Become a Creator today!Start creating today - Share your story with the world!
Start for free
00:00:00
00:00:01
On executive functioning skills for adults and children with Dr. Peg Dawson
842 Plays1 year ago
In this episode, we're going to dive into what's important about executive functioning and why this is an area that we as OTs need to learn more about. We're very fortunate today to have the opportunity to have a conversation with Dr. Peg Dawson. She has over 40 years of experience as a psychologist in clinical practice and has worked with thousands of children and teens who struggle at home and in school.
She and her colleague, Dr. Richard Guare, have written numerous books about executive skills, some of which you'll recognize as Smart But Scattered and Smart But Scattered Teens.
Dr. Dawson is also a recipient of the National Association of School Psychologist's Lifetime Achievement Award.
You can learn more about Dr. Dawson at smartbutscatteredkids.com.
Jump through this episode using our timestamped chapters:
(00:00) Welcome Remarks
(00:30) Introducing Dr. Peg Dawson
(01:19) Peg's background and journey
(04:15) Leaders in the field of executive skills
(05:17) Brief assessment
(07:19) What executive functioning is and why it's so important
(10:20) Are there certain skills that kids or adults usually have greater issues with than others?
(13:34) Goal setting for children
(16:58) Goal setting in adults
(18:40) How to approach task initiation in adults
(20:58) Learning disorders and executive skills
(23:13) The challenge with using standardize test for measuing executive skills
(26:29) Recommendations for OTs specifically to learn more about executive skills
(28:00) How occupational therapy can help support excecutive skills
(29:43) Upcoming research in the area of executive skills
(31:50) Connecting with Dr. Peg Dawson
(32:28) About the SAOT workshops
(37:08) Rapid fire questions
Recommended
Transcript
Introduction and Podcast Purpose
00:00:02
Speaker
Welcome to the inaugural episode of Growing OT. This podcast is developed and produced by the Society of Alberta Occupational Therapists. SAOT is a voluntary, non-regulatory body that provides networking, education and advocacy opportunities for its members. My name is Wilmarie Myberg and I will be your host.
00:00:25
Speaker
This podcast is intended to get listeners excited about different areas of clinical practice. In this episode, we're going to dive into what's important about executive functioning and why this is an area that we as OTs need to learn more about. We are very fortunate today to have the opportunity to have a conversation with Dr.
Guest Introduction: Dr. Peg Dawson
00:00:44
Speaker
Peg Dawson.
00:00:45
Speaker
She has over 40 years of experience as a psychologist in clinical practice and has worked with thousands of children and teens who struggle at home and in school. She and her colleague, Dr. Richard Weyer, have written numerous books about executive skills, some of which you'll recognize as smart but scattered and smart but scattered teens.
00:01:06
Speaker
Dr. Dawson is also a recipient of the National Association of School Psychologists Lifetime Achievement Award. Peg, we are so thrilled to have you with us today. Please tell us a little about yourself.
Background and Interest in Executive Skills
00:01:19
Speaker
Sure. Okay. So my background is school psychology. I worked in the public schools in Maine and New Hampshire, a variety of school systems for about 16 years. And then I joined my colleague and my coauthor, Dr. Guare. We had a private practice for a while and then we merged with the local community mental health center. So that's where I work now on a very part-time basis. But at that, in that setting, I was, my job was primarily
00:01:48
Speaker
assessing children and adults with learning and attention disorders. So my interest in executive skills came about in that work because I was working with a lot of kids with ADHD and or referred for attention problems and
00:02:03
Speaker
The more I worked with them, the more I realized that the American Psychiatric Association's diagnostic criteria for ADHD is problems with attention or problems with hyperactivity, impulsivity, or both. And I just found that these kids had way more problems than that. They had problems with planning and time management, organization, those kinds of things.
00:02:21
Speaker
And I remember talking to my colleague Dick about it, Dr. Greer about it at the time. He and I both did our doctoral work at the University of Virginia, although he went on to do a postdoc in neuropsychology at Children's Hospital in Boston. So as I described these issues, he said, well, Peg, those are executive skills.
00:02:36
Speaker
This was the late 80s, early 90s, and people were not using that term much in those days. So he and I decided we wanted to understand this whole domain a whole lot better. What does the research say? What are these skills? How do they develop? What's going on in the brain? How do they impact school performance? And most importantly, how do you help kids with weak executive skills become more successful students?
00:03:00
Speaker
So that's what led to our writing. We wrote a book for professionals first called executive skills and children and adolescents. And then we realized there was a huge role for parents in all of this. So that's what led us to write Smart but Scattered and Smart but Scattered Teens. We have other books. We have a book on coaching kids with executive skill challenges. We have a book for adults. So for the past, I would say 15 or 20 years, I really divided my time between
00:03:24
Speaker
still do it working in a clinic setting, doing assessments and following up with consultation to parents and teachers, but then also doing a lot of trainings, similar to what I would do for SAOT in terms of helping professionals, particularly I really enjoy working with schools and with teachers because they're on the front lines.
