The next social challenge to public health: the information environment.pptx
BRS ADHD Workshop
1. www.DrNowell.com Lend Me Your Brain: Practical Strategies for Managing ADD/ADHD, Executive Dysfunction, and Processing Disorders DavidNowellSeminars DavidNowell
33. Central Auditory Processing Disorder CAPD refers to a deficit observed in one or more of the central auditory processes responsible for generating the auditory evoked potentials and the following behaviors: sound localization and lateralization auditory discrimination auditory pattern recognition
34. Central Auditory Processing Disorder - Poor "communicator" (terse, telegraphic). - Memorizes poorly.- Hears better when watching the speaker. - Problems with rapid speech. - Interprets words too literally.
35. Central Auditory Processing Disorder - Often needs remarks repeated. - Difficulty sounding out words.- Confuses similar-sounding words.- Difficulty following directions in a series. - Speech developed late or unclearly.
51. ….and the rest of the criteria Onset before age 7 Impairment in 2 or more settings Significant functional impairment Not better accounted for by another mental disorder
52.
53. Functional impact of core symptoms Arousal / alertness Mental effort Determination of saliency Focal maintenance
54. Functional impact of core symptoms Arousal / alertness Mental effort Determination of saliency Focal maintenance
55. Functional impact of core symptoms Arousal / alertness Mental effort Determination of saliency Focal maintenance
56.
57. Functional impact of core symptoms Arousal / alertness Mental effort Determination of saliency Focal maintenance
58. Functional impact of core symptoms Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
59. Functional impact of core symptoms Satisfaction control Previewing . Inhibition Tempo control Self-monitoring and correcting
60. Functional impact of core symptoms Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
61. Functional impact of core symptoms Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
62. Functional impact of core symptoms Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
63. Subtypes of ADHD ADHD, predominantly inattentive type ADHD, predominantly hyperactive type ADHD, combined type ADHD, Not Otherwise Specifed
64. Subtypes of ADHD ADHD, predominantly inattentive type ADHD, predominantly hyperactive type ADHD, combined type ADHD, Not Otherwise Specifed
65. Common comorbidities with ADHD Learning disorder Behavioral disorder Anxiety Depression Substance abuse Sensory processing and auditory processing challenges
66.
67. Common comorbidities with ADHD Learning disorder Behavioral disorder Anxiety Depression Substance abuse Sensory processing and auditory processing challenges
73. ADHD and women More tasks More diffuse More parental responsibility Less likely to have an “executive” partner Less likely to have assistants at work Less likely to focus on a narrow area More likely to feel shame about disorganization
75. The Executive Functions Internalizing speech Previewing Prioritizing Tempo control Inhibition
76. The Executive Functions Determining salience (what’s in it for me?) Blocking out distractions Self-monitoring and correcting Certain aspects of memory / learning
81. Age-appropriate expectations K – 2nd grade 2-3 step directions Bring papers home 20-30 minute assignments Simple spending decisions Follow rules / inhibit / no grabbing
82. 3rd – 5th Simple shopping list Keep track of personal items Longer homework assignments Simple project planing Keep track of variable daily schedule Save money Inhibit and regulate even w/o teacher present Manners Simple delayed gratification (phone) Age-appropriate expectations
83. 6th – 8th complex chores Babysitting Organizing system Complex schedule Longer term projects Time management Self soothe Manage conflict Age-appropriate expectations
84. Teenage – mid 20s Independent with assignments Make adjustments based on feedback Longer term goal setting Managing leisure time Inhibit reckless behavior Easily walk away from provocation Say “no” to fun activity if other plans already made Take others’ perspective Age-appropriate expectations
114. Time Out Select target behavior Set place Determine how much time Dress rehearsal Measure the time Withdraw attention Establish the cause and effect
115. Token economy Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
126. Preferred States: What Does Dopamine Feel Like? Great experience Kodak moment The feeeeling
127. PREFERRED STATES INVENTORY David D. Nowell, Ph.D. 189 May Street Worcester, Mass. 01602 DrNowell.com www.Lulu.com
128. Identify 20 peak experiences. For each peak experience, identify the highlight moment – the snapshot. Go to the visceral…what was the feeling of that moment? Name it. Check the 20 peak moment-feelings for clusters, groupings. There will probably be 4 or 5. PREFERRED STATES INVENTORY
129. Find a word, a label, for each of the groupings. Check for accuracy (“gut” check). Those are your preferred states, your “values,” ways that you really like to feel. Now you know your motivation…use this knowledge to review your daily activities and planning. PREFERRED STATES INVENTORY
139. The reward-and-planning system Anticipate goal Identify tasks Sequence / problem-solve Block out distractions Get the reward
140. Ways the reward-and-planning system can go wrong Alicia R. Ruelaz, M.D.: “the biggest issue for me, and others I've seen, has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completed.”
