Unstuck and On Target!

An Executive Function Curriculum to Improve Flexibility, Planning, and Organization

Second Edition

by

Lynn Cannon, M.Ed.

The Ivymount School The Maddux School Rockville, Maryland

Lauren Kenworthy, Ph.D.

George Washington University School of Medicine Children’s National Health System Washington, D.C.

Katie C. Alexander, OTD, OTR/L

The Occupational Therapy Institute La Mesa, California

Monica Adler Werner, M.A.

The Ivymount School Rockville, Maryland

and

Laura Gutermuth Anthony, Ph.D.

University of Colorado School of Medicine Children’s Hospital Colorado Aurora, Colorado

Contents

Unstuck Fast Facts ... inside front cover About the Online Materials ... ix About the Authors ... xi Foreword John Elder Robison ... xiii Acknowledgments ... xvii Introduction ... 1 Reinforcement System ... 13 Icon Glossary ... 17 Script Practice Throughout the Manual ... 19

Topic 1 Foundational Skills ... 23

Lesson 1 Get to Know You ... 25 Introduction ... 26 Activity 1: Code of Conduct ... 28 Activity 2: Who Knows Whom? ... 30 Handout: All About Me! ... 31 Closing ... 32 Classroom Practice 1 ... 34 Home Practice 1 ... 37 Lesson 2 Introduction to Goal, Why, Plan, Do, Check ... 39 Introduction ... 40 Activity 1: Introduction to GWPDC ... 42 Activity 2: Wacky GWPDC ... 44 Handout: Wacky GWPDC ... 45 Closing ... 46 Classroom Practice 2 ... 47 Home Practice 2 ... 48 Lesson 3 Emotional Identification ... 49 Introduction ... 50 Activity 1: Feelings Target ... 52 Visual: Feelings Target ... 53 Materials: Feelings Target Cards ... 54 Activity 2: How Does It Make Me Feel? ... 55 Activity 3: Feelings Chain ... 56 Visual: Feelings Chain Scenarios ... 59 Handout: Feelings Chain Blank ... 60 Closing ... 62 Classroom Practice 3 ... 63 Home Practice 3 ... 64 Lesson 4 What Can You Do to Feel Better? ... 65 Introduction ... 66 Activity 1: Disappointment and Coping ... 68 Handout: Disappointment and Coping ... 69 Activity 2: Coping Skills Investigation ... 70 Handout: How to Feel Just-Right ... 71 Handout: Just-Right Strategies Investigation ... 72 Handout: My Mission to Get Back to Just-Right ... 73 Handout: Deep Breathing ... 74 Activity 3: Strategy Cards ... 75 Handout: Strategy Card Examples ... 76 Additional Activity: Coping Choices ... 77 Closing ... 79

Topic 2 What Is Flexibility? ... 83

Lesson 5 Flexibility Investigation ... 84 Introduction ... 85 Activity 1: Flexible vs. Rigid Scavenger Hunt ... 86 Activity 2: Flexible Is Faster (and More Efficient) ... 87 Closing ... 88 Classroom Practice 5 ... 89 Home Practice 5 ... 90 Lesson 6 Flexibility ... 91 Introduction ... 92 Activity 1: Mystery Word—Flexibility ... 93 Handout: Mystery Word 1 ... 94 Educator Guide: Mystery Word 1 Key ... 95 Handout: Unstuck and On Target! Dictionary—Flexible ... 96 Activity 2: As Flexible as Putty ... 97 Handout: Flexible Fun ... 99 Handout: Fun Putty Recipe ... 100 Closing ... 101 Classroom Practice 6 ... 102 Home Practice 6 ... 103 Lesson 7 Getting Stuck ... 104 Introduction ... 105 Activity 1: Mystery Word—Stuck ... 106 Handout: Mystery Word 2 ... 107 Educator Guide: Mystery Word 2 Key ... 108 Handout: Unstuck and On Target! Dictionary—Stuck ... 109 Activity 2: Flexible/Stuck Role Play ... 110 Closing ... 111 Classroom Practice 7 ... 112 Home Practice 7 ... 113

Topic 3 How to Be Flexible ... 115

Lesson 8 Plan A → Plan B ... 117 Introduction ... 118 Activity 1: Mystery Words—Plan A → Plan B ... 119 Handout: Mystery Word 3 ... 120 Educator Guide: Mystery Word 3 Key ... 121 Handout: Unstuck and On Target! Dictionary—Plan A → Plan B ... 122 Activity 2: Speed B ... 123 Activity 3: Build a Plan A, B, C ... 124 Handout: Build a Plan A, B, C ... 125 Closing ... 126 Classroom Practice 8 ... 127 Home Practice 8 ... 128 Lesson 9 Compromise ... 129 Introduction ... 130 Activity 1: Mystery Word—Compromise ... 131 Handout: Mystery Word 4 ... 132 Educator Guide: Mystery Word 4 Key ... 133 Handout: Unstuck and On Target! Dictionary—Compromise ... 134 Activity 2: Compromise Game ... 135 Materials: Compromise Game Cards ... 137 Closing ... 138

