Bright Kids Who Cant Keep Up: Helping Children Conquer Slow - - PDF document
Bright Kids Who Cant Keep Up: Helping Children Conquer Slow Processing Speed and Succeed in a Fast-Paced World Brian Willoughby, Ph.D. Co-Director, Achieve New England Clinical Research Associate, University of Massachusetts Boston
Brian Willoughby, Ph.D. Co-Director, Achieve New England Clinical Research Associate, University of Massachusetts Boston
u Name? u Where you are from? u Current Position? u Favorite board game growing up?
u What is slow processing speed? u What does a student with slow processing speed look
u What intervention strategies can be used in the
u What are the other “costs” of slow processing speed –
u The amount of time to perceive information, process the
u The time required to perform an intellectual task u How long it takes to get stuff done
u Visual processing u How quickly our eyes perceive information and relay it
u Verbal Processing u How quickly we hear a stimulus and react to it and how
u Motor Speed u Fine motor agility, such as how fast we can copy
u
Visual Processing (Flash Match)
u Problems with attention to details u Difficulty proofreading work u Trouble with subtle visual cues of social relationships u
Verbal Processing (Taboo)
u Trouble following directions u Needs more time to answer a question u Problems keeping up with the pace of class discussions u
Motoric Processing (Hand Slap)
u Slow at the physical aspect of writing u Moves around at a slow pace u Slow to compete written tests
u Who conducts assessments of processing speed? u Neuropsychologist u Child Psychologist u School Psychologist u Others? u Types of Assessment u School-based assessment u Independent neuropsychological assessment
25 24.4 8.71 26 24.4 8.71 27 24.4 8.71 28 24.4 8.71 29 24.4 8.71 30 24.4 8.71 31 24.4 8.71 32 24.4 8.71 33 24.4 8.71 34 24.4 8.71 35 28.54 10.09 36 28.54 10.09 37 28.54 10.09 38 28.54 10.09 39 28.54 10.09 40 28.54 10.09 41 28.54 10.09 42 28.54 10.09 43 28.54 10.09 44 28.54 10.09 45 31.78 9.93 46 31.78 9.93 47 31.78 9.93 48 31.78 9.93 49 31.78 9.93 50 31.78 9.93 51 31.78 9.93 52 31.78 9.93 53 31.78 9.93 54 31.78 9.93 55 31.72 10.14 56 31.72 10.14 57 31.72 10.14 58 31.72 10.14 59 31.72 10.14 60 31.32 6.96 61 31.32 6.96 62 31.32 6.96 63 31.32 6.96 64 31.32 6.96 65 33.84 6.69
25 50.68 12.36 26 50.68 12.36 27 50.68 12.36 28 50.68 12.36 29 50.68 12.36 30 50.68 12.36 31 50.68 12.36 32 50.68 12.36 33 50.68 12.36 34 50.68 12.36 35 58.46 16.41 36 58.46 16.41 37 58.46 16.41 38 58.46 16.41 39 58.46 16.41 40 58.46 16.41 41 58.46 16.41 42 58.46 16.41 43 58.46 16.41 44 58.46 16.41 45 63.76 14.42 46 63.76 14.42 47 63.76 14.42 48 63.76 14.42 49 63.76 14.42 50 63.76 14.42 51 63.76 14.42 52 63.76 14.42 53 63.76 14.42 54 63.76 14.42 55 68.74 21.02 56 68.74 21.02 57 68.74 21.02 58 68.74 21.02 59 68.74 21.02 60 64.58 18.59 61 64.58 18.59 62 64.58 18.59 63 64.58 18.59 64 64.58 18.59 65 67.12 9.31
Processing Speed
Motor Speed Visual Processing Long-term Memory Familiarity Verbal Processing Attention Shifting
u Processing speed: the amount of time to perceive information, process the
information, and enact a response
u
Three primary types of processing speed:
u Visual, Verbal, Motor
u It’s complicated!
u Measurement of processing speed does not account for other skills u Science of processing speed still poorly understood and likely multifactorial
Mom: “Joseph may be the laziest person I know. He can’t get anything done. It’s strange… growing up, he was such a good kid – a leader. He would organize these big performances with his cousins. He was funny and such a bright student. Teacher’s always told me how smart he was. Then in 8th grade, something just kind of changed. He stopped seeming to care about homework – and spent way more time playing those videogames. Ninth grade was the worst. He got an F in English and and F in History. He did get a B in Math, but basically everything else was a D or an F . Teachers comments are always the same, bright student who needs to put in more effort. Now, everyday is an argument about homework and I’m tearing my hair out!” Hypotheses?
