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Plan Organize Work Evaluate Reward Finish!: A Multi-faceted Occupational Therapy Program to POWER! Executive Function

Plan Organize Work Evaluate Reward Finish!: A Multi-faceted Occupational Therapy Program to POWER! Executive Function
Nicole Quint, Dr.OT, OTR/L
January 29, 2016

Executive Function Skills

Executive functioning skills is used as an umbrella term, but it includes a lot of things.

  • Planning/prioritization.
  • Response inhibitionI have a lot of children who struggle with response inhibition.  This is always a big focus.
  • Working memory.  This is being able to take the information from the past and bring it to the present.  This can also be challenging for children.  Children with dyslexia have a difficult time with working memory, and a lot of the children I see, who have sensory processing disorder and ADHD, also have a lot of difficulty with working memory.
  • Emotional control.  This is another big one.  As you heard in my bio, I am focused on social emotional learning. You cannot have executive functioning skills and be at a high developmental functioning level if you do not have emotional regulation.  I also think this is probably an area in OT that we need to be addressing more.
  • Sustained attention.  For some of our children, you will hear the complaints that they have a hard time with attending and focusing.  Sustained attention is a developmental skill related to executive function.
  • Task initiation.  This is the child who has a hard time starting a project.  Some of you might call yourselves procrastinators, because you have a hard time with task initiation, while for other people, it is easy for them to start a task.  This is another executive function skill.
  • Organization.  How many of you consider yourself an organized person?  How many of you consider yourself to be a disorganized person or not so organized?  I consider myself someone who is disorganized in the traditional sense. Although I work in this area, I think my understanding of what it is like to struggle with organization skills is what allows me to help people who also struggle because I understand it.  The thing about organization is everyone can be organized.  There are traditional ideas of what is organized and what is not organized.  We will talk about learning styles and behaviors, and how that influences organization.
  • Time management.  This is another one that is difficult for people.  Many children have a difficult time with time; understanding it, estimating it, and being able to manage their time while they are in the moment.  It is difficult to manage time when you are experiencing flow, which is another goal that we have as therapists.  When you are playing, you often lose recognition of time.  Time management is a tricky one, and sometimes it is important for children not to overly manage time.  It can also be a red flag.  It is an interesting thing to consider.
  • Goal-directed persistence.  Can our children, as well as adults, create a goal, stay on that goal, and use the goal to actually motivate him or her?
  • Cognitive flexibility.  Some of you who work with children on the autism spectrum are probably working with children were challenged by their ability to display some cognitive flexibility. 
  • Metacognition.  Metacognition is incredibly important.  I think it is not given the attention it needs.  That is thinking about one’s thinking.

​Executive Function and Self-Regulation

Executive function and self-regulation go hand-in-hand.  Miyake et al., 2000, scrutinized the literature and the research out there.  They found that inhibitory control, cognitive flexibility, and working memory were the three dimensions related to executive function.  This is how we are able to remember information, filter distractions, resist impulsive urges, maintain our attention during an activity, and stay on that goal.  We then adjust our plan or problem solve as needed, as well as avoid frustration and regulate our emotions.  That is the complication of executive function that we related to being air-traffic controller.  I also would call this occupational performance, which is a term used a lot in the OT practice framework, through an OTA, and through the way that we are teaching students these days.  The goal of OT is to increase performance and participation.  This is what we are talking about when we talk about the analysis of what it takes to have true occupational performance. 

nicole quint

Nicole Quint, Dr.OT, OTR/L

Nicole Quint, Dr.OT, OTR/L has been practicing occupational therapy for over 14 years in both adult and pediatric practice.  She currently serves as Assistant Professor at Nova Southeastern University, teaching in both the Masters and Doctoral programs.  She also provides pediatric therapy services in both the Nova Southeastern University Outpatient Pediatric Clinic and at the University School, a private school on campus within their resource program.  Dr. Quint worked at Healthsouth Rehabilitation Hospital for over six years in the adult and pediatric Day Rehabilitation program, aquatics, and outpatient pediatrics.  Her interests are in sensory processing disorder, learning disabilities, and other “invisible” diagnoses that influence behavior, learning, and socialization, resilience in children and adults, executive function skills and occupation, and leadership within occupational therapy and healthcare.  Dr.Quint is currently a PhD candidate in the Conflict Analysis and Resolution program at Nova Southeastern University. 


Related Courses

Making Sense of Meltdowns: How to Identify and Intervene for Children with Sensory Based Disruptive Behaviors
Presented by Nicole Quint, Dr.OT, OTR/L
Course: #3106Level: Intermediate1 Hour
This course emphasizes how to incorporate sensory strategies for self-regulation in school-based therapy, clinic-based services, and home health services to promote participation and performance in varied environments, including the school context. Emphasis will be on preventing behaviors and meltdowns related to sensory processing, collaborating with teachers and parents to implement into daily routines, and monitoring outcomes for documentation and program evaluation.

Fun, Practical, Client-Centered Activities to Encourage Social Emotional Development in Pediatric Practice
Presented by Nicole Quint, Dr.OT, OTR/L
Course: #3158Level: Intermediate2 Hours
This course emphasizes social emotional learning (SEL) to promote successful occupational participation and performance for children. Social emotional learning emphasizes the process of how children develop the ability to regulate emotions and prosocial behavior through thoughtful decision making processes.

Pediatric Case Study: Child with Oculomotor and Perceptual Challenges
Presented by Nicole Quint, Dr.OT, OTR/L
Course: #4536Level: Intermediate1 Hour
This course focuses on a case study for a 7-year-old male child experiencing difficulties with reading, homework, and following instructions during second-grade class. Utilizing developmental approaches and the Skeffington model, participants will learn both remediative and adaptive strategies to promote occupational performance.

Pediatric Case Study: Child with ADHD
Presented by Nicole Quint, Dr.OT, OTR/L
Course: #4577Level: Intermediate1 Hour
This course focuses on a case study for a 9-year-old male with ADHD experiencing occupational challenges in education, ADL, IADL, and social participation.

Motor Skill Acquisition for Optimal Occupational Performance
Presented by Nicole Quint, Dr.OT, OTR/L
Course: #3747Level: Introductory1 Hour
This course focuses on how the motor learning model can promote motor skill acquisition throughout the lifespan. Utilizing dynamic systems theory, participants will learn how to provide feedback, adapt the environment and the task and how to assess motor learning effectively to optimize occupational performance.

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