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.

Contents

• About the Reproducible Materials ... ix
• About the Authors ... xi
• Foreword *Brenda Smith Myles ... *xv
• Acknowledgments ... xvii

Introduction and How to Use This Manual ... 1

• For Whom Is This Book Written? ... 2
• How to Use This Manual ... 2
• Making Unstuck and On Target! a Way of Life ... 4

1 What Is Executive Function, How Is It Impaired in Autism Spectrum Disorder, and Two Ways to Help ... 5

• What Is Executive Function? ... 5
• How Is Executive Function Impaired in Autism Spectrum Disorder? ... 6
• Two Ways to Help: Change the Environment and Teach New Skills ... 13

2 Overview of the Unstuck and on Target! Intervention ... 17

• Three Executive Function Skills ... 17
• How Do You Make It Happen? Four Teaching Methods ... 18

3 Unstuck: Teaching a Child to Be Flexible ... 25

• What Is Cognitive Flexibility, and Why Is Being Flexible Important? ... 25
• What Are the Key Words and Scripts or Phrases? ... 26
• Teach by Doing: How to Model Being Flexible/Unstuck ... 33
• How to Make It Fun ... 38
• Key Visual and Technological Supports ... 40

4 On Target: Planning to Achieve Your Goals ... 43

• What Are Goal Setting and Planning, and Why Are They Important? ... 43
• What Are the Key Words and Scripts or Phrases? ... 44
• Teach by Doing: How to Model Goal, Plan, Do, Check ... 47
• How to Make It Fun ... 55
• Key Visual and Technological Supports ... 55

5 Target Goal ... 61

• What Is a Target Goal, and Why Is It Important? ... 61
• What Are the Key Words and Scripts or Phrases? ... 63
• Teach by Doing: How to Model Staying on Target ... 65
• How to Make It Fun ... 67
• Key Visual and Technological Supports ... 69

6 Troubleshooting: Changing the Environment to Solve Everyday Problems ... 77

• Why Keep It Positive ... 77
• How to Keep It Positive ... 78
• Why Avoid Overload? ... 87
• How to Avoid Overload ... 88
• Why Break Things Down (When This Child Is So Smart)? ... 93
• How to Break Things Down and Help a Child Build up to Mastering New Skills ... 97
• Why Talk Less, Write More (When This Child Has a Bigger Vocabulary than I do)? ... 99
• How to Talk Less, Write More ... 100
• Why Should I Take Care of Myself (When It’s My Child Who Is Having Difficulty)? ... 103
• How to Take Care of Yourself ... 104
• Why Have Coping Strategies Ready? ... 107
• How to Have Coping Strategies Ready ... 107
• Why Think “Can’t, Not Won’t”? ... 114

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.

Laura Gutermuth Anthony, Ph.D., is a clinical and developmental psychologist and the associate director of the Center for Autism Spectrum Disorders.

Katie C. Alexander, M.S., OTR, is an occupational therapist and served as the founding program director for the Model Asperger Program.

Monica Adler Werner, M.A., is the director of the Model Asperger Program at The Ivymount School.

Lynn Cannon, M.Ed., is the social learning coordinator at The Ivymount School.

Lisa Greenman, J.D., is an attorney specializing in issues relating to developmental disability and mental illness.

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. 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: Set and work toward target goals on a daily basis (e.g., to be a good parent or teacher, to make it to work on time).
• Whims: Constantly presented with whims that may or may not be in conflict with your target goal.

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.