u Intelligence u Academic Skills u Language u Attention/Executive Functioning u Visual Motor Skills u Memory u Social, Emotional, and Behavioral
90 125 134 80 69 40 50 60 70 80 90 100 110 120 130 140 150 Verbal Visual Spatial Fluid Reasoning Working Memory Processing Speed
WISC-V Intellectual Skills
92 80 125 92 79 40 50 60 70 80 90 100 110 120 130 140 150 Reading Reading Comprehension Math Spelling Essay Writing
WIAT-III Academic Skills
90 90 88 65 112 40 50 60 70 80 90 100 110 120 130 140 150 Receptive Language Expressive Langauge Phonological Awareness Rapid Naming Pragmatic Language
Language and Phonological Processing
109 72 70 85 93 40 50 60 70 80 90 100 110 120 130 140 150 Trails A: Sequencing Trails B: Set Shifting Verbal Fluency Sustained Attention Rey Complex Figure
Attention and Executive Functioning
115 120 125 40 50 60 70 80 90 100 110 120 130 140 150 Visual Motor Integration Fine Motor Dexterity Visual Organzation
Visual Motor Functioning
110 90 100 100 125 135 90 114 120 140 129 76 115 117 140 40 50 60 70 80 90 100 110 120 130 140 150 Depression Anxiety Social Problems Conduct Problems Executive Functioning
Psychological Test Findings
Self Report Parent Report Teacher Report
Strengths
Attention & Executive Functioning
Language & Phonological Processing
rec/exp language
awareness
naming ACADEMIC PROBLEMS
Reading/Comprehension Taking in material Study Skills Task Initiation
DEPRESSION
u Think of a student you know well – or your own child u Now, complete your own checklist u Small Groups u Anything surprising? u Are you a “match”? Why? Why Not?
u “Fit” is critical u Fast Parent/Teacher – Slow Child u Slow Parent/Teacher – Slow Child u Flexible Parent/Teacher – Slow Child u Fit of the whole family u Fit of the whole classroom
u Examples of Common Problems u Slow to complete tests and assignments u Lacks persistence to complete tasks u Slow to read and recall basic math facts u Categories of “slow processors” u Mr. Chill u Mr. Anxious u Mr. Lost
u I’m the Head of School at Slowville International School u A school-wide assessment showed 58% of 7th grade
u Poor task initiation u Trouble “shifting sets” u Poor working memory/multi-tasking u Disorganization u Forgetful re: school materials
u Sales pitch: tutoring system, technology, etc.
Accommodate
Accept
u Educate teachers on the topic of processing speed u “Bad seed” or cognitive deficit: Move away from focus on
u Refer students for evaluations when slow processing speed is
u School Characteristics
u Parent-teacher communication u Attention to individual differences u Lack of clutter u Breaks and recess u Flexible groupings of students
u Specific Accommodations
u Ample time… and time management u Extra set of textbooks at home u Utilize technology u Model finished product of assignments u Explicit beginning and end points for assignments u Lose the busy work
u Speak with the student’s other teachers about observations u Consult with school psychologist/counselor and attend team
u Communicate strengths and weaknesses to student’s parents u Help students transition to become self-advocates
u Formal Special Education Plan
u Individualized Education Program (IEP) – Academic Support Lab u 504 Plan u Specialized “track” (School Within a School)
u Private Executive Function Tutors (e.g., Beyond Booksmart) u Specialized Private School u “Brain Training” Centers - $$$ u Effective progress and educational law
u Surprise!: There is no cure for slow processing speed u But… what about medication management of
u Stimulant medications (e.g., Ritalin) u Non-stimulant medications (e.g., Strattera)
u Accept the problem
u Homework confusion, slow starting, and trouble finishing
u Accommodate
u Keep things at the same time, same day, same place! u Change the way you talk at home u Watch the clock! u Remember that actions (and visuals) speak louder than words
u Advocate
u “Anna is not choosing to be slow… it’s the way her brain is wired.”
u Can dietary changes play a role in improving slow processing speed? u Could slow processing speed just improve on its own - over time? u What sports are best for students with slow processing speed? u What are homework expectations for students with slow processing
speed? How flexible can we be?
u The perils of applying for extended time on standardized tests!
u Sample of 600 children and adolescents (ages 2 to 20) from a hospital–based
assessment clinic
u Of the “slow processers” of the sample:
u 70% were boys u 33% had significant social skills weaknesses u 40% had co-occurring language impairments u 61% met criteria for ADHD u 28% had a reading disability u 20% had Generalized Anxiety Disorder u 77% were receiving special education support at school
Slow (<85 WISC PS) Average (86 – 114 WISC PS) Fast (>115 WISC PS) T-Score 50 60 70
A is significantly (p<.01) different from B
A A A A B B B B B
Anxiety
(CBCL)
Inattention
(CBCL)
Social Problems
(CBCL)
T-Score 50 60 70
A is significantly (p<.01) different from B
A B
Learning Problems
(BASC-2 Teacher)
Conduct
(CBCL)
Oppositional
(CBCL)
A B
Total Problems
(CBCL)
B
Slow (<85 WISC PS) Average (86 – 114 WISC PS) Fast (>115 WISC PS)
u Accommodations and Supports
u Tone down emotional conversations u Help find an area of success u Increase the “frequency of fun” u Think about therapy – with the right therapist u Medication? – the pros and cons
u Advocate
u Educate others about depression/anxiety u Initiate school-based support
u Examples of Common Problems
u Trouble picking up on social cues u Stilted or awkward interactions u Poor time management leads to exasperated friends
u Accommodations
u Simplify social interactions and provide guidance u Scaffold social interactions u Provide support for organization and communication u Provide assistance during complex and fact-paced situations
u Advocate
u Teach a child to stand up for themselves
u Is “traditional therapy” the right type of therapy for a
u Do social skills training programs really work?
u What is slow processing speed? u What does a student with slow processing speed look
u What intervention strategies can be used in the
u What are the other “costs” of slow processing speed –