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Teenage Interventions And Helping Teens Build Bridges, Part 2

Teenage Interventions And Helping Teens Build Bridges, Part 2
Tere Bowen-Irish, OTR/L
January 19, 2024

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Editor's note: This text-based course is a transcript of the webinar, Teenage Interventions And Helping Teens Build Bridges, Part 2, presented by Tere Bowen-Irish, OTR/L.

Learning Outcomes

  • After this course, participants will be able to compare and contrast executive function influences on the teen’s performance in school.
  • After this course, participants will be able to identify specific characteristics as they evaluate, then plan for direct treatment.
  • After this course, participants will be able to recognize how to integrate treatment initiatives to aid the teenager in coping with school day self-regulation demands.


Greetings, everyone. I appreciate your presence in this continuation of our discussion. In our previous segment, we delved into the intricate transformations in the adolescent brain and explored their profound impact on learning and intrinsic motivation. Dr. Siegel's groundbreaking research shed light on the brain's burgeoning specialization during this pivotal stage of development. We also scrutinized the fundamental necessities crucial to teens and navigated the dual nature of technology, serving as both a boon and a bane in their journey through adolescence.

Our exploration extended to effective strategies, aiming to forge meaningful connections and establish the necessary pathways for a therapeutic alliance. Creating an environment where teens willingly engage in these connections emerged as a focal point. Additionally, we briefly touched upon the Universal Model of Design, presenting it as an educational theory. Recognizing its position under the educational umbrella, we acknowledged the potential for smoother collaboration with educators and teachers.


Moving forward, our focus will be on unraveling strategies for engaging with these young individuals. By deepening our understanding of them, we aim to forge the essential links and connections that foster trust and compatibility. The key lies in recognizing them as unique human beings, each undergoing a transformative self-discovery journey – a birthing of sorts, as I like to term it. In steering clear of the Stepford approach, where individuals are categorized solely based on their academic standing, such as "sophomore" or "eighth grader," we acknowledge the ineffectiveness of a one-size-fits-all mentality. Tailoring our approach to the individual and understanding their distinct needs are paramount in building meaningful connections and facilitating a collaborative working relationship.

Student Style

  • Seeing them as they really are as an individual, knowing their developmental level, and understanding their dreams/wishes
  • Are you finding the student is often rejecting offers of connection? Are they more engaged if asked to help?
  • Let’s now delve into using Multiple Intelligence (Howard Gardner’s theory) as a means of further inquiry, executive functioning, and prefrontal development, as well as strategies and ideas to enhance self regulation

Resuming our exploration, a crucial aspect of our endeavor is understanding and appreciating the diverse styles of our students. Viewing them as individuals, we gain insights into their developmental strengths and challenges. Central to this understanding is the exploration of their dreams and aspirations. In instances where a student appears resistant to forming connections, it prompts us to consider alternative approaches.

Drawing from my experiences at Seacoast Learning Collaborative, a school catering to students with various diagnoses, notably those grappling with emotional control challenges, I've found success in extending invitations for collaboration. Tasks such as organizing the yoga room or assisting with dog walks become opportunities for connection. The act of offering a helping hand often yields significant breakthroughs in establishing rapport.

I encourage you to explore the concept of multiple intelligences, as exemplified in Gardner's theory. Taking cues from Gardner's framework, akin to the approach in "What Color is Your Parachute?", allows us to bridge the gap between teenagehood and adulthood. This perspective challenges the conventional wisdom that expects students to seamlessly transition from elementary to high school without acknowledging the transformative journey they undergo during these critical years. By dismantling these figurative walls, we can better facilitate their transition, recognizing each student's unique paths.

What is MI Theory?

  • “It is of the utmost importance that we recognize and nurture all of the varied human intelligences and all of the combinations of intelligences. We are all so different largely because we all have different combinations of intelligences. If we recognize this, I think we will have at least a better chance of dealing appropriately with the many problems we face in the world.” Howard Gardner, 1987

Howard Gardner's theory resonated strongly with me as an effective means of understanding the teenagers I was working with. The essence of the multiple intelligence theory lies in recognizing the diverse human intelligences that exist, each person possessing unique combinations thereof.