141. Ways the reward-and-planning system can go wrong Jacy, a freelance artist from Connecticut,: I get so excited about a new idea, I forget the zeal that I had once felt for an old one. Thus creating my inevitable "idea graveyard.“
142. Ways the reward-and-planning system can go wrong Juzer :“my biggest problem is that I want to do everything all at once!”
143. Ways the reward-and-planning system can go wrong Inna: “I just get blank. I usually start sitting more slouched, hold my head with my left hand, ….you freeze and instead of being able to think of alternatives, you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to you.”
144.
145. Lend Me Your Brain Supporting Clients with Executive Dysfunction
146. Ways the reward-and-planning system can go wrong Hank: “I have things I need to do to improve my marriage, my health and my financial situation, but I honestly believe that I have zero chance of actually making any of those three things actually get better. ”
147. Ways the reward-and-planning system can go wrong Alice, a oach from Long Island: The difference between a dream and a goal is a plan. It is the myriad of steps BETWEEN point A and point B that fail to happen. That is why a coach can be so important to folks with ADHD. A coach can help the person develop a step-by-step plan and help the person decide which steps they can & will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones).
148. Ways the reward-and-planning system can go wrong Anticipate goal (state) Identify tasks Sequence / problem-solve Block out distractions Get the reward
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150. Ways the reward-and-planning system can go wrong Anticipate goal (state) Working memory Insight Alexithymia / emotional intelligence Disconnect from values Diminished options Overly influenced by externals Too busy with current activity Field dependent
151. Ways the reward-and-planning system can go wrong Identify tasks Working memory Intelligence / development Overly conventional thinking Insight Emotional intelligence
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153. Ways the reward-and-planning system can go wrong Identify tasks Working memory Intelligence / development Overly conventional thinking Insight Emotional intelligence
156. Ways the reward-and-planning system can go wrong Sequence / problem-solve Verbal working memory Nonverbal working memory
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158. Ways the reward-and-planning system can go wrong Sequence / problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
161. The best defense against the manipulation of our attention is to determine for ourselves – in advance - how we want to invest it. - E. Goldberg
162.
163. Ways the reward-and-planning system can go wrong Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
175. Self-Talk Proficiency • -“How are you going to know when to be ready?” • -“How are you going to stop yourself from…?” • -“What is your goal?” • -“What do you want it to look like?” • -“How long do you think it will take?””
176. Self-Talk Proficiency • -“How are you going to know what you need?” • -“How are you going to know what is most important?” • -“How are you going to decide what to do first?” • -“How will you know when you are done?”
177. Self-Talk Proficiency • -“How will you continue when you are tired?” • -“How did that work out?” • -“How long do you think that took?” • -“Would you do anything differently?” “Who will be the first person to notice that….”