00:03:42
Speaker
But anybody who
Helping Kids with Executive Skill Challenges
00:03:43
Speaker
works with kids, and a lot of my audiences, I have a lot of OTs, and I've actually learned a lot from OTs over the years, just in terms of recognizing that their practice really fits very nicely with helping kids with executive skill challenges.
00:03:58
Speaker
which is a whole lot different. When I was a school psychologist, the OTs were working on fine motor skills. So it took me a while to realize, oh no, they're working with kids on functional skills and so much of executive skills, you know, falls into that category. Thank you so much for sharing. I am wondering when you did first get started in this field, besides yourself and Dr. Guare,
00:04:23
Speaker
Did you have any mentors when you first thought started? And besides yourselves, who else would you see as leaders in this field today?
00:04:32
Speaker
Yeah, that's a good question. I've certainly met people along the way. I wouldn't say any of them are necessarily mentors, but more like colleagues. I mean, for instance, the people who created the behavior reading inventory of executive function, the brief, which is, you know, there are a number of different rating skills out there to assess executive skills. I happen to like that one the best. And I've gotten to know a couple of the authors of the instrument along the way. I've done some work or I've done some co-training with Russ Barkley, who
00:05:01
Speaker
I consider the world's leading expert on ADHD and he certainly knows executive skills really well as, as well. So whether he's a mentor or not, I wouldn't know, but I would certainly highly respect him and he's very knowledgeable in this area. Thank you so much. Can you tell us why you like the brief assessment for most?
00:05:23
Speaker
Sure. So there are several things that I like about it. One is that the items really sort of capture what executive skills look like in everyday life. And so there's a parent version and a teacher version. And so it really is asking parents and teachers to make assessment about the everyday kinds of issues. Like, I don't know whether this is still on the brief, but it was one of my favorite items from the original brief, leaves a trail of belongings wherever he goes.
00:05:51
Speaker
This really just sort of captures that sort of disorganization that goes along with many kids with executive skill challenges. I like the way it's scored that it breaks it down by different categories. So behavior regulation, emotion regulation, and cognitive regulation, all of those I think really capture the different
00:06:10
Speaker
ways that executive skills sort of manifest themselves. There's a preschool version that I actually really like, and I have to admit when they first came out with the preschool version, I thought, how can you measure executive skills in preschool? Because these kids are so young and they don't have much in the way of executive skills, but they really capture it nicely, especially compared to, I use other social emotional rating scales. And I just,
00:06:33
Speaker
It makes a whole lot more sense with preschoolers to talk about things like problems with impulse control or problems with emotional control than it is just to put labels on them like oppositional defiant or anxious. I mean, I'd just rather, it's just a nicer way of talking about kids and it really helps parents and teachers understand what's going on with their children. There's also an adult version, which I like as well. There are other adult rating scales that I might use a little more than the brief, but at any rate, I do think they,
00:07:01
Speaker
The other thing I like about them is when they break it down into individual scales, their labels for the scales map really nicely onto our labels. So I can look at their results and translate them into our terminology in a way that I think makes sense. It's excellent. For our listeners that might not be as familiar with your work, can you explain to us what executive functioning is and why it's so important?
Understanding Executive Skills
00:07:30
Speaker
Okay, sure. So, and it's interesting when you call it executive functions, we tend to refer to them as executive skills. I was going to mention that. We love the word function. So if I understand that, and I mean, that is the more common term, but we chose to call them executive skills for a very specific reason. And that was the skill implies whatever level you're at, you can get better at it and doesn't give you that same message.
00:07:56
Speaker
So if we're going to use function, I would prefer to use executive function skills. And a lot of people combine them because that keeps skills in the title. But what are they? They are the skills required to execute tasks. That's why we call them executive skills. And so, or actually my favorite definition was given to me by a second grade teacher who took a class. I teach a class at the university of Southern Maine every summer on executive skills.
00:08:20
Speaker
And she took the class and she was trying to figure out how to explain executive skills to second graders. And what she came up with was, they're the skills you need to get things done.
00:08:31
Speaker
So if you think about it, planning, task initiation, sustained attention, organization, time management, those are all skills you need to get things done. And in fact, they are this sort of the infrastructure that supports learning. We don't necessarily refer to executive skills in any curriculum standards that I've ever seen. I mean, I don't know what Canada uses, but we have a common core curriculum in the United States.