Our individuality is shaped by a myriad of interests, creating a rich tapestry of differences. For instance, my enthusiasm for physical activity and interpersonal engagement is evident even in our current interaction. What may not be immediately apparent is my passion for cooking and painting. By delving beyond the conventional categorizations and exploring not just occupational traits but also leisure and avocational interests, a more comprehensive portrait of the individual emerges. This approach allows us to appreciate the entirety of a person, fostering a deeper understanding of their multifaceted identity.


  • It is a questionnaire online or hard copy. I like to interview and fill in answers. From that, I can pick up more information to expand my assessment.


Typical questions:

  1. Public speaking makes me nervous
  2. I like individual sports
  3. I love to read
  4. I play an instrument
  5. I care about the environment
  6. Drawing comes naturally
  7. I love keeping stats on my favorite football team

In my practice, I often opt for an interview approach with students when utilizing the questionnaire. Conducting a conversation provides a richer source of information, allowing for a more nuanced understanding of the individual.

Consider typical questions from the test, such as assessing comfort levels with public speaking. As the student responds, additional insights emerge. For instance, their discomfort with reading in class unveils a deeper layer of information. Exploring preferences for individual sports, like karate or bowling, might reveal a reluctance to engage in team activities due to challenges in teamwork dynamics.

A more comprehensive picture of the student unfolds when the conversation delves into interests like reading or playing an instrument. A recent encounter with a 13-year-old who received drums for Christmas exemplifies the illuminating nature of these discussions. By recognizing their passion and encouraging self-expression, we can tap into their enthusiasm.

Even seemingly straightforward questions about caring for the environment or drawing reveal nuances in the student's inclinations. Scoring the test in collaboration with the student allows them to identify areas where their strengths lie. It's important to convey that these identified intelligences don't dictate a rigid career path but provide valuable insights into their abilities.

By emphasizing the positive aspects of students through the multiple intelligence theory, we can counteract conventional perceptions and foster a more holistic understanding of their capabilities.

Accentuate the Positive (Rosenthal and Jacobsen)

  • Rosenthal and Jacobsen say that “the ways in which educators view a student can have a subtle but significant effect upon the quality of teaching the student receives and may help to determine the student’s ultimate success or failure in school.”  

  • * “Self-fulfilling Prophecy or Pygmalion Effect”

As noted by Rosenthal and Jacobsen, educators' perceptions of students wield a subtle yet profound influence on the quality of teaching and, subsequently, on the student's ultimate success or failure in their educational journey. This holds particular relevance during the formative teenage years.

Acquiring a deeper understanding of students during this critical period allows us to contribute significantly to their development. Armed with this knowledge, we can actively assist them in constructing a bridge that propels them forward in a manner both captivating and respectful of their individuality. By acknowledging and appreciating who they are, we foster an environment conducive to meaningful growth and success.

Has Our Culture Defined Intelligence Too Narrowly?

  • Gardner believes there are at least eight basic intelligences
  • Gardner wanted to broaden the scope of human potential beyond the IQ score
  • He believed intelligence had more to do with solving problems and creating products in a rich, natural setting that offered opportunities to explore and produce

Whether our culture has defined intelligence too narrowly is pertinent, especially when considering the traditional emphasis on IQ scores in educational settings, often witnessed during Individualized Education Program (IEP) meetings. In the 80s, introducing Howard Gardner's theory of multiple intelligences presented a refreshing perspective on intelligence. However, a challenge arose when some educators misinterpreted the theory, narrowing their approach to exclusive reliance on a student's identified intelligence.

