a clock, and I can say, oh, okay, I know that by this mark in time, I want to be dressed, or this mark in time, I need to have this number of problems done.
But there is a similar strategy that you can be using verbally with your students to help with following directions. So, typically, I think we say to kids, “Oh, it’s time for dance practice. Go upstairs, get your leotard, put on your tights and braid your hair. Go upstairs, come on, we’ve got to get upstairs, let’s go, let’s go!” The problem is, when I’m the parent and I say, “Go upstairs, get dressed”, I’m actually the one that’s holding that visual plan and the movement through space. So our recommendation in a practical strategy is instead, stop the child at the bottom of the stairs and say, “Okay, it’s time for dance practice. When you go upstairs, point, use your hand and show me what’s your plan when you get up there?” And you want that child to say, “Well, I’m going to go into the bathroom” and point to the bathroom, “and I’m going to braid my hair. And then I’m going to go into my bedroom, and I have to get my leotard and I have to get my stockings. And then I’m going to come back downstairs.” Because when they are at the bottom of the stairs or they’re at the end of the hallway and they’re pointing out their plan, what they’re really doing is seeing that spatial-temporal plan of, “I’m in this space, the kitchen, but what do I see myself looking like in the bathroom?” So you’re really fostering the development of that skill. So instead of saying, “Put your homework in your backpack and don’t forget to turn it in tomorrow”, instead, say to the student, “When you get to school tomorrow, tell me where you are and what time do you see handing that in?” So that the student can think, “Okay, well let’s see, you’re going to drop me off at 9, I have chemistry first, this is due in English, so I would be handing it in around 11:30”, so that they’re really starting to plan that future. And it’s just a simple change your language that has a huge impact to develop this future-planning skill.
Dr. Nicole Beurkens:
I love that because then they’re not just continually dependent on our frontal lobe and executive function skills, they’re developing them for themselves and creating that mental map, that preview that helps them with that, that’s so powerful.
Sarah Ward:
I had a really nice experience, an interesting experience. I gave a presentation last weekend and it was to the Greater Phoenix Autism Society, and this adult woman came up to me and she said, “Oh my goodness, this is such a profound game-changer.” She said, “Let me tell you why. I am late for everything and it makes my family crazy. And I’m actually really good at making to-do lists and tasks. And she said, what I will do, is I’ll make a list and I’ll have all the tasks that I need to do. It will say things like “Make the lunches, make sure to take out the trash, pick up the book off of my desk, and I’ve got to then go get gas” and all these things, and she said, “But all I do is see it as a list of the things — I never took that task and imagined myself moving through the house and moving through the space and where I was going to complete that task so it never existed as an amount of time. I now see that I can’t just look at ‘take out the trash’ as a list of words, to-do list, check trash’, I now have to think, I’ve got to pull it out of the can, I then have got to take it, I’ve got to wrap it up, I’ve got to go down the stairs, open up the garage, put into the trash can, drag the trashcan out to the end of the road, then I’ve got to come back in, close the garage, come back upstairs, I’ve got to take a new bag and put it into the trash can.” She goes, “I never saw myself moving through those steps, I now see I have to envision that to be realistic about the amount of time something will take.” And I thought that was really fascinating. And she has just lived a life as an adult with ADHD, really struggling. So it’s a life skill that we need to teach our kids and that we have to own.
Dr. Nicole Beurkens:
Absolutely, and I know that you have created a lot of really valuable resources. I mean, you’ve got a website with lots of great information, but you’ve got some great resources that you and your partner have created, like I know we use your planner quite a bit here at the clinic, can you talk a little bit about some of the things that you have available and also where people can find those and learn more about what you’re doing?
Sarah Ward:
Absolutely. So our website, pretty easy to remember, it’s efpractice.com. We’ve created a whole number of products. Some of our products are actually for classrooms and for teachers to utilize. I think the critical thing for teachers to understand is this is not a skill that’s exclusive to, say, just students with ADHD or autism. All children are developmentally learning to utilize their executive skills. So we find that there are powerful ways just within the context of the classroom, and using your existing curriculums to foster the development of these executive skills. So we have tools for teachers, we have lots of tools designed specifically for teaching time management.
We have an entire program called “The Time Tracker Program” where we teach kids to utilize analog clocks, to visualize and we create markers on the clocks using magnets so they can visualize where they need to be at a point in space and time and then we have tools for teaching daily time. So we have academic planners, we have a planner for elementary students and adults because our adults liked our planners so much, we tweaked it and got rid of the homework and added it for adults. And one of the coolest things we have is something called a Walk Through Time Banner. It is a giant — I think it’s 20-feet long and it’s a giant schedule. We roll it out on the floor and we literally have kids walk through their day to physically feel how time is going to fill up and how time will pass. It’s powerful, when you see a student do that, we say, “Is that how you thought your day was going to feel?” They’re like, “No, I had no idea.” and they either realize, “I have way more time than I expected!” Or, “Wow, I don’t have a lot of time and I’m going to have to plan my time efficiently.”
So those are tools that I think parents can access, as well as teachers, and last but not least, we have a lot of tools for just teaching students how to break down tasks. We teach that you plan backwards to execute forwards, so that that students really learn this idea of what will the task look like when I’m done? What do I need to make it look like that, and then, what are the materials that I’ll need? So that they’re planning efficiently. And I’ll end with that by saying, I think one of the hardest things is, if you are a parent and you get a child and they get their homework out, and then all of a sudden, mid doing the homework, the child is struggling and you enter as a parent and you say, “Well, did the teacher give you a study guide?” Or “Did the teacher give you a resource?” Or “Do you have anything in your notes?” The problem is, at that point, the child’s already frustrated. At this point, the child is already melting down and, “I don’t know! It’s fine! I don’t know what to do! I’ve got to do all these!” There is this real angst for the child, whether they give up, or whether they just feel that they have to persist. So we really talk about how important it is to start that planning before the child does the homework. So the idea of “Alright, what will the homework look like when I’m done? I’ve completed this worksheet on my algebra.” Alright, what do you need to do? “Well, I need to use this particular formula for the order of operations.” Alright, well let’s get ready. What tools and materials do you have to do that? Did your teacher give you a resource? A list of how to do it? Do you have anything in your notes? And we get the student to really lay all those materials out before they get started. And what we find is when you do that, then you really smooth the waters and you reduce that sort of mid-homework meltdown where it’s hard to intervene as a parent.
Dr. Nicole Beurkens:
Yeah, absolutely, it’s a proactive approach as opposed to a reactive approach as opposed to a reactive approach and it makes all the difference for their emotional and behavioral regulation too.
Sarah Ward:
Absolutely.
Dr. Nicole Beurkens:
So many great resources that you have. I really encourage people to check those out and I think what’s really powerful about this is for those of use who just get this stuff, inherently and didn’t grow up with these challenges, it’s hard to imagine that a person isn’t able to think through things in this way, and yet, what you’re doing is really helping us to understand more how we do this and how we naturally break it down so that we can understand where those challenges are happening for our kids, to be able to guide them through it. Such powerful information. Sarah, I really can’t thank you enough for being here today, this was wonderful!
Sarah Ward:
Thanks for the invite, I had a lot of fun! Happy to connect!
Dr. Nicole Beurkens:
Alright everybody, thanks for being here with us on this episode, we’ll see you next time on The Better Behavior Show!