192. Am I having fun now? Is this what I set out to do?
193. Am I having fun now? Is this what I set out to do?
194. Key Features of Video Games Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish inappropriate behavior – never reverse this
195. Key Features of Video Games Always follow up on rules, no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming focus groups to determine what really “grabs ‘em”
196. Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human BrainVolkow, et al. 2004
225. www.DrNowell.com Lend Me Your Brain: Practical Strategies for Managing ADD/ADHD, Executive Dysfunction, and Processing Disorders DavidNowellSeminars DavidNowell
Notes de l'éditeur
MYSTERY BOXHAVE ST / VP PUT NAMES OF ATTENDEES IN HATAPPENDIX A p. a2: TO DO
What does this have to do w/ my clients?Identify 2 clients w/ whom you can apply + psych tools we’ll review today.EXPLAIN WKSHOP’S PURPOSE, INCREASE SALIENCE, RELATE TO PRIOR K’LEDGEWhat do you already know about executive functioning? Attention, memory, organization? Why are 16 yo drivers less safe? Why do we have legal drinking age? In your own life, where are you most impulsive, and where do you have the best behavioral control? APPENDIX B p. a3: THIS WKSHOP WILL BE A SUCCESS FOR ME IF…“in avoiding what needs to be done, how can I can I start the project early, not the 11th hour?”“…how to make my dtr > I with adls homework etc”
Dx approach
APPENDIX C pa4: ANY TERMS OR WORDS U DON’T UNDERSTAND, JOT ON LIST.WORD WALL
Good news ands bad news: it’s 2009.
Infants: R to loud noise, R to bells or whistles, R to lullabies, R to peek a boo, sound source locationDifferentating among people, R to lights and colors; eye contactManipulating toys, feeding, R to touch, investigating world with hands and mouthPlaying with toes, grasping objects, experimenting w diff. body positionsSitting up, lifting headSitting up, lifting head, kicking, truncal stability
A very high threshold of empirical data has been set for adding a new disorder to DSM-V in order to insure that only diagnostically valid disorders are added to the system. The types of data that would be required include 1) evidence that sensory processing disorder describes a condition that is not adequately covered by an existing DSM-IV disorder; 2) evidence supporting its diagnostic validity; 3) evidence supporting its clinical utility; and 4) evidence supporting that there is a low risk of false positive diagnoses that might result if sensory processing disorder were to be added.
Carlos, 5 yo boy. …. M c/o tantrums, stubborness. Bedtimes difficult. Pushes his sister. Per OT pt performs poorly on measures of sensory modulation, esp tactile. Suggests he is easily overwhelmed.You learn that mom suspects he is in cntrol of tantruming? he negotiates. Often ? Of Primary or Secondary gain.The less cntrl he seems to have over this behavior, the more concern we have re: sensory or some other overload.
Douglas. 6 yo w h/o school avoidance. Picky eater. Wears sunglasses outdoors. ? Of adhd. w/drawn, sullen after giving up on peewee football b/c the helmet was stinky.
Parents’ goal: well adjusted 18 yo….or 21 yo
1st we need to consider construct validity b/f we “tx” a conditionIn small N studies Specific tx interventions have proven more effective than no tx, but no diff. from other alternative tx. Note problem of placebo.
adults routinely adjust for their sensory processing irregularitiesw by carefully making choices that allow them to honor their nervous systems w/o intruding on others. Swedish shoes, diesel, glare when fatigued, tight clothing, short shirtsleeves.Kids: less independent, poorer insight, poorer abstraction. OT can increase insight, normalize their sensory prefernces. Have their defensiveness in the presence of a supportive adult. K.o. like going off the high dive.
CUTTING PLAY DOH WITH SCISSORS
1st we need to consider construct validity b/f we “tx” a conditionIn small N studies Specific tx interventions have proven more effective than no tx, but no diff. from other alternative tx. Note problem of placebo.
Douglas. 6 yo w h/o school avoidance. Picky eater. Wears sunglasses outdoors. ? Of adhd. w/drawn, sullen after giving up on peewee football b/c the helmet was stinky.
A Central Auditory Processing Disorder (CAPD) exists when achild has apparent difficulty in processing auditory informationwhile possessing normal hearinglittle consensuson a definition, criteria for assessment and diagnosis, andthe efficacy of remediation and management.