Gardner intended to broaden the scope beyond the limitations of IQ scores. His theory proposed that intelligence encompasses various modalities, influencing how individuals solve problems and create products. Rather than advocating for a singular approach based on identified intelligence, Gardner encouraged a more inclusive and diverse understanding of intelligence. Unfortunately, a segment of educators misunderstood this intention, leading to a loss of credibility for the theory within certain educational circles.

Gardner's vision was rooted in the belief that embracing a broader definition of intelligence provides ample opportunities for individuals to explore and understand themselves better. It extends beyond a one-size-fits-all mentality, recognizing the richness of human capabilities and problem-solving approaches. The challenge remains in promoting a balanced and accurate interpretation of Gardner's theory within the educational framework.

Overview of Each of the Intelligences

Now, we're going to overview each of these intelligences briefly.


  • Use of words in an effective manner.  Manipulation of language structure, sounds of language, meanings of language, and the practical use of language in relationship to one’s environment.

As conceptualized by Gardner, linguistic intelligence aligns closely with conventional education methods. It revolves around the adept use of words, effective language manipulation, and a keen understanding of language structure and sounds. Students who excel in linguistic intelligence often thrive in the academic environment, where reading and writing are fundamental learning components.

Logical Mathematical Intelligence

  • The capacity to use numbers effectively and use reason. This individual may be very adept in understanding logical patterns, relationships, propositions (cause-effect), functions, and abstractions. The primary processes are classification, inference, calculation, categorization, and generalization.

In Gardner's framework, logical mathematical intelligence spotlights individuals who wield numbers with precision and effectiveness. These individuals excel in reasoning, showcasing a knack for patterns, calculation, and categorization. Their understanding of how mathematics permeates various aspects of life is not just theoretical but applied in practical scenarios.

Much like linguistic intelligence, logical-mathematical intelligence aligns closely with traditional educational structures. It thrives within the academic landscape, where numerical proficiency and analytical thinking are highly valued. These two intelligences, as delineated by Gardner, find their place comfortably under the expansive umbrella of education.

Spatial Intelligence

  • Ability to perceive the spatial world accurately. Based on their perceptions, they then apply those to transform their work (architects, decorators, etc.). Colors, lines, forms, shapes, and space use are tools to graphically stand for spatial and visual ideas.

Spatial intelligence, as defined by Gardner, illuminates the capacity to accurately perceive and navigate the spatial world. Individuals endowed with spatial intelligence possess a unique ability to translate their perceptions into practical applications, transforming their understanding into tangible work. This form of intelligence is particularly pronounced in individuals who excel in roles such as decorators, architects, engineers, and other professions where a keen grasp of colors, lines, forms, and graphic expression is paramount.

Body Kinesthetic

  • Using one’s body to express ideas and emotions. An affinity to produce or renovate things (sculptor, mechanic, surgeon).  Certain physical skills exist such as coordination, balance, dexterity, strength, flexibility, and speed. There are also proprioceptive, tactile, and haptic capabilities (related to touch).

Body kinesthetic intelligence, as outlined by Gardner, involves the ability to express ideas and emotions through physical means. Many of our students exhibit strength in this intelligence, often influenced by their unique characteristics or diagnoses. In the broader context, this form of intelligence finds resonance in professions and activities that necessitate hands-on work. This includes individuals engaged in physical labor, dancers, or those who excel in activities such as horseback riding.


  • The capacity to express, transform, and discriminate musical forms. The person is sensitive to rhythm, melodies, and pitch. They can have a figural sense of music (intuitive) or technical/analytical comprehension.

Musical intelligence involves the ability to express, transform, and discriminate. Individuals with this intelligence are sensitive to rhythms, melody, and pitch. They may possess a figural sense of music, characterized by intuition, or demonstrate a very technical analytical comprehension.


  • The ability to have a sensitivity to moods, facial expressions, gestural responses, and voice intonation and to respond to those cues pragmatically to promote action. 