00:08:56
Speaker
that some states have adopted. I poured through that looking for references to executive skills. There aren't any. And yet everything we ask kids to do in school requires them to use executive skills. And in fact, not only that, but executive skills, I've just started saying in my workshops lately is to teachers, I say, if you have students in your class who are good students, it's probably because they have good executive skills. If you have students in your class who are struggling,
00:09:25
Speaker
at least a part of the reason they're struggling is weak executive skills. I can almost guarantee that they are so critical to school success. And in fact, they are more predictive of school success than IQ is. Now, if you look at elementary age, there are studies that looked at elementary age kids and then looked at them again in middle school and they find that the executive skills that they're exhibiting in elementary school are better predictors of academic performance in middle school than IQ is.
00:09:54
Speaker
And the way we talk about executive skills, they're so manageable. They're things you can do things about. You can help a kid figure out how to get started on a task more promptly, or how to stick with a task long enough to get it done, or how to plan a task. Those are things that you can work on with kids. Teachers understand them, parents understand them. So that's what they are, and that's why I think they're important.
00:10:20
Speaker
That's great. Thank you.
Addressing Executive Skills Across Age Groups
00:10:22
Speaker
When you do go about working on these executive skills, are there certain skills that you might tackle first ahead of others or are there certain skills that kids or adults usually have greater issues with than others?
00:10:38
Speaker
Yeah, that's a really good question. So we talk about 11 different skills. And in my workshops, it's not in our books, but in my workshops, I've started dividing them into two groups, foundational skills and advanced skills. So the foundational skills are the ones that tend to emerge earlier in childhood.
00:10:55
Speaker
many of them during the first year of life, you see the early signs of the foundational skills and they're things like response inhibition, impulse control or emotional control, working memory, task initiation, sustained attention and flexibility. Those were all the foundational skills. And so I generally recommend that you start by addressing the foundational skills. Cause they're actually in some ways the building blocks for the later skills. So the later skills are planning and prioritizing
00:11:24
Speaker
organization, time management, goal directed persistence, and metacognition. They are more complicated skills. They take much longer to develop and they're built on a foundation of those foundational skills. So lately in a lot of my workshops, and I've been doing a lot lately, either workshops or webinars, I ask teachers to identify, give them, here are the 11 skills we're talking about. Which of the biggest challenges for kids at your grade level?
00:11:50
Speaker
And I've started asking teachers all the way from pre-K up through high school. There are some commonalities. Sustained attention they're reporting is challenging across the board these days, which I think is in part one of the lingering effects of the pandemic. But what you find is that at the elementary level, teachers are reporting those foundational skills as being the most problematic.
00:12:11
Speaker
Whereas by the, I like, I worked with eighth grade teachers in Hamilton, Ontario today. And I asked them to rank order the top three challenges and what came up actually, I look at the top four, but what came up three of the four were those advanced skills, organization, planning, time management, and then throw in either task initiation or sustained attention. So you can see that progression. And actually, I think the other thing that progression reflects.
00:12:39
Speaker
is that by the middle school level, our expectations for executive skill development are out of sync with executive skill development. So I think in general, middle school teachers have expectations for things like planning and time management organization.
00:12:56
Speaker
that exceed what kids at that age are capable of. So that's why they're reporting these kids are struggling with them because they don't have enough support because these are just emerging skills for many kids at that age level. And I'm not blaming middle school teachers. I think this is true of society at large that we have these expectations that by the time kids hit middle school, they should be able to remember everything we need to remember.
00:13:19
Speaker
They should be able to plan how their days are going to go. They should be able to manage their time effectively. They should be able to set goals. And kids of that age are not there yet. They still need guidance, support, structuring, scaffolding, you know, whatever you want to call it. And that's interesting that you say that they're just not quite there yet. When we have these expectations, we often feel, oh, this child is unwilling to do what we need them to do.
00:13:45
Speaker
as opposed to, oh, you know, maybe they don't have those skills yet, or they're just not developmentally ready to do that. So speaking about that, when you are going about goal setting with a child, how would you approach that on a case-by-case basis? How do you get them involved in the process, or what's your strategy?
Goal Setting and Adult Executive Skill Issues
00:14:07
Speaker
Yeah, so I mean, it really depends on the age of the child. The younger the child is, we may be a little more directive. We may sort of talk to them about, you know, for instance, you might say, you know, teachers notice that you're having trouble sort of calling out and forgetting to raise your hand. And it's making it hard for the class to work because sometimes the teacher forgets what she's trying to say when you interrupt and other kids aren't happy when you're interrupting them.
00:14:32
Speaker
Is that something you're willing to work on? So we're always trying to, even if we're suggesting a goal, we always want to get mine from the kid. We want them to agree, yeah, this is something I'm willing to work on. With older kids, like middle school, high school, we often start by having them fill out one of our own informal executive skills questionnaires, which are in all of our books.