…how I wonder …b/f this: …I’m not half the man I used to be….Toothpaste box w/ beans / buttons
A Central Auditory Processing Disorder (CAPD) exists when achild has apparent difficulty in processing auditory informationwhile possessing normal hearinglittle consensuson a definition, criteria for assessment and diagnosis, andthe efficacy of remediation and management.
What teacher might notice
Dx approach
Jennifer, 4 yo. Limited language. Expressive better than receptive. Makes prefernces known. Intense eye contact but ? Understanding. Plays well with cousins and sister, less well with others at daycare seting with some older children.
Parents’ goal: well adjusted 18 yo….or 21 yo
Environmental modifications Reduce ambient noise CARPET RUBBER TIPS ON CHAIRS CLOTH AND MAT POSTER BOARDSpreferential seating AWAY FROM SOURCES OF NOISE FANS CORRIDOORS OUTSIDE TRAFFIC Frequent checks for comprehension
ACTIVE LISTENING CHECKS FOR COMPREHENSION MULITISENSORY INSTRUCTION MNEMONIC DEVICES TO ASSIST MEMORY
APPENDIX E . a6
EXPLAIN WKSHOP’S PURPOSE, INCREASE SALIENCE, RELATE TO PRIOR K’LEDGE
85-x*36540 yo = 16425 28 yo = 20805 52 yo = 12045“gonna eat all the gum and candy I want”It is a most mortifying reflection for a man to consider what he has done, compared to what he might have done. ~Samuel Johnson, in Boswell's Life of Johnson, 1770
The full existential horror of being an adult
Distracted by whatever’s eye-catching in the moment? Or engaging in specifric and familiar activites whose fx it is to maintain sensory homeostasis?
Sleep problems FatigueFidgety when needs to concentrateInconsistent/erratic patterns of attnTx: sleep hygeine
Has trouble getting started w workWorks only on thihngs that are partic. Interesting to him/herEffort is unpredictableTx: use hi-interest topics, Premack principle, cueing, R cost (tokens)
Cant tell important from unimp.Recalls irrelevant detail rather than pertinentDistracted by irrelevant background noisesConcentrates on visual stimlui that others would ignoreTx: vary potency of stimli; highlighting certain words/phrases; explicit training in id’ing “what’s most important” (picture completion subtest)
Cassidy is working on master’s thesis. When she sits down 2 do ork, felt need to clean apt. Didn’t esp. like cleaning the apt but felt the urge whenever she needed to write. She actually fet she could not work unless e.t. in her apt was cleaned and in order.
Not a good listenerNot in volitional control of the process of focus: can overfocus, can fail to concentrate long enoughMisses key parts of directions / explanationsTx: keep verbalizations short and simple; check for understanding; use bookmarks that facilitate focus
Hard to satisfy, wants things all the time; needyRestless, craves excitementConcentrates well only on exciting stimuliPoor delayed gratificationTx: provide stimulating learning situations; do not r+ inappropriate or off-task behav.
Fails to look ahead and predict consequences, Task approach is seemingly w/o plan, w/o regard to time needed, w/o regard to resources needed. Difficulty w transitions, Difficulty foreseeing solutionsTx: train in self-talk and problem solving. R+ instances of behav,. Inhibition and planning ahead (e,.g. raising hand, packing umbrella); modeling. EG: tom, 8th grader, procrastination. TS . worked with mom, who coordinated w/ school 2 b notified of any longer term projects. LONG TERM PROJECT PLANNING SHEET. Eg report on dangerous sea animal. Brainstorm, choose, id materials needed, subgoals, assign dates, plan R+ for meeting goals.
Inappropriate behaviors, Does things the hard way, breaks things, Blurts inappropriate comments, prim. Proc.Tx: use DRO to increase soc. Appropriate behav.; be explicit; use + px (w many repetitions)EG: circle time a struggle for kristin, 2nd grader. Despite clear rules about turn taking, kristin wd blurt out while others were talking. Tchr introduced a talking stick. Then gave each child 2 chips (to ask ?s). If pt blurts, lose chip. FADE over time.