Topic 4 Why Be Flexible? ... 181

Lesson 13 The Advantages of Being Flexible ... 182 Introduction ... 183 Activity 1: What to Do When What I Want Is Impossible ... 184 Educator Script: My Two Choices ... 186 Visual: Group Flexibility Chant ... 187 Activity 2: Flexibility Freeway Game ... 188 Educator Guide: Flexibility Freeway Game Rules ... 189

Topic 5 Your Goals: Getting What You Want ... 213

Lesson 15 Setting and Achieving Goals Using GWPDC ... 214 Introduction ... 215 Activity 1: Think Pink—GWPDC ... 216 Handout: Think Pink—GWPDC ... 217 Closing ... 218

Topic 6 Flexible/Goal-Directed Futures ... 259

Lesson 21 Interview (& Optional Game) ... 260 Introduction ... 261 Activity 1: Talk Show ... 262 Handout: Flexible Futures ... 263 Additional Activity: Four Corners ... 265 Educator Script: Four Corners Questions & Answer Key ... 266 Closing ... 267 Handout: Graduation Certificate ... 268

Appendix ... 273

Index ... 281

Introduction

GOAL OF THIS MANUAL

Unstuck and On Target! is a plan of action for teaching students how to be more flexible, planful, and goal directed. The goal of this intervention is twofold:

1. To increase the cognitive flexibility, organization, and planning abilities of students with executive dysfunction so that they can more easily shift from topic to topic, task to task, and person to person; consider new ideas, alternative beliefs, or another person’s point of view; and work independently on multistep tasks in the classroom and beyond.
2. To provide the intervention in a way that works in the classroom and ultimately creates more time for the teacher to focus on teaching and less time managing behavior.

WHO WILL BENEFIT FROM THIS INTERVENTION?

Unstuck and On Target! is designed for 8- to 11-year-old students who have difficulties with flexibility, organization, and planning. Specifically, school-age children who may have autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), anxiety, or other related problems, who also have average IQ and at least a second-grade language and reading level.

WHO SHOULD PROVIDE THIS INTERVENTION?

Unstuck and On Target! is designed for use in a small, school-based weekly group of students led by a professional (teacher, psychologist, social worker, speech-language therapist, occupational therapist, counselor, or highly trained teaching assistant). Those implementing this curriculum should have basic skills in working with students with special needs, including an understanding of positive reinforcement techniques, and should read the entire manual before beginning the curriculum. Unstuck and On Target! has also been successfully used by clinicians and parents in small group or individual sessions.

GUIDE TO THE LESSON PLANS

This manual includes 21 lessons, which are divided among six topics.

Topics

Each topic begins with an overview page that summarizes the topic, expected outcomes, and background on the rationale for the topic. The information on this page covers the material for all of the lessons included in that topic. Each topic includes a progress report. This is designed to help monitor student progress throughout the curriculum and communicate progress with parents and caregivers.

Lessons

Each lesson plan has the same structure and includes:

• A statement of the purpose of the lesson
• A list of required materials
• Suggestions for modifications
• Descriptions of each activity
• Handouts Every lesson has a standard opening and closing routine. The lesson is introduced to the students in a Goal, Why, Plan, Do, Check (GWPDC) format in order to reinforce a key script taught in Unstuck and On Target! for completing any multi-step task. Each lesson also begins with a summary of the previous lesson (i.e., Lightning Round), highlighting the vocabulary students have learned. Each lesson ends with the review and completion of the GWPDC. It is critical that you completely understand the lessons before beginning them with the students. Read through the entire topic before beginning instruction in order to gain a full understanding of the skills being taught and how the lessons fit together, as well as prepare and gather materials.

Home and Classroom Practice

Each lesson includes a Home Practice handout (available in English and in Spanish) and a Classroom Practice handout. The goal of these handouts is to:

• Provide additional practice opportunities
• Share key scripts, vocabulary, and concepts with families and classroom teachers
• Promote generalization across settings by encouraging families and classroom teachers to use similar language and practice concepts at home and in the classroom. The students will benefit from going over their Home Practice handout before they take it home. To promote generalization you are encouraged to share the Classroom Practice handout with school personnel who interact with your students.

OVERVIEW OF Unstuck and On Target!

The Unstuck and On Target! curriculum has the following major goals:

• Teaches what flexibility is through concrete, hands-on experiments with physical and cognitive flexibility, and a specific vocabulary (e.g., flexibility, Plan A → Plan B, stuck), which is then used consistently throughout the intervention.
• Explains why it is important to be flexible. The curriculum provides explicit instruction to students on the benefits of being flexible (e.g., it gives them more choices, it helps them become a better friend).
• Teaches students how to be flexible by emphasizing routines and self-regulatory scripts that are continuously practiced and reinforced until they are automatic.
• Teaches what goals are and how to achieve them. The curriculum contains lessons to help students focus on what their goals are and distinguish major or target goals (e.g., getting good grades, making a friend) from distractors.
• Teaches a routine and script for setting a goal and completing any type of multiple step activity, project, or assignment. GWPDC is a universal strategy that improves executive functioning, efficacy, and independent work habits for a variety of tasks. It promotes goal-directed behavior, sustained effort, problem solving, self-monitoring, and flexibility. It is such a critical strategy that we use it as the framework for every lesson and embed it in activities as often as possible.
• Teaches students how to cope when being flexible and using goal-directed behavior is hard. Positive reinforcement and humor are embedded throughout the curriculum, as they both have magical powers for shaping the behavior of students. The curriculum also teaches coping strategies for those times when being flexible is especially hard.