00:14:55
Speaker
So that they themselves can identify, okay, these are my stronger skills. These are my weaker skills. And then we might say, okay, so one of your weaker skills is response inhibition. So that means you may have trouble going to raise your hand or not interrupting, or you may, you know, get fights out at recess. Is this something that you think, can you think of an area where this gets you in trouble? And is there something you'd like to work on? We always phrase like, is there something you'd like to work on?
00:15:22
Speaker
It's interesting as kids get older, a lot of the kids we've been working with lately are somewhat resistant to the whole idea of goal setting. And I think it's in part because in many cases they've had bad experiences with goal setting. Now they've been asked to set goals. They haven't met them. They'll feel terrible for not meeting them. And I'm talking particularly about kids with attention disorders because they, you know, they tend to have more failure in school around things like that.
00:15:46
Speaker
And so we're more likely to say, is there something you'd like to work on? Is there something you'd like to get better at and not necessarily calling it goals, or even if we're calling it goals, being fairly, not vague, but we don't try to pin them down too much because then they're just afraid they're going to experience failure again.
00:16:04
Speaker
The other thing we do around goal setting is that we always try to build a cushion of success. So especially for kids who have experienced failure with goal setting, we are really encouraging them to set very small goals. You know, if they're not doing any homework in any subject, we won't say, okay, should we set a goal that you're going to get all your homework done five days a week? No, we might say, is there one subject you'd like to work a little harder on in terms of getting your homework done? And
00:16:32
Speaker
Could we set a goal of handing in your homework twice a week? So we tear it down because we really want the kid to experience some success. And especially if the kid themselves are involved in the goal setting, they're more likely to achieve success because it's something they want to work on rather than something a teacher or a parent is saying, you need to work on this.
00:16:57
Speaker
Right. And can you tell us a little bit about how this might show up differently in adults? Question. So in adults, what we find is that it depends on the setting. This is true of kids as well, but particularly in adults, the issues may look very different at home as opposed to in the workplace. And so, you know, we have some adults who, you know, they manage home just fine, but at work it's a problem.
00:17:25
Speaker
or the reverse. They handle work just fine because it's fairly structured. I mean, work involves a job with a boss and a paycheck. And so many adults pull it together to be successful in the workplace and then they go home and they have nothing left for
00:17:43
Speaker
picking up the living room or doing their taxes or things like that. But usually, when I think about the adults that I've worked with over the years in terms of coaching, interestingly enough, a lot of it is around time management and planning.
00:17:59
Speaker
But a lot of that comes back to task initiation or problems with procrastination. So lots of times I'm working with adults to make plans to try to combat that tendency to keep putting stuff off and keep putting stuff off.
00:18:15
Speaker
I mean, there are adults certainly out there who struggle with emotional control and impulse control. I tend not to see them, and many of those end up in jail. It's an oversimplification. But ones that I'm seeing in my clinical practice, they're more concerned about productivity on the job, or they're more concerned about managing their home life so it doesn't overwhelm them. So that's where I see the issues with adults.
00:18:40
Speaker
Thank you. And what would you say when you are working with an adult on something like task initiation? What would your approach be in that case? Again, I would have the adults set the goal and I would have them make it really small to start with. I use the same approach of the adults that I do with kids.
00:19:02
Speaker
In fact, one of my favorite recommendations is that if you really want to change your behavior, the best intervention for executive skills is one that takes no more than five minutes a day, but that you're willing to do forever or as long as it takes. That's my advice for parents, but it's also my advice for adults.
00:19:23
Speaker
I was working with a woman last year who was, she had a number, she was an adult with ADHD, very successful, went to a very good college in the United States. She was working for the federal government, although she was on medical leave at the time I started working with her. And she felt like her house was disorganized. She was having trouble getting anything started. And so I said, okay, so let's choose one thing that you can do that won't take more than five minutes a day.
00:19:48
Speaker
that you can do every day or as many days as you can between now and the next time we meet. We were meeting once a week. And so what she decided was, you know, I said it should take no more than five minutes a day. And she said, okay, I'll make my bed. And I said, how long do you think that will take? And she said,
00:20:05
Speaker
Five minutes. I said, no, probably take less than five minutes. I said, so you need to time it and have something else to do for the rest of the five minutes. So that's so what she decided to do is she would make her bed and then with any time she had left over, she was setting the timer for five minutes. Anytime she had left over, she would do a little more tidying of the bedroom because that was the room she wanted to start with. And so.
00:20:29
Speaker
She, her ability to estimate time was problematic in part because that's true of many people with attention disorders, but we just broke everything down into really small pieces and she sort of worked away at it bit by bit. And that's the way I found that to be the most successful way to work with adults as well as with kids.
00:20:50
Speaker
That's great. So initiating those small incremental changes over a long period of time. Exactly. Now you did mention that executive skills can be challenging for individuals with attention disorders.