Does things slowly, or recklessly … barkley and time perceptionTrouble organizing time needs during taskDawdles, misses deadlinesLevel of activity seems inappropriate to actual urgency of taskTx: age approp. Time mgt tools; organizational charts, sub-goals, checklistst; px time estimates; beat the clock
Loses track during taskEasily derailed – responds to r+ in the moment rather than using mental representation of future r+ or p+Careless mistakesTx: give ongoing supportive feedback; encourage post-mortem reviews of behav; nag tapes
Ocd? Luvox? Cbt for ocd?
Stronger social support for being nice, developing emotional intelligence. Locker or desk mt be messy. Handwriting mt be messy. Mt be sensitive to visual stimuli and physical mvmt. Shy/wdrawn. If hyper, mt be hypertalkative and chatty.
More tasks, more diffuse
Who called the caterer? Designed and order tshirts? Considered potential hurt feelings re: invitation list. Set up the evite? Remembered that the reunion would coincide with 20th wedding reunion of one couple? Made sure the paper plates and cups match? Managed the household mood in the days leading up to the reunion?More tasksMore diffuseMore parental responsibilityLess likely to have an “executive” partnerLess likely to have assistants at workLess likely to focus on a narrow areaMore likely to feel shame about disorganization
Lay out the pork chops
22”
LADY GAGA AND 4 WORD LIST
FIGHTING NUN IN MYSTERY BOX: WHY IS THIS FUNNY? WE HAVE EXPECTATIONS BASED ON AGE, STATUS, ETC.Preschool Run simple errands (e.g., “Get your shoes from thebedroom”). Tidy bedroom or playroom with assistance. Perform simple chores and self-help tasks withreminders (e.g., clear dishes from table, brush teeth,get dressed). Inhibit behaviors: don’t touch a hot stove; don’t runinto the street; don’t grab a toy from another child;don’t hit, bite, push, etc.
FIGHTING NUN IN MYSTERY BOX: WHY IS THIS FUNNY? WE HAVE EXPECTATIONS BASED ON AGE, STATUS, ETC.Preschool Run simple errands (e.g., “Get your shoes from thebedroom”). Tidy bedroom or playroom with assistance. Perform simple chores and self-help tasks withreminders (e.g., clear dishes from table, brush teeth,get dressed). Inhibit behaviors: don’t touch a hot stove; don’t runinto the street; don’t grab a toy from another child;don’t hit, bite, push, etc.
Run errands (two to three step directions).Grade 2 Tidy bedroom or playroom. Perform simple chores, self-help tasks; may needreminders (e.g., make bed). Bring papers to and from school. Complete homework assignments (20-minutemaximum). Decide how to spend money (allowance). Inhibit behaviors: follow safety rules, don’t swear,raise hand before speaking in class, keep hands to self.Look both ways before x streetShare toys w/o grabbing
Run errands (may involve time delay or greater distance, such as going toa nearby store or remembering to do something after school). Tidy bedroom or playroom (may include vacuuming, dusting, etc.). Perform chores that take 15—30 minutes (e.g., clean up after dinner, rakeleaves). Bring books, papers, assignments to and from school. Keep track of belongings when away from home. Complete homework assignments (1 hour maximum). Plan simple school project such as book reports (select book, read book,‘write report). Keep track of changing daily schedule (i.e., different activities afterschool). Save money for desired objects, plan how to earn money. Inhibit/self-regulate: behave when teacher is out of the classroom;refrain from rude comments, temper tantrums, bad manners.f/u simple classroom rulesWaits till m,f off tc before telling something
