Brain Based interventions v 15 April 20 2014


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The NEW Brain-based Interventions 6 Hour Talk

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  • Do you know this child?
  • We used to think that very bright children’s executive skills should also be advanced but research has not supported this.
  • Brain Based interventions v 15 April 20 2014

    1. 1. Lynne Kenney, PsyD @drlynnekenney Brain-Based Interventions 2014
    2. 2. Becoming A Brain-Based Clinician
    3. 3. TODAY’S LANDSCAPE ADHD and EF Learning Disabilities and EF Social Skills and EF Teaching skills sets across diagnoses Play Math (STM, WM, VSM, M2T) Neurocognitive Interventions
    4. 4. WHAT IS A BRAIN-BASED INTERVENTION? An intervention that engages cognitive or motor parts of the brain One that increases neuronal communication One that builds skill sets One that increases collaborative parenting strategies
    6. 6. BOOKS ON BRAIN DEVELOPMENT Brain Facts – Society for Neuroscience  The Brain That Changes Itself ~ Norman Doidge, MD  The Woman Who Changed Her Brain ~ Barbara Arrowsmith-Young  Brain School ~ Howard Eaton  Teaching with The Brain in Mind ~ Eric Jensen  The Whole Brain Child ~ Dan Siegel, MD  How To Reach and Teach Children with Challenging Behavior ~ Otten & Tuttle
    7. 7. GET AHEAD IN THE GAME Brain Facts – Society for Neuroscience Social by Matthew Lieberman Conference videos www.eatonarrowsmithschool. com
    10. 10.  The D ~ word and evolution  Bears and Berries  Does evolutionary DNA exist?  Anthropologist Lynne Isbell  Perception, vision or intuition  Heredity, infection, environment, brain injury  The Wiring Effect  Bring on the BDNF Evolution, Genetics and EF
    11. 11. WHAT DOES EXECUTIVE DYSFUNCTION “LOOK LIKE”  Joey and his dog ate it, his mom forgot it and the monkey hid it kinda day.  Jessica and her kinda sorta outta controlla trip to the airport.
    12. 12. EF COMES IN SEVERAL FLAVORS  Inattentive  Distractible  Impulsive  Disorganized  Sensory overwhelmed  Tracking & “How did I get here?”  Pausing to re-organize  Wrapping it up with a bow  Starting again
    13. 13. WHAT IS EXECUTIVE FUNCTIONING (EF)? An umbrella term covering related yet distinct skills Refers to mental control/self- regulatory processes Can be understood Cognitive, Limbic and Motor
    14. 14. EF DOMAINS (KENNEY, 2012)  Attention, focus, distractibility  Cognitive control, shift and flexibility  Memory, input, manipulation, output  Emotional regulation and modulation  Problem solving, decision making  Impulse control and management  Organization, planning, and time management  Motor management planning, pacing, initiation, maintaining, stopping
    15. 15. I. EXECUTIVE FUNCTIONS INCLUDE THE ABILITY TO:  Survey and preview  Plan, organize, sequence, initiate and execute tasks  Hold, manipulate and retrieve memory  Shift focus, sustain attention, tolerate and adapt to changes in expectations  Stop, think, decide, respond
    16. 16. II. EXECUTIVE FUNCTIONS INCLUDE THE ABILITY TO:  Conduct visual-spatial mental operations  Track information and activities in working memory  Perceive, read, interpret and respond to social situations  Regulate and manage emotions  Evaluate, plan and manage time  Use language to facilitate communication within relationships  Reason, evaluate choices and make decisions
    17. 17. TWITTER ~ THE RESEARCH PLAYGROUND BRAIN DEVELOPMENT  @davidnowell  @drbethkids  @all4mychild  @braininsights  @viviensabel  @drmarty01  @DrEscotet  @TheTeenDoc
    18. 18. BE AN ENERGY TREE
    19. 19. The Discipline Trap
    20. 20. INTERVENTION PYRAMID  Medication  Neurotransmitters Food/Nutrition Developmental, Behavioral, Learning Interventions
    21. 21. Understand Before You Intervene
    22. 22. CASE EXAMPLE Sammy and his “falling off” chair.
    23. 23. DATA BASED TREATMENT PLANNING  Do you have a brief neuropsych eval to assess IQ and executive function?  Do you see an OT for sensory issues?  Do you improve food and nutrition?  Do you look into amino acids to impact neurotransmitters?  Do you do brain training?  What behavioral interventions do you consider?  Is it time for a medication trial?
    24. 24. ENHANCING EXECUTIVE FUNCTION WITH SKILL SET DEVELOPMENT Where we are heading: Improving Neuronal Connections Knowing the different between a skill deficit and willful non-compliance Strategies to build brain connections
    25. 25. YOUR BRAIN IS LIKE A PLACEMAT Insulted? Don’t be. A placemat is a good thing. Connect the dots.