Executive Skill Challenges in Psychological Conditions
00:21:05
Speaker
Are there any other conditions or diagnoses that we might see in clinical practice where people are struggling with these skills?
00:21:13
Speaker
Sure. So I often say that every learning disorder or psychological or social-emotional disorder has an executive skills component to it. So that's something to keep in mind. But the ones that jump out at me, there's some clear patterns with kids with ADHD, just like you said, but also autism spectrum disorder.
00:21:35
Speaker
And it's interesting because they tend to have a different set of executive skill challenges, whereas kids with ADHD struggle with response inhibition and task initiation and sustained attention. Kids on the autism spectrum struggle with emotional control.
00:21:51
Speaker
flexibility and metacognition. And then obviously any kid with anxiety, there's problems with emotional control. With depression, there's problems with task initiation at a minimum. Bipolar disorder, and you can get into some of the more significant psychological disorders and there are executive scope components to them. Bipolar disorder is complicated because
00:22:13
Speaker
depending on whether they were in a manic phase or an oppressive phase, you can see problems with task initiation or you can see problems with sustained attention or whatever. So it's helpful no matter what the nature of the diagnosis of the child you're working or adult that you're working with.
00:22:31
Speaker
to look at their executive skills and get an understanding of what that profile is because sometimes you can work to improve those skills and other aspects of their disorder becomes less disruptive. And then the other thing about that is, especially with kids, kids don't like to think of themselves as having social emotional issues.
00:22:52
Speaker
because there's a lot of stigma attached to that. If you can translate that into problems with flexibility or problems with time management, those sound like things that everybody struggles with to some degree or another. And so they're often more willing to tackle those than if you put them in a group to address social and emotional issues.
00:23:13
Speaker
Yeah, that's a very good point for sure. Now you did mention that you typically will use the brief if you're assessing for executive
Assessment Methods for Executive Skills
00:23:22
Speaker
skills. Are there any other tools that you would recommend that you used in practice?
00:23:28
Speaker
So here's my thinking about this. There are tests of executive skills out there. I don't like any of them. I mean, the Dulles Kaplan executive function system, or the psychologists may be more familiar with these instruments than OTs, but the NEPSI has some subtests that sort of capture executive skills. The problem is anytime you use a standardized test to measure executive skills, you're not getting a clean measure of executive skills because standardized tests
00:23:59
Speaker
because they're structured, because they have to be administered in a certain way, they reduce the need for the child or the individual to use their own executive skills to perform the task. So for instance, I often use these examples when I'm talking about assessment. You know, standardized tests, the eye as the evaluator is telling kids when to start and how much time they have.
00:24:20
Speaker
So how am I going to, and most of the tests are very brief because I'm trying to measure as many different cognitive processes in a shorter period of time as possible. So how am I going to measure task initiation and sustained attention under those circumstances?
00:24:35
Speaker
However, I do use formal tests, but more as, and this is where I think there's a connection with occupational therapists. I use it as an opportunity to a structured clinical observation of the child. Kids are more, and this is particularly true of kids, with adults it's much more interview format, but with kids are more doers than they are talkers.
00:24:55
Speaker
So if I can give them a bunch of testing materials and watch how they interact with those materials, then that may tell me a lot about executive skills. And I think what OTs do with kids works the same way. I mean, you can pick up problems with kids that kids have with emotional control or response inhibition just by watching how they interact.
00:25:15
Speaker
with the materials you give them, or if you put them in a performance situation and they feel, oh, they have to get everything right, then you can sometimes see anxiety coming up. So in our executive skills in children and adolescents, we just created a test observation form where we took each of the executive skills and said, OK, these are the behaviors. If you see these behaviors when you're testing kids,
00:25:39
Speaker
That may be a sign that they've got problems with response inhibition or working memory. So for response inhibition, you ask a question before you finished asking it, the kid answers the question. Or you set up materials and they grab the materials before you've given them instructions for what to do with them. Or you give them instructions and they can't remember the instructions. So that would be working memory, where they remember the first part of the instructions, but not the last. So we've done that with each of the executive skills. And I actually think.
00:26:09
Speaker
If you have a lot of experience doing evaluations, a lot of experience working with kids, you could take that checklist and you could say, Oh yeah, now I see how the behaviors that these kids are exhibiting. That's telling me something about their executive skills, which actually may be more helpful and more valid than any test scores they get on any test you might administer.
00:26:29
Speaker
Great. Thank you. That's very helpful.
Resources and Recommendations for OTs
00:26:32
Speaker
Do you have any recommendations for OTs specifically to learn more about executive skills and how to incorporate this learning into practice besides taking your workshop, of course?
00:26:44
Speaker
Yeah, I certainly think reading more about it, there are, I mean, and we have a number of books, but there are others out there, there's a book by Lori Faith is the primary author, she's at the University of Toronto, executive functioning skills in the classroom, I think is the title of that book.