Often overlooked in traditional assessments, emotional intelligence revolves around the ability to discern and express mood through facial expressions, gestural responses, and actions. Individuals with this intelligence excel in social-emotional communication, often becoming the go-to person for others seeking support or guidance with their problems in a classroom or social setting.


  • This individual has self-knowledge and acts adaptively with that knowledge. They have an accurate picture of one’s self (strengths and weaknesses), understand inner intentions, moods, and needs, and demonstrate the capacity for self-discipline, esteem, and understanding.

Intrapersonal intelligence, often overlooked, manifests in individuals who exude a sense of being an old soul. These individuals possess a deep understanding of themselves, acting adaptively with a keen awareness of their limitations and capabilities. With heightened self-discipline, self-esteem, and profound self-understanding, they consistently show up as grounded and self-aware individuals.


  • This person has keen sensory skills, likes to be outside, and cares about animals and plants.  Interested in TV shows, books, objects and information about nature. Has heightened environmental concerns and sees interconnections and patterns on a large scale. May enjoy collecting, organizing, and categorizing.

Naturalist intelligence, the final addition by Gardner, is evident in individuals who harbor a deep love for the outdoors, a genuine concern for animals, and a preference for nonfiction over fiction. These individuals are drawn to understanding natural phenomena and are often fascinated with topics like marine life. Naturalists tend to be collectors, organizers, and categorizers, showcasing a strong affinity for the intricacies of the natural world.

An intriguing observation, though without specific research backing, is that many individuals diagnosed with the autism spectrum lean towards this category. While lacking formal evidence, this alignment within Gardner's multiple intelligences theory adds an interesting dimension, particularly in its parallel with developmental considerations. The resonances between naturalist intelligence and the preferences and tendencies observed in certain individuals offer an additional layer of insight and curiosity within the broader framework of multiple intelligences theory.

Intelligences: Developmental Trajectory

  • There exists a developmental trajectory.
    • Each level has its own time to arise in childhood. Intra and interpersonal are critical areas in the first 3 years of life. Others burst in childhood such as linguistics and remain until old age.
    • The earliest intelligence to develop is musical.
    • Spatial starts in early childhood and continues to old age.
    • Mathematical peaks in adolescence and early adult years, with higher insights decreasing at age 40.
    • Body-kinesthetic varies based on strength, flexibility, and both gross and fine coordination.
    • MI theory has been investigated in terms of neurological systems and brain function.
    • MI theory has been connected to what people choose to do professionally.

Each of the eight intelligences we've explored has its own developmental timeline in childhood. Intrapersonal and interpersonal intelligence, crucial for self-awareness and social interaction, are particularly significant in the first three years of life. During this period, a child's understanding of themselves, their sensory preferences, confidence, and trust in their caregivers begins to take shape. The early cultivation of these intelligences can impact a child's ability to connect with others as they progress through preschool and kindergarten.

Certain intelligences, like linguistic, can continue to develop and benefit individuals throughout their lives. Engaging in activities such as learning new words daily, listening to books, or playing word games contributes to the ongoing growth of linguistic intelligence. This continuous stimulation helps build and reinforce the neural connections in the brain, a process that extends from childhood into old age.

The earliest intelligence to emerge is musical; its development often starts in infancy. Singing to a six-week-old grandchild, for example, can captivate their attention and trigger a sense of curiosity about the source of the sounds. Mathematical intelligence peaks in adolescence and early adulthood, with higher insights decreasing by age 40.

Bodily kinesthetic intelligence, related to physical coordination and movement, varies widely among individuals. Many children facing challenges with strength, flexibility, and motor coordination can benefit significantly from interventions that facilitate this intelligence, contributing to their overall development and sense of wholeness.