    26. 26. A GOLF CLUB, REALLY?
    28. 28. CONNECTIONS  Neurons can connect with up to a hundred thousand other cells. This number of connections is a truly enormous number: 10 thousand trillion.  One neuron can have as many as 100,000 dendrites.  In a human, there are more than 125 trillion synapses just in the cerebral cortex alone
    30. 30. NEUROTRANSMITTERS Arousal Inhibition
    31. 31. 9 MIN ALERT OR CALM PROCESS  Movement  Music  Art/drawing  Rhythm and timing
    32. 32. WE MOVE TO LEARN Flip n push the single ball bounce Bouncing snow cones Boom Boom Slap Double ball bounce
    33. 33. BRAIN TRAINING Some programs include Lumosity,  LearningRx, COGMED, MC2, Brain Gym and BALAVISX. Exercise is brain training. XBox Dance Dance Revolution, karate, double dutch jump rope, yoga, hacky sac, swimming and tennis.
    34. 34. PATTERNS ARE INNATE  A pattern is consistent repetition  What does a pattern look like?  What might a pattern sound like?  Why patterns are important for brain development.
    35. 35. MOVEMENT RESOURCES Suzy Koontz Jean Blaydes Madigan SparkPE Eric Jensen Gil Connell @movingsmartnow
    36. 36. EXECUTIVE FUNCTION AND EDUCATION  EF and intelligence  Twice Gifted  Disorganized students  Homework interventions  Task Analysis  Skill-set development  Multi-sensory interventions (MIT)
    37. 37. NOVELTY Only four to eight minutes of pure factual lecture can be tolerated before the brain seeks other stimuli, either internal (e.g., daydreaming) or external (Who is that walking down the hall?). If the teacher is not providing that novelty, the brain will go elsewhere. Bruce Perry, PhD
    38. 38. TEACHING WITH VISUAL AIDES AND MOVEMENT 50 % of children are kinesthetic learners so why not begin with touch? Visual learners learn by watching, 40% of learners are in this category. Only 10 percent of secondary students learn best auditorily, but 80 percent of instructional delivery is auditory.
    40. 40. EF AND INTELLIGENCE Developed by Frederic Perez-Alvarez & Carme Timoneda-Gallart, neuroscientists ~ A Better Look at Intelligence from Girona, Spain. Applying PASS theory developed by JP DAS, FUNDI is designed to teach children, parents and their teachers about critical aspects of meta- cognition and executive function.
    41. 41. WHAT EVERY STUDENT NEEDS TO KNOW ~ HOW TO… Plan Initiate Execute Review Revise Turn In
    42. 42. APPLYING BRAIN RESEARCH We move to learn, we play to behave (provide opportunity for creativity and critical thinking) Multi-modal sensory learning strategies Rhythmic daily movement Make children the teachers/mentors Instruct less, interact more
    43. 43. EF SKILLS AT HOME AND IN SCHOOL Calendars, planners and schedules Routines and daily activities Task Lists Project Management SYSTEMS: Digital, paper, post-it notes, planners, mobiles tools,,
    44. 44. MANAGE THE WORK SPACE What does your space look like? How functional is it?  How organized is your study space?  Does your student have all the items he needs?  Does your student have the ability to use multi-sensory transfer skills?  Describe the study space setting, could you work there?  Is there an adult near-by?  Do you have a time set aside?  Are you working in 15 min increments or those suitable to your child?  Do you have prompts or cues?  Is your workspace portable or stationary?
    45. 45. PRIORITIZATION The modified Sullivan technique for prioritizing, planning and execution A B C 48 hrs
    47. 47. EF AND BEHAVIORAL CHANGE  Visualizing and verbalizing  Role Play  Social Stories  The Beginning, Middle & End  Going Full Circle  See, say, play, touch, build  Mentoring others  Motor movement
    49. 49. BREAKING DOWN SKILL SETS I Listening  I chose not to speak  I established eye contact  I listened to someone speaking  I nodded my head to show I was listening  I repeated back what I heard, when asked  I asked a question when I did not understand  I remembered instructions  I followed the instructions
    50. 50. BREAKING DOWN SKILL SETS II For The Parent  I defined an expected behavior  I named the expected behavior  I chose my behavior, thinking it through  I practiced ready, steady, act  I practiced “I have a choice”  I thought about the next step  I spoke the sequence of my actions  I wrote the sequence of my actions
    51. 51. IMPULSIVITY Waiting one’s turn Refraining from touching others Keeping one’s hands to self Not grabbing without permission Keeping one’s body still Thinking before you act Managing oral-motor movements Verbalization, waiting one’s turn Speaking in turn
    52. 52. HELPING CHILDREN “DO AS EXPECTED” TAKES PREVIEWING AND PLANNING  1. Tell the children what is about to happen. “We are going outside to play. We will quietly get in line, stand helicopter distance from one another and keep our voices quiet.”  2. Tell them what they can do with their hands and their bodies. “While you are on the playground, keep your hands to yourself as you run, jump and play.”  3. Tell them how they will know the activity is over. “When you hear our ‘secret signal’, you will line up at the red door and we will slowly walk back inside.”