00:27:01
Speaker
where she just describes how teachers can interact with kids to support executive skill development in the classroom. And although it's geared more towards teachers, she talks about it in such an authentic way that I think OTs could pick up on that and apply
00:27:16
Speaker
some of her suggestions to the work that they're doing with kids. Certainly with individual sessions with kids, how you structure those sessions and being intentional about executive school you're going to support during that session or whatever conversations you might have with kids about
00:27:34
Speaker
OK, so here's why we're doing this, because planning is really important. So let's make a plan for how we're going to interact with these materials or what we're going to do for our session today. I don't know books written specifically for OTs on executive skills. Maybe, do you?
00:27:51
Speaker
I can't say that I do at this moment in time, but I'm sure there is something out there that we can definitely look into for sure. And then I guess my last question in regard to this would be, what do you think is unique about occupational therapy that we can bring to the table when we are helping to support these executive skills?
00:28:13
Speaker
So here's what I think OTs can do. I think they've got really good observational skills. And I think they have a really good understanding of children's behavior and what that means. So very often they're interpreting behavior in terms of motor skills or sensory skills, sensory issues or things like that, which I think certainly is valid. But if they added a layer to
00:28:36
Speaker
Oh, so this is flexibility as well. In fact, I got an, I have a good friend who's an occupational therapist and we first started working together. We would get in these sort of discussions where I would say, she would say, I think this is sensory processing. And I'm thinking, no, I think it's flexibility. And we sort of put our, we combined the two. I said.
00:28:54
Speaker
Yeah, they both have a role to play. So OTs already understand the sensory systems, they understand the motor systems, and they know how to observe kids' behavior. If they added that layer on of executive skills, that would enrich what they have to offer. So they could offer multiple interpretations. So they could say, yeah, I think we're dealing with sensory overload here. But I also think this is a pretty rigid and flexible kid.
00:29:21
Speaker
And he has trouble dealing with more than one thing at a time. And so do you see what I'm saying? That you can have a conversation around both what you traditionally do, but that added layer of executive skills I think would be so useful.
00:29:35
Speaker
Yeah, I think that's, we'd be unstoppable then for sure. Now, just tying up some recent here, what should we be looking out for in the coming months and years?
Exciting Research and Developments
00:29:46
Speaker
Is there any exciting research in this area that you know about?
00:29:52
Speaker
or that you're currently involved in? Yeah, I don't do research myself. I try to track it pretty closely. And certainly, I mean, the brain research is fascinating because they keep finding more sophisticated ways of measuring what's going on in the brain while kids are doing things. So for instance, way back when people first started writing about executive skills, one of the early researchers said, you know, there's really only one executive skill. We call it the central executive.
00:30:18
Speaker
And now we're talking about as many as 33 different executive skills, and we've localized it to different parts of the brain. So we know, I mean, the executive skills are managed out of the frontal lobes anyway, but we know right frontal, left frontal, and even more technical terms than that. The understanding of how dopamine and other neurotransmitters impact executive skill, the display of executive skills, I think we're getting our understanding of how that works.
00:30:43
Speaker
And I mean, we've known for some time that the stimulant medications raised dopamine levels for kids with attention disorders. And that that's why they were effective because kids with ADHD don't have enough dopamine. But we're expanding out to understand so much more about how to raise dopamine levels. Physical exercise raises dopamine levels.
00:31:01
Speaker
another role for OTs in there. And so for kids who don't respond well to medication or whose parents are resistant to medication, I think we'll be finding more and more options to help these kids manage despite the fact that their attention spans are short or they have problems with impulse control.
00:31:21
Speaker
So again, I think, I mean, this is the trend in psychological or behavioral research anyway, is we're getting more refined about treatment protocols and what works for some people. What are the variables involved in, you know, why did this intervention work for this kid with this executive skills profile and not for this kid who may have had a very similar profile, but there were other issues in there. So I guess that's what I would be watching for there.
00:31:50
Speaker
Great, thank you so much.
Contact Information and Workshops
00:31:52
Speaker
And if someone had a question for you or wanted to connect with you online, what's the best way to do that?
00:31:59
Speaker
OK, there are a couple of ways. One is my own personal email, dawson.peg at gmail.com. I also have a website called smartbutscatteredkids.com. And if you go there, you can contact me through that. If you email me through my website, it gets to my personal email. So I get a lot of emails through my website. And there are some other interesting articles and tools and little videos on my website as well. So that's smartbutscatteredkids.com.
00:32:27
Speaker
Excellent. Thank you. And we do know that you have some workshops coming up here for SAOT that we're very excited about. Can you tell us about them and what we can expect to learn?
