Smart but Scattered Teens

The "Executive Skills" Program for Helping Teens Reach Their Potential

The Guilford Press

Contents

Executive Skills and the Teen Brain

It is Tuesday morning at 6:30 A.M. in the Smith household. There is no indication to Mr. or Mrs. Smith that Jesse, their 15-year-old son, is stirring, although he was supposed to be up at 6:15, since his bus comes at 7:00. His mother knocks loudly on his door to remind him that he needs to get up immediately or he will be late. In a voice muffled by his pillow, Jesse mumbles, "Relax, Mom, I'll get there on time." Mrs. Smith sighs. If Jesse misses the bus, she will need to drive him and won't be able to get to work early as planned. Jesse emerges from his room at 6:40, grabs a bowl of cereal, and casually leafs through the sports pages. Every few minutes, his mother reminds him of the time, and he in turn reminds her that she needs to relax. Jesse does manage to get out the door and make the bus but calls 15 minutes later to tell his mother he forgot his lunch and his algebra book, which has his homework in it. He thinks it's on his desk. Could she drop it off on her way to work, before the end of his first period? His mother agrees because she knows Jesse already has missing assignments.

In the last 2 weeks, Jesse has missed his bus twice, forgotten his soccer equipment once, and been late with a major English paper. His teachers have said that Jesse needs to be more responsible for himself and more motivated and conscientious if he expects to go to college. They know he can do the work if he makes the effort, and they have recommended that his parents consider letting him suffer the consequences of low grades and detention to help motivate him. His parents aren't convinced. Over the past year and a half, since he entered high school, "natural consequences" have not had a significant impact on Jesse's time management, sense of time urgency, or organization.

Jesse did well in elementary school. He was a bit disorganized but typically got good grades, and his teachers noted how creative he was. In middle school, his parents had to provide increased support, but he still managed good marks, although his grades for study skills were weaker. Since starting high school, however, Jesse has struggled more. Whereas in middle school teachers used agenda books and checked them at regular intervals, in high school the student is expected to manage these tasks more independently, and Jesse seems increasingly overwhelmed.

Mr. and Mrs. Smith are realizing that while Jesse expresses a desire to be more independent (he said he set an alarm for this morning), they need to provide continuing and in some cases increased support. They don't mind doing that as long as there is some end in sight, but Jesse doesn't seem to be developing the skills he needs to manage the increasing demands of high school. Nor does he welcome their help as he used to. The more irritably he responds, the more conflict seems to characterize their relationship. Now his parents are losing sleep over what will happen when he turns 16 and can drive. And how about after that, when he's ready for college? He has the academic ability, but will he succeed without the parental and teacher support he's getting now? Like many parents, Mr. and Mrs. Smith have a sense that the clock is ticking. How can a young man who is bright and who expresses a desire and an intention to go to college be so scattered?

The problem for Jesse, as for many adolescents, is not one of intelligence. During elementary and even middle school, Jesse demonstrated the ability to do well in school. Around the house, his parents can see that he's bright and engaging, and they, like his teachers, have seen the spark of creativity. When it comes to smarts, adolescents like Jesse have plenty. What they lack, however, are some of the brain-based skills that we all need to plan and direct activities, to regulate behavior, and to make efficient and effective use of these smarts. The trouble does not show up in math or reading; rather, it shows up when they need to regulate their behavior to respond to the demands of a specific situation. Despite their good intentions, these adolescents can struggle with time management and organization. They can say things in conversation or take risks in situations where it seems like they should know better. They do not lack the intelligence to know better, but they may well lack the executive skills to help them use that intelligence to regulate their behavior.

WHAT ARE EXECUTIVE SKILLS?

When people hear the term executive skills, they sometimes assume it refers to a set of skills required of good business executives—skills like strategic planning, decision making, and information management. There is some overlap—executive skills definitely include decision making, planning, and management of information, and, like the skills used by a business executive, executive skills help kids get done what needs to get done. But in fact, the term as we use it comes from the neurosciences literature and refers to brain-based skills required for humans to effectively execute, or perform, tasks and solve problems.

By the time your child has reached adolescence, she (like you) needs executive skills to manage the range of tasks and problems she will confront on a daily basis, as well as to regulate her behavior in the face of the temptations and distractions that will arise from the presence of peers. From activities as simple as getting up in the morning or remembering to take a homework assignment to school, to the complexity of managing school and extracurricular activities or driving in a car with a group of peers, executive skills are essential. For 15-year-old Jesse, managing his morning routine requires a number of executive skills. If the morning is to go smoothly and without the nagging of his parents, he needs to plan how much time he will need in the morning, remember to set his alarm clock, organize his homework and get it into his backpack, and get to sleep at a decent hour, inhibiting the urge to respond to the nearly continuous flow of text messages from his friends. If he does manage to remember to set his alarm, when it goes off in the morning he needs to initiate getting himself out of bed instead of opting for the immediate pleasure of additional sleep and then run through a mental checklist of what he needs to get together before he gets on the bus.

Let's be clear here. In general, many teens will have wake-up issues. These come with the territory of adolescence. From a biological perspective, the "wake–sleep clock" in adolescents' bodies changes so that they are naturally awake later but still need a good night's sleep. Unfortunately they live in a school world that does not accommodate these changes. School starts early, and even if nothing else were going on, waking up would be somewhat of a struggle. Add to that a day crammed with school, extracurricular activities, and socializing, and you get some idea of what keeps them up late at night. So even teens with good executive skills are going to struggle at times. Biology and busy lives conspire to ensure this.

Our point about Jesse is that when the system is taxed further by a weakness in executive skills, the struggle begins to take a significant toll on the teen's and parents' lives and threatens to impact school performance in a student who is more than academically capable.

For teenagers who struggle with these skills, more trouble lies ahead as the tasks in life become more complicated and more demanding of their ability to plan, sustain attention, organize information, and regulate feelings and how to act on them.

Executive skills are, in fact, what your teenager needs to make any of your hopes and dreams for her future—or her hopes and dreams—come true. By late adolescence, our children must meet one fundamental condition: they must function with a reasonable degree of independence. That does not mean that they do not ask for help and seek advice at times, but it does mean that they no longer rely on us to plan or organize their day for them, tell them when to start tasks, bring them items they've forgotten, or remind them to pay attention at school. When our children reach this point, for most of us our parenting role is coming to an end. We begin to speak of our children as being "on their own" and hopefully accept this at some level of comfort, as well as hoping for the best for them. Social institutions do the same, defining them as "adult" for most legal purposes.

To reach this stage of independence, a child must develop executive skills. You have probably seen an infant watch his mother leave the room, wait for a short time, and then begin to cry for his mother's return. Or maybe you have listened to your own 3-year-old telling herself (in a voice that sounds suspiciously like your own) not to do something. Or how about watching a 9-year-old who actually stops and looks before he races into the street after a ball? Or maybe you've watched your teenage son secure a job and take care of his work schedule without your assistance. In all of these cases, you are witnessing the development of executive skills.

OUR MODEL

Our initial work in executive skills dates to the 1980s. While evaluating and treating children with traumatic brain injuries, we found deficits in executive skills to be the source of many cognitive, behavioral, and academic problems. In our clinic we also noted similar, although less severe, types of problems in children with attention disorders. From these origins, we began investigating the development of executive skills for a broad range of children and adults. While there are other systems for developing executive skills (the Resources section at the back of the book includes references for these systems), our model has been designed to achieve a specific goal: to help us come up with ways that parents and teachers can promote the development of executive skills in kids who have demonstrated weaknesses.

We based our model on two assumptions:

1.Most individuals have an array of executive skills strengths as well as executive skills weaknesses. In fact, we found that there seem to be common profiles of strengths and weaknesses. These patterns apply across the board to children and adults, for those who are developing typically as well as those who have been diagnosed with cognitive, behavioral, or academic difficulties. We wanted a model that would enable people to identify those patterns so that kids could be encouraged to draw on their strengths and work to overcome or bypass their weaknesses to improve overall functioning. We also found that it made sense to help parents identify their own strengths and weaknesses so they could be of the greatest help to their kids.

