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  • 9/23/2016

    1

    Increasing Executive Functioning Skills in Children with Hearing Loss

    N E E N A M A L O S K Y, M . E D , I T F S

    C H R I S C Z A J KO W S K I , B . S , N B C T, I T F S

    Disclaimer Presentation materials are for registered participants of the 66th Conference on Exceptional Children. The information in this presentation is intended to provide general information and the content and information presented may not reflect the opinions and/or beliefs of the NC Department of Public Instruction, Exceptional Children Division. Copyright permissions do not extend beyond the scope of this conference.

    What is Executive Functioning?

    It is a neuroscience term that refers to a persons ability to organize thoughts, plan behaviors, say no to impulses, and manage between what he/she is

    feeling and what he/she does. Source: www.parenting.com. The Executive Function Skills Every Kid Needs, Elizabeth Foy Larsen

  • 9/23/2016

    2

    If the brain is a symphony,

    then executive function is the conductor. Thomas E. Brown, Ph.D., professor of psychiatry at the Yale University School of Medicine

    Executive Functioning Skills in Children with Hearing Loss: Highlighted Research

    Figueras, B., Edwards, L.,& Langdon, D. (2008) found a correlation between language ability and Executive Functioning skills in deaf children with and without cochlear implants. The author concluded that deaf childrens deficits in EF are not a consequence of deafness, but are linked to delayed language acquisition.

    Working memory and inhibitory control have been shown by some to be

    poorer in children who are deaf and hard of hearing. (Beer, et al, 2012). Pisoni, Kronenberger, Roman and Geers (2011) found that high school

    students with cochlear implants spoken language outcomes could be correlated with working memory and verbal rehearsal speed in elementary school.

    Source: Executive Function In Children With Hearing Loss | Seattle Childrens Hospital". Seattlechildrens.org. N.p., 2016. Web. 31 Mar. 2016.

  • 9/23/2016

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    Executive Functioning Skills in Children with Hearing Loss: What the Research Tells Us

    Listening primes the brain for cognitive processes such as sequencing sounds, numbers, words, events, etc. Auditory deprivation can result in less efficient cognitive control.

    As a person matures, more sophisticated language is required for EF development. Delays in language may influence development of EF skills.

    Children with hearing loss use more effort to listen and comprehend which leads to less cognitive control and more impulsivity. Listening in noise compounds this issue.

    There is a pattern of weakness in self-control and working memory for children who are D/HH.

    Early deficits in working memory are associated with later language skills and literacy outcomes in children who are deaf or hard of hearing.

    Problems with working memory were found to be related to speech perception in noise and general language ability in deaf children with cochlear implants.

    Language ability appears to be correlated with Executive Functioning in children who are D/HH.

    Source: Executive Function In Children With Hearing Loss | Seattle Childrens Hospital". Seattlechildrens.org. N.p., 2016. Web. 31 Mar. 2016.

    Why is building Executive Functioning skills important for children with Hearing Loss?

    Executive functioning skills are essential to being able to function successfully in and out of the classroom.

    Every day skills- listening and attending in different environments, maintaining attention to follow complex directions with competing distractions, problem solving daily life challenges, evaluating class work or homework, remembering and following rules.

    Social competence- regulating behavior with varying social demands (classroom, recess, home, in play, at a restaurant, etc.), self expression, feeling empathy.

    Math skills- mental math, word problems, correcting errors, remembering basic facts to apply to complex problems

    Reading/Writing- sequencing sounds to decode words, problem solving, predicting, perspective-taking, verbal reasoning, answering questions, developing a written story.

    Source: Executive Function In Children With Hearing Loss | Seattle Childrens Hospital". Seattlechildrens.org. N.p., 2016. Web. 31 Mar. 2016.

    Can you think of a child you work with who

    -is easily distracted?

    -has difficulty paying attention?

    -seems to struggle with making choices?

    -has difficulty starting tasks?

    -has trouble following multi-step directions?