00:32:41
Speaker
Sure. So yeah, this is, I think about the third year that I've offered workshops for SAOT and I always enjoy doing them. There'll be one more geared towards kids and it's basically, I will begin by just helping people understand executive skills.
00:32:58
Speaker
in terms of what's going on in the brain, how do the skills develop? So a developmental perspective, I go through each of the executive skills and I talk about strategies that can be used with each executive skill. That tends to be what the morning looks like. I spend a little time on assessment. Again, although I come at it from a psychologist perspective, I'm always trying to build that bridge too. Here, if you're an OT, here's how you could use these assessment suggestions.
00:33:22
Speaker
And then we get into the categories of interventions, like how do you modify the environment to support kids with weak executive skills? How do you teach the skills to kids? How do you use incentives, if need be, to entice kids to practice those skills so they can get better at them? And so that's what the afternoon looks like. I have a protocol for designing individual interventions.
00:33:46
Speaker
for kids with executive skill challenges that I go through. So that's what the kid one looks like. The adult one is similar in that, except we're talking about all of that from an adult perspective. So if I'm going through the individual executive skills, I'm more talking about what strategies you might use with adults. I come at working with adults more from a coaching model.
00:34:08
Speaker
So you get a feel for what our coaching process looks like and how we collect the kinds of information that we need to understand the adults that we're working with and how with the adults you might build an intervention plan so that they can improve their skills. I think one of the differences between kids and adults, we start small in both cases, but we really need to understand that there's much more neuroplasticity in kids than in adults.
00:34:36
Speaker
You can't assume that, you know, if you're lousy at time management that you could work with a coach and you get great at time management because it's hard to change at that age. So we talk more about how can you build an environment that can offer supports for you given what some of your executive skill challenges are rather than assuming that, oh yeah, we can strengthen these so they won't be a problem for you. It's like, okay, so you have problems managing time. Let's think about where does it get you in trouble?
00:35:06
Speaker
And what can we put in place to help you be more successful in those situations? And then if you're lucky, it'll spread out and you'll get better at it over time. But we're more realistic with adults in terms of how do you modify the environment to support adults with weak executive skills?
00:35:24
Speaker
That's a really excellent point. So you're kind of tackling it from an environmental perspective. It would be best to intervene with kids if possible before they become adults that have challenges with executive skills.
00:35:38
Speaker
Yeah, and I don't mean to say that adults can't change. It's just that you have to be pretty committed to want to do that. Yeah, definitely. And there are adults out there who are. Sometimes I'm tempering their expectations when I'm working with adults, saying, let's take one thing at a time. Because I've worked in the past with people who've tackled five different skills in five different domains, and they burn out after a month. So I'm much more trying to sort of shepherd people along.
00:36:05
Speaker
modify the environment, and how can we work bit by bit to get better at those skills that you want to work on.
00:36:12
Speaker
Thank you. And for our listeners, those workshops are Smart But Scattered, Improving Executive Skills at Home and at School. And that'll be taking place on March 18th from 9 to 4. And the workshop geared towards adults is called Smart But Scattered Adults, How to Work with Clients to Strengthen Executive Skills. And that takes place April 15th and 22nd from 9 to 12.
Special Offers and Personal Insights
00:36:39
Speaker
And these workshops will be delivered virtually via Zoom. To register, you just go to www.saot.com, and listeners of today's podcast who would like to register can take advantage of a special promotion for $25 off of their registration fee with the code PODCAST25.
00:37:00
Speaker
Now to wrap things up finally here with you, Peg, we'd like to thank you so much for sharing your time and your energy with us today. We really appreciate it. We do have a few rapid fire questions for fun. These are meant to just be fun questions that you can answer quickly and not think too hard about. So I will just go ahead and we're excited to learn more about you.
00:37:24
Speaker
If you could have any other job, what would it be? Many years ago, I thought I would love to join the Foreign Service. I spent a year when I was in high school in Norway as an exchange student, and I spent a year in Scotland when I was in college. And foreign travel has always been fun for me, and I think if I were redoing everything, I'd think about, so how could I?
00:37:46
Speaker
become and work in an embassy somewhere. So that's interesting. But that would be an interesting alternative. Do you have any pets?
00:37:57
Speaker
I have had, I'm a cat person. I've had cats for years and the latest cats I had was I got when my son moved to Japan, cause he had two cats and he couldn't take them with them. I loved them dearly and they're now gone. And I traveled too much to want to get more pets at this point cause I had to take care of them. But at some point if I stopped traveling, I'm definitely getting a cat again. Although my husband tells me I'll have to choose between him and a cat. And I tell him not sure about that. Just kidding.
00:38:27
Speaker
Did you speak more than one language? I grew up in the United States at a time where they thought early exposure to foreign language was a great idea. So I started taking French in third grade. And so I took French all the way through high school and even a year into college. And then I became quite fluent in Norwegian, actually, while I was there. Took Latin. I wouldn't say I'm fluent in anything at this point, although I can still get a point across in Norwegian. In fact, we're taking a cruise of the Norwegian coast in June.