Help out with chores around the home, including both dailyresponsibilities and occasional tasks (e.g., emptying dishwasher, rakingleaves, shoveling snow); tasks may take 60—90 minutes to complete. Baby-sit younger siblings or for pay. Use system for organizing schoolwork, including assignment book,notebooks, etc. Follow complex school schedule involving changing teachers andchanging schedules. Plan and carmy out long-term projects, including tasks to beaccomplished and reasonable timeline to follow; may require planningmultiple large projects simultaneously. Plan time, including after school activities, homework, familyresponsibilities; estimate how long it takes to complete individual tasksand adjust schedule to fit. Inhibit rule breaking in the absence of visible authorityHandles conflcit w/o physical fightsCan calm down or self soothe
Manage schoolwork effectively on a day-to-day basis, including completing andhanding in assignments on time, studying for tests, creating and followingtimelines for long-term projects, and making adjustments in effort and quality ofwork in response to feedback from teachers and others (e.g., grades on tests,papers). Establish and refine a long-term goal and make plans for meeting that goal. If thegoal beyond high school is college, the youngster selects appropriate courses andmaintains grade point average (GPA) to ensure acceptance into college. Theyoungster also participates in extracurricular activities, signs up for and takesScholastic Aptitude Tests (SATs) or American College Tests (ACTs) at theappropriate time and carries out the college application process. If the youngsterdoes not plan to go to college, he or she pursues vocational courses and, ifapplicable, employment outside of school to ensure the training and experiencenecessary to obtain employment after graduation. Make good use of leisure time, including obtaining employment or pursuingrecreational activities during the summer. Inhibit reckless and dangerous behaviors (e.g., use of illegal substances, sexualacting out, shoplifting, or vandalism).Able to walk away from provocationCan say no to fun activitgy if other plans have already been madeResists saying hurtful things
APPENDIX L p.a13: LAST TXGIVING HOLIDAY: ON SCALE FROM 1-10 HOW GOOD WAS IT FOR U AND YR FAMILY? HOW COULD IT BE A (+1)?MAIN RELATIONSHIP…MOST IMP RELATIONSHIP: WHAT WOULD MAKE IT 10% BETTER? WHAT COULD I DO THIS WK’END TO MAKE THAT HAPPEN?
APPENDIX L p.a13: LAST TXGIVING HOLIDAY: ON SCALE FROM 1-10 HOW GOOD WAS IT FOR U AND YR FAMILY? HOW COULD IT BE A (+1)?MAIN RELATIONSHIP…MOST IMP RELATIONSHIP: WHAT WOULD MAKE IT 10% BETTER? WHAT COULD I DO THIS WK’END TO MAKE THAT HAPPEN?
NeuroanatomyNeurotransmittersPhenomenology of dopamine and serotonin
Parents’ goal: well adjusted 18 yo….or 21 yo
What questions do you have re: rx?
What questions do you have re: rx?
147”
R+ inhibitionPremack principleBehav contractToken system
Dawson p 81Setting him up for success – think about the “box” and its capacity. Don’t overload it.Change physical or soc. Environment – add bariers, <distractions, >org. structure, change social mixChange nature of tasks – reduce complexity (if > 3/10 on difficulty scale)Why do students shape up when tchr close by? >insight, activate rules, clearly they “can” – performance deficit vs skills deficit.
Dawson p 81Setting him up for success – think about the “box” and its capacity. Don’t overload it.Change physical or soc. Environment – add bariers, <distractions, >org. structure, change social mixChange nature of tasks – reduce complexity (if > 3/10 on difficulty scale)Why do students shape up when tchr close by? >insight, activate rules, clearly they “can” – performance deficit vs skills deficit.
Dawson p 81Setting him up for success – think about the “box” and its capacity. Don’t overload it.Change physical or soc. Environment – add bariers, <distractions, >org. structure, change social mixChange nature of tasks – reduce complexity (if > 3/10 on difficulty scale)Why do students shape up when tchr close by? >insight, activate rules, clearly they “can” – performance deficit vs skills deficit.
2:00
Make task shorter, build in breaks, use salient r+ for afterwards, make steps more explicit, make task more appealing (beat the clock, write steps down on slips of paper, in jar)
242”
R+ inhibitionPremack principleBehav contractToken system
242”
He should just do it!
