phb-kenworthy-all.indb

Solving Executive Function Challenges

Simple Ways to Get Kids with Autism Unstuck and on Target

by

Lauren Kenworthy, Ph.D.
Children’s National Medical Center
Washington, D.C.

Laura Gutermuth Anthony, Ph.D.
Children’s National Medical Center
Washington, D.C.

Katie C. Alexander, M.S., OTR
The Ivymount School
Rockville, Maryland

Monica Adler Werner, M.A.
The Ivymount School
Rockville, Maryland

Lynn M. Cannon, M.Ed.
The Ivymount School
Rockville, Maryland

and

Lisa Greenman, J.D.
Baltimore • London • Sydney

Excerpted from Solving Executive Function Challenges: Simple Ways to Get Kids with Autism Unstuck and on Target by Lauren Kenworthy, Ph.D.; Laura Gutermuth Anthony, Ph.D.; Katie C. Alexander, M.S., OTR; Monica Adler Werner, M.A.; Lynn Cannon, M.Ed.; & Lisa Greenman, J.D.
Brookes Publishing | www.brookespublishing.com | 1-800-638-3775 © 2014 | All rights reserved

Contents

Introduction and How to Use This Manual

1 What Is Executive Function, How Is It Impaired in Autism Spectrum Disorder, and Two Ways to Help

2 Overview of the Unstuck and on Target! Intervention

3 Unstuck: Teaching a Child to Be Flexible

4 On Target: Planning to Achieve Your Goals

5 Target Goal

6 Troubleshooting: Changing the Environment to Solve Everyday Problems

Endnotes

Appendix A: Sample Goal, Plan, Do, Checks

Appendix B: Sample Individualized Education Program Goals and Accommodations that Address Executive Dysfunction

Index

About the Authors

Lauren Kenworthy, Ph.D., is the director of the Center for Autism Spectrum Disorders at Children’s National Medical Center and is an associate professor of psychiatry, pediatrics, and neurology at The George Washington University Medical School. She has specialized in the neuropsychological assessment of children with social learning disorders and executive dysfunction since 1995. Dr. Kenworthy has published more than 40 peer-reviewed papers investigating autism and executive function and developed the most widely used assessment tool in the field, the Behavior Rating Inventory of Executive Function (BRIEF; with Gioia, Isquith, & Guy; Psychological Assessment Resources, 2000). She is a coauthor of Unstuck and On Target! An Executive Function Curriculum to Improve Flexibility for Children with Autism Spectrum Disorders, Research Edition (Paul H. Brookes Publishing Co., 2011).

Laura Gutermuth Anthony, Ph.D., is a clinical and developmental psychologist and the associate director of the Center for Autism Spectrum Disorders at Children’s National Medical Center and an associate professor in the Departments of Psychiatry and Behavioral Sciences and Pediatrics at Children’s National Medical Center (CNMC) in The George Washington University School of Medicine and Health Sciences. She leads the intervention program at the Center for Autism Spectrum Disorders, an interdisciplinary evaluation, treatment, research, and training clinic. Dr. Anthony has expertise in developing clinical interventions and extensive experience in studying and treating behavioral rigidities (executive dysfunction) and stereotyped behaviors in children with developmental disorders.

Katie C. Alexander, M.S., OTR, is an occupational therapist and served as the founding program director for the Model Asperger Program (MAP) at The Ivymount School. She has specialized in serving individuals with autism spectrum disorder (ASD), their families, and the professionals who support them since 2000.

Monica Adler Werner, M.A., is the director of the Model Asperger Program (MAP) at The Ivymount School. In that capacity, she has spearheaded the development of a social learning curriculum that emphasizes problem solving, self-advocacy, and self-regulation.

Lynn Cannon, M.Ed., is the social learning coordinator at The Ivymount School. She is responsible for helping to develop and oversee the social learning and academic curriculum for the lower, middle, and high school students at The Ivymount School.

Lisa Greenman, J.D., is an attorney in Washington, D.C., specializing in issues relating to developmental disability and mental illness that arise in the defense of death penalty cases.

Target Goal

In this chapter, you will learn to teach how to set priorities, identify distractors, and monitor progress.
The balance between working toward a goal and giving in to whims is a difficult one, because we all like to have fun in the moment.
The skills in this chapter will help those with ASD make conscious choices about when to work toward a goal and when to just have fun.

What Is a Target Goal, and Why Is It Important?
A target goal is something that you want or need to do that is more important than anything else you may want to do at the same time. Children with ASD often have difficulty determining what is most important in a situation. They can easily lose sight of the big picture and become distracted by smaller details.

Tip

Distinguishing Between Target Goals and Whims
Target Goal: You set and work toward target goals on a daily basis (e.g., to be a good parent or teacher or therapist, to make it to work on time).

These goals are overarching in nature, may include multiple steps, and often take a long time to achieve (i.e., work toward some goals— such as being healthy, being a good student, getting a 3.5 grade point average, or maintaining a friendship— must be sustained over many years).
Whims: You are constantly presented with whims that may or may not be in conflict with your target goal (e.g., turning off the alarm clock and going back to sleep when your target goal is to get to work on time).

Whims are defined as distractors that can interfere with reaching a target goal. We often have to choose between target goals and whims. For example, your target goal might be to lose weight. A co-worker is celebrating her birthday and offers you a piece of cake. Your whim (or immediate objective) is to enjoy a piece of cake and celebrate with your friend; this has the potential to derail your target goal of losing weight.

When the child is on target, the dart is heading straight for the bull’s-eye; when he or she is off target, tempted by a distractor or whim, the dart is heading for the edge or off the board.

What Are the Key Words and Scripts or Phrases?

In this chapter, you will continue to use and build on the language you learned in Chapter 4: Goal, Plan, Do, Check. You will learn how to help a child distinguish big, important target goals from smaller, less important whims.
The following new phrases to use are:

Alternative Language for Target and Whim Scripts

Target goal

Whim

Teach by Doing: How to Model Staying on Target

Often, you can point out in yourself when a whim is getting in the way of a target or help a child ignore, postpone, or modify a whim until a target is reached.
The following are examples of modeling these scripts: