Monday, November 25, 2013

A Quick Look at Barkley's Theory of Executive Functions

Here is a post for theory lovers.
Psychologist Russell Barkley's new book, Executive Functions (Guilford Press, 2013), contains a large-scale theory of executive function and self-regulation skills. 
He begins the book by arguing that we do not have a clear picture of what executive function is. Next he uses logical reasoning and a method derived from the work of evolutionary biologist, Richard Dawkins'(The Selfish Gene) to create a model of executive functioning consisting of five distinct layers or levels that we move through as we develop and mature. Finally, he describes each layer, how it works, what can go wrong and what types of interventions are helpful. The material in this last section rests firmly on the advances of neuropsychological research. Before he has concluded the book, he claims that executive function and self-regulation are equivalent and further claims that ADHD is the chief disorder of executive function.  
Here are the five levels:
 1. Pre-EF underlies true executive function (EF) in the brain. This is our raw sensing, attention /awareness, motor, emotions, language and our automated responses. We may respond to what we feel, see and hear but do not exert anything but primitive control over our reactions.
 2. Self-directed EF is the first level of true EF. With this level's set of skills we create our first set of reactions to what is happening within us and around us. These reactions are directed inward rather than outward to others. This level allows us to regulate our response to our body, emotions and environmental input (via our senses). The functions are:  Self-awareness, self-restraint (inhibition), sensory-motor actions, private speech or self-talk, appraisal including calculating the emotional cost of an action, play, reconstitution of memories and thoughts, and problem-solving.
Here is an example: if I am confused and don’t want anyone to know, I will work to keep my face from showing confusion. To the degree that I keep my body still and hide my emotions, no one is privy to what I am feeling.
3. Self-reliant EF gives us the self-management skills necessary to be independent with activities of daily living (ADLS) such as dressing, preparing food, eating and so on. Barkley compares the person operating at this level to Robinson Crusoe who was able to manage his life on his own without social support. However, at this level, we may find ourselves occasionally competing for resources. People operating at this level are performing in a social context, but it is “everyone for themselves.” A child at this level will be competing for toys or play-space during parallel play, or competing with a sibling for a parent’s affection.
 4. Tactical-reciprocal EF: At this level, we use social relationships to achieve our goals. We learn to share and we provide mutual help to friends. We learn what it means to be a friend, and we begin to act accordingly. We begin to regulate our actions, emotions, sensory behaviors, and social behaviors for the purpose of successfully interacting with others. For the first time, moral rules come into play.
5. Strategic-cooperative EF is more an extension of tactical-reciprocal EF than a set of new functions. At this level, our actions have a larger scope. We may make career decisions, volunteer to help with a community project, get involved with political activities, or organize a large group for a united goal. The concerns of this level are adult-oriented, but an older teen can begin to work through issues that involve strategic-cooperative EF skills.
Knowing these five levels of executive function can guide those of us who work with children and young adults with ADHD. It helps us select interventions that are appropriate to their EF development level as opposed to their age level. In this way, we can help them move from where they are stuck into the next level of their growth.




Nurtured Heart Approach

When I mentioned Howard Glasser's work, The Nurtured Heart Approach during one of my seminars as an example of a program for developing positive parenting/teaching/therapy skills, someone in the back asked, ‘Is that back in style again?’

The question caught me by surprise. Things go in and out of fashion, it’s true. But this method seems to have a great deal of relevance today: 

     “Parenting skills training helps parents learn how to use a system of rewards and consequences to change a child's behavior.Parents are taught to give immediate and positive feedback for behaviors they want to encourage, and ignore or redirect behaviors they want to discourage.”

 There are other “flavors” of positive interaction programs including Love and Logic and Positive-Parenting. It is the simplicity of the Nurtured Heart Approach that draws me to it.

 Glasser’s three big lessons are:

1)      Do not feed a child’s negative impulses with attention to him when he is acting-out
       2)      Give tons of positive attention to the child at times when he is not acting out
3)      Absolutely follow through with consequences when a rule is broken rule so that there is no confusion regarding what is okay and what is not okay.

 A 6-hour internet-based training class (for CEUs) is available from Glasser that very clearly describes his philosophy and shows how his techniques can help the challenging children and adults in your life.  

Sunday, November 3, 2013

The Book is Written

It is great to be back writing the blog again. My book, Self-Regulation Strategies and interventions, is written and edited. The publisher, Premier Publishing, is prettying-up the graphics and laying out the book. They haven't given me a release date, but I believe it will be late December or early January. 

Content is similar to the topics I cover in this blog and in my PESI course, Self-Regulation in Children -- but with much more theory and a ton more interventions than I have time for in my class. I'll announce the publication date when I get it.