Victoriah’s F re: u sh just do it, tense/frustrated
Does spanking work?
147”
Lady Gaga and 4 word list
What questions do you have re: rx?
PREP FOR TRANSITION
APPENDIX J: p. a11Where exactly do u feel that? E.g. my morning feeling after good nights sleep
Broaden+emo enlarge the cog context, ? d/t dopamine levelsFaster learning and improved cognitive performanceBuildEnduring personal resources – physical, intellectual, and social41”
Why aren’t we getting exactly what we want, all the time?
APPENDIX L p.a13: LAST TXGIVING HOLIDAY: ON SCALE FROM 1-10 HOW GOOD WAS IT FOR U AND YR FAMILY? HOW COULD IT BE A (+1)?MAIN RELATIONSHIP…MOST IMP RELATIONSHIP: WHAT WOULD MAKE IT 10% BETTER? WHAT COULD I DO THIS WK’END TO MAKE THAT HAPPEN?
APPENDIX L p.a13: LAST TXGIVING HOLIDAY: ON SCALE FROM 1-10 HOW GOOD WAS IT FOR U AND YR FAMILY? HOW COULD IT BE A (+1)?MAIN RELATIONSHIP…MOST IMP RELATIONSHIP: WHAT WOULD MAKE IT 10% BETTER? WHAT COULD I DO THIS WK’END TO MAKE THAT HAPPEN?
Why aren’t we getting exactly what we want, all the time?
Why aren’t we getting exactly what we want, all the time?
Why aren’t we getting exactly what we want, all the time?
Why aren’t we getting exactly what we want, all the time?
PREP FOR TRANSITION
Why aren’t we getting exactly what we want, all the time?
Why aren’t we getting exactly what we want, all the time?
St’s going to happen today at 5:00
Insight re: match b/t activities and PSI
Insight re: match b/t activities and PSI
77”How would you get to 495 if 290 were shut down from auburn to plantation street exit?
Attn is a precious commodity. Things and ppl will compete for itBest defense vs the manipulation of one’s attn is to determine for oneself how one wants to invest itSt’s going to happen today at 5:00
APPENDIX F p.a7: WRITE DOWN ?S YOU’VE HAD TO THIS POINT
132
What’s the one thing I need to do…. APPENDIX O p. a16Challenge: move that item to To Do list, APPENDIX A p.a2
Which behavior (more or / less orf) would make the biggest difference?
What are non-impaired kids doing that this pt is NOT?You can say: “If I keep doing this it islikely my teacher/friend will……”Ask to hear what the inner voice wassaying: “Tell me what you like bestabout that!”“Tell me what you were thinking whenyou came up with that idea!”“That must have been a challenge…whatdid you tell yourself to get past it?”• -“How are you going to know when to be ready?”• -“How are you going to stop yourself from…?”• -“What is your goal?”• -“What do you want it to look like?”• -“How long do you think it will take?”• -“How much did time did it take last time?”• -“How are you going decide where to set that up?”• -“How are you going to know what you need?”• -“How are you going to know what is most important?”• -“How are you going to decide what to do first?”• -“How will you know when you are done?”• -“How will you continue when you are tired?”• -“How did that work out?”• -“How long do you think that took?”• -“How did you manage/know how to do it?”• -“Would you do anything differently?”• -“Have you done anything like this before?”• -“Was that harder or easier than….”
What are non-impaired kids doing that this pt is NOT?You can say: “If I keep doing this it islikely my teacher/friend will……”Ask to hear what the inner voice wassaying: “Tell me what you like bestabout that!”“Tell me what you were thinking whenyou came up with that idea!”“That must have been a challenge…whatdid you tell yourself to get past it?”• -“How are you going to know when to be ready?”• -“How are you going to stop yourself from…?”• -“What is your goal?”• -“What do you want it to look like?”• -“How long do you think it will take?”• -“How much did time did it take last time?”• -“How are you going decide where to set that up?”• -“How are you going to know what you need?”• -“How are you going to know what is most important?”• -“How are you going to decide what to do first?”• -“How will you know when you are done?”• -“How will you continue when you are tired?”• -“How did that work out?”• -“How long do you think that took?”• -“How did you manage/know how to do it?”• -“Would you do anything differently?”• -“Have you done anything like this before?”• -“Was that harder or easier than….”