    -gets frustrated at changes in schedule?

    -says or does things with out thinking of them first?

    -needs lots of prompts to stay on task?

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    All of these things are controlled by Executive Functioning!!

    Lets break it down

    Working Memory

    Self Control

    Mental Flexibility

    Working Memory

  • 9/23/2016

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    Working Memory

    The ability to hold information in mind and use it.

    Source: Enhancing and Practicing Executive Function Skills With Children From Infancy to Adolescence Center on the Developing Child at Harvard University.

    Working Memory The ability to:

    Reorganize thoughts to accommodate new information

    Follow complex and multi-step directions

    Apply previously learned information to new situations

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    Two Types of Working Memory

    Auditory Memory-the ability to hold on to information you hear long enough to use it.

    Visual Spatial Memory-the ability to use

    your minds eye to hold onto visual information long enough to use it. Its like a camera in your brain.

    Source: WWW.UNDERSTOOD.ORG, 9 Terms To Know If Your Child Struggles With Executive Functioning Issues, Amanda Morin

    Auditory Memory

    Visual Spatial Memory

  • 9/23/2016

    7

    What does Working Memory look like?

    A young child can recall 1-2 step directions to remember what to do during a board game when it is their turn

    A kindergartner can name rhyming words for a given word

    A child can pick out important pieces of information in directions (critical

    elements)

    A child can listen to a story and then answers questions about the story.

    A student can read an assigned passage and then listen and retain the additional instructions the teacher just gave to the class

    Signs of Executive Functioning Delays in Working Memory

    Unable to remember rules to a game

    Difficulty remembering steps of a task

    Information just doesnt stick

    Self Control

  • 9/23/2016

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    Self Control The ability to master thoughts and impulses so as to resist

    temptations, distractions, and habits, and to pause and think

    before acting.

    Source: Enhancing and Practicing Executive Function Skills With Children From Infancy to Adolescence Center on the Developing Child at Harvard University.

    Self Control The a b i l i t y t o :

    -Delay gratification

    -Resist and not act on impulse

    -Self-regulate physical, emotional, and verbal responses

    What does self control look like?

    A young child can state their emotions, take deep breaths when upset, and take turns during a game.

    Putting toys away upon request. Plays cooperatively in a group of 2-3. A kindergartner can self monitor for speech and language

    errors. An older child can make the decision not to go to the

    movies with their friends because they have a school assignment that needs to be completed.

  • 9/23/2016

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    Sign of Executive Functioning Delays in Self-Control

    Impulsivity

    Remorse after breaking rules, but continues the behavior

    Difficulty following directions or completing

    a task when worried or upset

    Mental Flexibility

    Mental Flexibility

    The capacity to switch gears and adjust to changing demands,

    priorities, or perspectives.

    Source: Enhancing and Practicing Executive Function Skills With Children From Infancy to Adolescence Center on the Developing Child at Harvard University.

  • 9/23/2016

    10

    Mental Flexibility The ability to:

    Switch gears and look at things differently.

    To unlearn old ways of doing things.

    To see things from another persons

    perspective.

    What does Mental Flexibility look like?

    Younger children can wait their turn, even when extra people unexpectantly join the game.

    Children can deal with changes to their daily routine/schedules.

    Children can create a new ending to a familiar story.

    Children are able to understand a characters point of view.

    Sign of Executive Functioning Delays in Mental Flexibility

    Not able to think outside the box.

    Difficulty understanding other peoples emotions.

    Has trouble problem solving.

  • 9/23/2016

    11

    Additional Factors Affecting Executive

    Functioning

    Poverty According to one new study, living in poverty is equivalent to losing 13 IQ points. The brain is so preoccupied with trying to meet basic needs and has less mental energy available

    for processing other decisions. Source: Watson, Angela. How Working Memory Games Can Improve Kids Executive Function in 5 minutes a Day." thecornerstoneforteachers.com.

    "In a predominantly low-income, population-based

    longitudinal sample of 1,259 children followed from b

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