00:38:57
Speaker
So my goal between now and then is to brush up on some of my Norwegian. Wow, that's so interesting. Do you have a bucket list?
00:39:08
Speaker
I've really resisted that because a bucket list implies that once everything you've crossed up everything off the list, then you're done. And also just because I want to keep my options open. I mean, there are trips, again, this trip to Norway is one that we were going to go two years ago and then the pandemic hit. So this is if I had a bucket list, that would have been on it. I want to go back to Scotland because I spent time there and I just want to see that one more time.
00:39:37
Speaker
Other than that, I just want to enjoy what I do every day. And, you know, I enjoy reading. I enjoy going for walks. I enjoy my work. I think I'll taper it off. I mean, I'm 73 years old. Now I have to start thinking about retirement at some point. Well, I think I can taper it down. So I'm continuing to do meaningful stuff, but also have a little more time to do the, to just relax, basically. That's great. And are you in the profession that you dreamed of when you were a child?
00:40:07
Speaker
That was such a great question. And there's probably a long answer to that, but I'll give you the short answer. Cause I always was going to be a teacher. I mean, from the time I was in first grade, I was going to be a teacher. And by the time I was in high school, I had a French teacher I really liked. So I thought I'm going to teach French. And then I went to Norway.
00:40:24
Speaker
and learn Norwegian. And in the middle of that year, I realized, oh, if you want to become fluent in a foreign language, you just need to go to that country and live there. So I couldn't imagine teaching French anymore. So I thought, what am I going to do now? Because for the first time in my life, I did not have a profession out there. And in that same year, spending a year as an exchange student, I was living in a town 50 miles south of the Arctic Circle.
00:40:48
Speaker
You know, I was writing letters to my friends because this was before the computer. And so that was the only way of contact I was having with friends. So I was really struggling with, you know, some identity issues. I was helping friends back home, sort of manage some stuff. And I thought, psychology, that's what I want to do. And then when I got to college, I remember stumbling across a book in the college library called Psychology in the Schools.
00:41:12
Speaker
And I thought, oh, you can do psychology and work in schools? Cool. So that's how I ended up. It was a long road, but I really felt like once I'd realized that you could do psychology in the schools and I felt like I'd sort of hit my sweet spot. And so even though I don't work in the schools anymore, I work with schools all the time. So yeah. And now you are kind of a teacher with all of your workshops and facilitating. I'm going to think of it. Thank you. I didn't even think about that, but you're right.
00:41:40
Speaker
Yeah. That's amazing. Wow. Would your 12 year old self think you were cool? Yeah. Yeah, I think she would.
00:41:51
Speaker
If 12-year-olds can actually reflect on what someone looks like 60 years later, which, you know, 12-year-olds are fairly self-absorbed. But yeah, I think so. I think she would be pleased that actually that I'm still sort of out there and interacting with kids and have those connections. So yeah, I'd have to say yes to that. Good question. And what is your favorite breakfast?
00:42:17
Speaker
My favorite breakfast. Okay. So here again, I am a creature of habit. So I typically have some kind of fruit, either oranges or cherries in the summer and almonds. Sometimes I'll have, you know, a more traditional, you know, bacon and eggs, but my usual everyday breakfast is some kind of fruit and almonds and a cup of coffee. Coffee is essential. All right. Our last one here is what is your hidden talent?
00:42:47
Speaker
hidden talent. I don't have one. Years ago as a kid, I used to play the guitar. I actually performed some, I mean, in church things and things like that. But my vocal range has shrunk and my fingers don't work the way they used to, so I can't do that anymore.
00:43:07
Speaker
You know, I think the way I communicate with people is probably, it's not a hidden talent. I think I get complimented on that, but I think that's what I take some satisfaction with that. I know how to connect with people, whether they're kids that I'm working with in my office or their parents or the audiences that I work with. So. That's great. Thank you. I would agree having just met you briefly. And just because we talked about it earlier, is your bed made right now?
00:43:40
Speaker
It's even better. That's been the nice thing. And he's retired now. So he's taken on some of the organizing, because organization is not my strength. So he takes on things like, if I leave dirty dishes in the sink, he cleans some for me. He's so sweet about that. He makes my coffee in the morning. But even if he didn't make the bed, I would, because it took me a long time to get to the point where I really do like things to be pretty neat. And so I would make my bed if he didn't.
00:44:01
Speaker
You know what? My husband makes my bed.
00:44:10
Speaker
Thank you so, so much for your time at Energy Peg. I know this episode will have a lot of value for our listeners, and we really appreciate it. It was nice chatting with you. Yeah, likewise. Thank you. This was fun.