What Is Executive Function?

Executive function is a set of brain-based abilities that help people control their behavior (e.g., stay seated at desk) and reach their goals (e.g., finish something with multiple steps, like getting ready for school). There are many different brain-based abilities that make up executive function, including:

• Initiation (getting started on something quickly and easily)
• Inhibition (impulse control, “putting on the brakes,” and “thinking before acting”)
• Flexibility (shifting from one activity or idea to another, accepting a different way of seeing or doing things)
• Working memory (keeping information in mind while performing a task, e.g., remembering directions someone told you while you drive to your destination)
• Organization (keeping track of materials, understanding what the main point is, seeing the big picture, and knowing what is top priority at any given time)
• Planning (developing, carrying out, and modifying a plan of action, e.g., science fair project)
• Self-monitoring (tracking your performance, e.g., “How am I doing?,” “Am I doing what I am supposed to be doing?”) This curriculum focuses specifically on four aspects of executive functioning: flexibility, organization, planning, and monitoring skills.

What Is Flexibility?

Students who have biologically based rigidity and inflexibility can have difficulty with the following:

• Making transitions
• Tolerating changes and unexpected events
• Responding to feedback
• Coming up with new ways to approach a problem
• Accepting flexible interpretations of rules or events
• Managing an intense emotional feeling
• Responding to the needs or interests of friends
• Negotiating with others
• Accepting differing viewpoints In general, flexibility skills are essential for school and social success, and are a primary focus of this curriculum. Sometimes, however, inflexibility is adaptive. For example, most of us have a morning routine that we more or less follow when getting ready to leave the house. This prevents us from leaving the house before realizing we forgot to brush our teeth. Some- times inflexibility is essential for students with executive functioning problems, who can be easily overwhelmed in social, group, and novel situations. Once overwhelmed, children with executive function difficulties get more anxious, impulsive, or otherwise behave inappropriately. The risks they run at such times are profound, given the social isolation, teasing, and bullying they can experience at the hands of peers and even adults.

What Is Planning and Organization?

Students who have biologically based problems with planning and organization can have difficulty with the following:

• Setting realistic goals
• Predicting how long something will take
• Following a series of steps to reach a goal
• Integrating information into a unified understanding
• Showing what they know in a timely manner without undue effort
• Understanding that completing homework today will be important for getting a good grade in the future
• Turning in work that has been completed
• Getting started on a multiple step project
• Following directions in class (especially when they aren’t written down)
• Knowing what steps and materials are needed to complete a project
• Drawing inferences This curriculum shows you how to teach key organizational and planning skills and routines, like goal setting. In addition, just like with flexibility, students also need specific accommo- dations for these problems. Just as the inflexible student needs to be warned when a change will occur, the disorganized student needs an extra visual reminder in the classroom to turn homework in. Increased communication with parents to help them organize their children at home is also often needed (e.g., an email letting a parent know when a student has not brought homework to school). Breaking a big task down into a series of smaller steps and checking in with the student after each step is completed is another important accommodation for most students with organization/planning problems.

PREREQUISITES FOR SUCCESSFUL IMPLEMENTATION OF Unstuck and On Target!

This curriculum will teach kids like Michael the skills that made Lorraine so successful on her assignment, but specific supports have to be in place before Michael will be able to learn new skills. Next, we describe basic supports that should be in place within the school, classroom,

A Flexible and Supportive School Team Students learn best when there is a good fit between their brain-based abilities and the environmental and task demands of school. When this doesn’t occur naturally, there are two possible solutions:

1. The student learns new skills and adapts to the environment. The Unstuck and On Target! curriculum is designed to teach students new flexibility, goal setting, and organization skills to help them learn both in the classroom and in other environments.
2. The environment may need to be modified so that students have a better fit. Young children with executive dysfunction will benefit from predictability, structure, and support in their environments, all of which the Unstuck and On Target! curriculum teaching methodology can help refine.

For students with executive function challenges, problems with flexibility and goal-directed behavior can be a major obstacle to success. With this enhanced second edition of this popular curriculum—now in a new format that’s optimized for both in-person and virtual instruction—you’ll have everything you need to explicitly teach executive function skills in today’s educational
environment.
A highly effective intervention for students ages 8–11, Unstuck & On Target! gives you 21 ready-to-use, field-tested lessons that boost critical skills like cognitive flexibility, problem solving, coping, and goal setting. Ideal for use with learners with autism, ADHD, and other challenges that affect executive function.