What are non-impaired kids doing that this pt is NOT?You can say: “If I keep doing this it islikely my teacher/friend will……”Ask to hear what the inner voice wassaying: “Tell me what you like bestabout that!”“Tell me what you were thinking whenyou came up with that idea!”“That must have been a challenge…whatdid you tell yourself to get past it?”• -“How are you going to know when to be ready?”• -“How are you going to stop yourself from…?”• -“What is your goal?”• -“What do you want it to look like?”• -“How long do you think it will take?”• -“How much did time did it take last time?”• -“How are you going decide where to set that up?”• -“How are you going to know what you need?”• -“How are you going to know what is most important?”• -“How are you going to decide what to do first?”• -“How will you know when you are done?”• -“How will you continue when you are tired?”• -“How did that work out?”• -“How long do you think that took?”• -“How did you manage/know how to do it?”• -“Would you do anything differently?”• -“Have you done anything like this before?”• -“Was that harder or easier than….”
What are non-impaired kids doing that this pt is NOT?You can say: “If I keep doing this it islikely my teacher/friend will……”Ask to hear what the inner voice wassaying: “Tell me what you like bestabout that!”“Tell me what you were thinking whenyou came up with that idea!”“That must have been a challenge…whatdid you tell yourself to get past it?”• -“How are you going to know when to be ready?”• -“How are you going to stop yourself from…?”• -“What is your goal?”• -“What do you want it to look like?”• -“How long do you think it will take?”• -“How much did time did it take last time?”• -“How are you going decide where to set that up?”• -“How are you going to know what you need?”• -“How are you going to know what is most important?”• -“How are you going to decide what to do first?”• -“How will you know when you are done?”• -“How will you continue when you are tired?”• -“How did that work out?”• -“How long do you think that took?”• -“How did you manage/know how to do it?”• -“Would you do anything differently?”• -“Have you done anything like this before?”• -“Was that harder or easier than….”
154”Sarah ward, slpExecutivefunctiontherapy.com
GUESS HOW OLD?
HOW LONG HAVE WE BEEN HERE SINCE THE BREAK? HOW MUCH TIME DO WE HAVE LEFT? WHICH FEELS LONGER, THE TIME WE’VE BEEN HERE OR THE TIME WE HAVE LEFT?
122”
EXPLAIN WKSHOP’S PURPOSE, INCREASE SALIENCE, RELATE TO PRIOR K’LEDGE
STUDY BOX
If only I could be as org. as I am the day before vacation
EXPLAIN WKSHOP’S PURPOSE, INCREASE SALIENCE, RELATE TO PRIOR K’LEDGE
Google calendarsCloud based music serviceGoogle docsDrop box
Self-assessment or parent ass’mentAttitude of curiosityIf I was off task, why? Answer is never b/c I’m bad stupid lazy etc
BIG 5 QUESTIONNAIRESuccess isn't a result of spontaneous combustion. You must set yourself on fire. ~Arnold H. Glasow
BIG 5 QUESTIONNAIRESuccess isn't a result of spontaneous combustion. You must set yourself on fire. ~Arnold H. Glasow
BIG 5 QUESTIONNAIRESuccess isn't a result of spontaneous combustion. You must set yourself on fire. ~Arnold H. Glasow
BIG 5 QUESTIONNAIRESuccess isn't a result of spontaneous combustion. You must set yourself on fire. ~Arnold H. Glasow
BIG 5 QUESTIONNAIRESuccess isn't a result of spontaneous combustion. You must set yourself on fire. ~Arnold H. Glasow
MYSTERY BOXHAVE ST / VP PUT NAMES OF ATTENDEES IN HATAPPENDIX A p. a2: TO DO