    54. 54. SUBCORTICAL STRUCTURES  Subcortical Structures and Cognition: Implications for Neuropsychological Assessment ~ Koziol and Budding  Sensory Integration, Sensory Processing, and Sensory Modulation Disorders: Putative Functional Neuroanatomic Underpinnings Leonard F. Koziol & Deborah Ely Budding & Dana Chidekel Cerebellum. 2011 Dec;10(4):770- 92.  The Cerebellum: Brain for an Implicit Self by Ito, Masao
    55. 55. SENSORY INTEGRATION DYSFUNCTION There is considerable overlap between executive and sensory processing Both are related to self-regulation Many kids with sensory integration difficulties also have trouble with cognitive flexibility
    56. 56. OVERSENSITIVITY  Olfactory – “ewe it smells”  Gustation – “It’s gritty mama”  Tactile – “Ouch! That hurts”  Visual – “There is still light”  Sound – “I need to get out of this car!”  Motor - “Inside I am just shaking”  A learning story ~ 9 year old Jason There is still light!
    57. 57. ANGER MOUNTAIN
    59. 59. CALMING RESOURCES  SEL  Physical Movement  Repetitive Movement  Rhythmic Breathing Take Five  Music/Stories Listening  Art Drawing Mandalas  Listen to a Raisin – Meditate  Vision Therapy
    61. 61. THE CAVEMAN AND THE THINKER Your Child’s Two-Part Brain The Defensive Brain Collaboration Works Calm the caveman to engage the thinker
    62. 62. TWITTER ~ THE RESEARCH PLAYGROUND INTERVENTION  @Inclusive_Class  @marianne_russo  @special-ism  @movingsmartnow  @micheleborba  @braininsights  @Kiboomu  @kidlutions
    63. 63. 5 THINGS ABOUT THE TEEN BRAIN YOU WERE AFRAID TO ASK, BUT NEED TO KNOW  Teen brain growth (neuronal connections) is in spurts and starts The Teen Years Explained: A Guide to Healthy Adolescent Development (Johns Hopkins University, 2009) by Clea McNeely and Jayne Blanchard  Go away! Wait, where are you going? (Separation and Independence)  Why so moody? The limbic interference relates to neuronal growth, hormonal changes and brain re-organization  Why so cliquey? Teens are herd animals…  What? Your brakes aren’t working? (Impulsivity and risk taking and the teenage brain)
    64. 64. TEENS AND TWEENIES Teenage as a second language ~ Barbara R. Greenberg, & Jennifer A. Powell-Lunder Get out of my life! But first will you take me and Cheryl to the mall ~ Anthony Wolf Why do they act that way? ~ David Walsh
    65. 65.  Dementia prevention: Exercise, water, whole food, novel cognitive enrichment, sleep, socialization.  According to the Alzheimer’s Research & Prevention Foundation, physical exercise reduces your risk of developing Alzheimer’s disease by 50 percent.
    66. 66. Food Rules
    67. 67. YOU ARE WHAT YOU ASSIMILATE Get back to real whole food Consider amino acids
    68. 68. 5 FOOD GOALS WATER ~ 1 oz water per pound per day FRESH ~ If it does not rot or sprout do without PROTEIN ~ 1-2 oz protein/fats every four hours for children COLOR ~ 8-10 servings of color per day (1/2 cup per serving) GREEN ~ Eat when you are hungry, mostly plants
    69. 69. SLEEP S = Similar bed-time schedule and routine nightly L = Light-off, dark, cool sleep environment E = Everything off, phone, TV, music E = Exercise, regularly at least 45 mins daily P = Preparation and planning
    70. 70. TWITTER ~ THE RESEARCH PLAYGROUND NUTRITION @NutritionBlogs @TheSpicyRD @ChristysChomp @ RMNutrition @eatingarainbow  
    71. 71. FIELD TRIP!
    72. 72. Play Math is a cortico- cerebellar math program that alternates fine and gross motor movement to teach children ages 6-12 fact families, factors and fractions (Kenney 2012)
    73. 73. Mirror or Skip Count (Balls) Slide and Glide (Blocks) Over and Up (Blocks) How do numbers fit together? What makes a family? Advanced techniques The Method
    74. 74. THREE THINGS CHILDREN TAUGHT ME ABOUT HOW THEY LEARN MATH. We build brain connections with: a. Rhythm b. Fine and Gross Motor Movement c. Mentoring