2.The primary purpose of identifying areas of weakness is to be able to design and implement interventions to address those weaknesses. We wanted to be able to help children build the skills they need or find ways to manipulate the environment to minimize or prevent the problems associated with the skill weaknesses. The more discrete the skills are, the easier it is to develop specific definitions of them. When the skills can be defined specifically, it is easier to create interventions to improve those skills. For example, let's take the term scattered. It is great for a book title because as parents we read the word and know immediately that it describes our child. But "scattered" could mean forgetful, disorganized, lacking persistence, or distracted. Each one of these problems would call for a different solution. So the more specific we can be in our problem definition, the more likely we are to come up with a strategy that actually solves the problem.

The scheme we arrived at consists of 11 skills:

• Response inhibition

• Working memory

• Emotional control

• Flexibility

• Sustained attention

• Task initiation

• Planning/prioritization

• Organization

• Time management

• Goal-directed persistence

• Metacognition

These skills can be organized in two different ways: developmentally (the order in which they develop in kids) and functionally (what they help the child do). Knowing the order in which these skills emerge during infancy, toddlerhood, and beyond, as mentioned earlier, can help you understand how your teenager arrived at the point where she is, as well as what you can expect from her as she moves through adolescence. While all executive skills are important, when it comes to teenagers, parents are likely to be particularly aware of the impact of specific skills. For example, in managing the demands of school, sports, work, and an active social life, the skills of planning/prioritization, organization, task initiation, and time management are particularly important. In terms of the types of activities that teenagers engage in that keep parents awake at night, they will want to know that their children have the capacity for response inhibition so that they do not routinely engage in impulsive and risky behaviors. And as driving comes into play, sustained attention becomes a critical skill. This is especially true since sustained attention can easily be affected negatively by one of the most important elements in a teenager's life, the presence of peers, as well as the constant availability of devices to maintain contact with those peers.

In the table below are listed executive skills in the order of emergence, definitions of each skill, and examples of how they are manifested in teens.

When Do the Different Executive Skills Begin to Develop?

Infant research tells us that response inhibition, working memory, emotional control, and attention all develop early, in the first 6–12 months of life. We see the beginnings of planning a little later, when the child figures out a way to get a desired object. Flexibility shows in the child's reaction to change and can be seen between 12 and 24 months. The other skills, such as task initiation, organization, time management, and goal-directed persistence, come later, ranging from preschool to elementary school, with metacognition coming latest, at 10 or 11 years of age.

In some cases, parents know well before adolescence that their children have weaknesses in executive skills. A problem with flexibility might show up in preschool as regular tantrums in response to unexpected change. You might have learned early on that it was important to maintain predictable routines for your child. As time went on, the foot-stomping tantrums may have subsided, but you still recognize the burst of anger in your teen when you present an agenda different from the one he was planning. If your child's kindergarten teacher reported that your child couldn't wait his turn, was constantly out of his seat, and spoke without raising his hand, you might have been observing weak response inhibition. In adolescence, this weakness might evolve into fooling around and talking out in class and, on the home front, risk taking, particularly behind the wheel. (This is Dick talking:) When I volunteered in my son's first-grade class, I saw him regularly daydream through teacher directions, and throughout elementary school I was a regular visitor to lost and found. Interestingly, I often saw the other parents whose kids struggled with these skills there, and we came to recognize the belongings of one another's children, at times dropping them off for each other. Car keys, books, cell phones, and articles of clothing all fell victim to his weaknesses with attention and organization when he was a teenager.

Definition and Examples of Executive Skills

Executive skill: Response inhibition

Definition: The capacity to think before you act—this ability to resist the urge to say or do something allows your child the time to evaluate the situation and how his behavior might impact it.

Examples: Some teenagers think about the consequences before they do something. Other kids just act—they don't waste time thinking about the consequences.

Executive skill: Working memory

Definition: The ability to hold information in memory while performing complex tasks. It incorporates the ability to draw on past learning or experience to apply to the situation at hand or to project into the future.

Examples: Some kids keep track of their belongings, like coats, keys, or sports equipment, or are really good at remembering what they have to do. Other kids forget where they have left stuff and misplace things a lot or say, "I'll do it later," but then forget about it. Some kids seem to learn from experience; others don't.

Executive skill: Emotional control

Definition: The ability to manage emotions to achieve goals, complete tasks, or control and direct behavior.

Examples: Some teenagers have a short fuse and get easily frustrated by little things or get stressed out if something doesn't go right. Other teenagers can stay cool despite irritation and take unexpected events in stride.