MI Theory and Abilities Model

  • MI puts challenges in a broader context; I find it to be an abilities model.
    • Allows team to look at kids as whole human beings
    • Teases out what strengths exist in the 8 intelligence areas
    • Moves from a deficit paradigm to an ability/growth model
    • Think about it this way:
      • Speech Pathology
      • Emotional Disturbance
      • Mental Retardation
      • Attention Deficit Disorder

Multiple Intelligences theory, being brain-based, has undergone investigation concerning neurological systems and brain function. Its connection to the professional realm, particularly in fields like speech pathology and special education, highlights its practical implications. MI theory stands out as an abilities model, focusing on teasing out strengths rather than weaknesses in individuals, reframing the approach to diverse abilities.

In a professional context, where negative focuses like speech pathology, emotional disturbance, mental retardation (thankfully, this terminology is gone), and attention deficit disorder are common, MI theory shifts the perspective towards an ability focus. This redirection is crucial in recognizing and fostering the strengths of individuals rather than dwelling on perceived deficits.

I participated in an IEP meeting, working with a student who was in a wheelchair due to cerebral palsy. Despite the physical limitations, she exhibited what I would describe as average intelligence and relied on communicative devices for expression. In the course of our interactions, primarily conducted through interviews, I discovered something remarkable – her intelligence lay in the musical realm.

Music became a profound source of joy for her. Observing her response when music played, I noticed a remarkable release in her body, signaling a relaxation that was not only therapeutic but also captivating. The music captured her attention, enhancing her focus and concentration on other activities. This realization prompted me to incorporate Multiple Intelligences testing during her triennial evaluation.

During the subsequent IEP meeting, her mother looked at me with tears as I shared my findings about her musical intelligence. She expressed gratitude, stating, "Tere, no one's ever told me that she's intelligent in any way whatsoever. They always talk about what she can't do." On that day, I felt more than a professional; I felt like a therapist, recognizing and affirming the intelligence and strengths that had often gone unnoticed.

MI Theory and Growth Model

  • MI is based on a growth model.
    • Takes into consideration the student’s integrity
    • Provides an opportunity for collaborative teaching
    • Uses tasks, resources, and activities that are excellent for all students
    • Provides a variety of experiences based on real-life 
    • Uses authentic assessment, focusing on the child’s strengths
    • The student is a whole person who happens to have a disability

The Multiple Intelligences Theory operates on a growth model, considering each student's integrity. This framework recognizes individual strengths and opens avenues for collaborative teaching, fostering a more inclusive and tailored educational approach.

Reflecting on a specific case, I encountered a middle schooler with musical intelligence. Leveraging this insight, we integrated technology by downloading multiplication rock onto his iPod. He willingly engaged with this material during his bus commute, significantly improving his multiplication table proficiency within six weeks. This personalized and targeted approach showcased the effectiveness of MI theory and emphasized the potential for diverse and individualized experiences.

By tapping into the limbic system, where their intelligence lies, and acknowledging each student as a whole person, including those with disabilities, we create an educational environment that values and supports the unique capabilities of every learner.

Intelligence Examples

Let's look at examples in these different areas to discuss how we can stimulate specialization in a teenager.

  • Linguistic: Book clubs, poetry writing, helping to teach reading
  • Logical, Mathematical: Legos clubs, Sudoku, keeping stats on teams
  • Bodily Kinesthetic: Sports, individual and team, assisting with physical education or recess
  • Spatial: Graphic design, art classes
  • Interpersonal: Public speaking, student council, debate club
  • Intrapersonal: Meditation, mindfulness, journaling
  • Musical: Formal lessons, songwriting, joining a band
  • Naturalist: Environmental causes, volunteering at animal shelters, recycling initiatives, hiking

Matching students' strengths, abilities, and interests with appropriate activities can open new doors and make a significant impact. Above are some examples of each intelligence. These examples illustrate how tailoring activities to students' unique intelligences can create engaging and fulfilling experiences. Recognizing and leveraging their strengths enhances their learning and communicates a powerful message – that we see and value each individual for who they are.

  • Research on Gardner’s theory suggests that what we choose for our life’s work is based on our intelligences…
    • Public Speaker: Interpersonal
    • Writer, Blogger: Intrapersonal
    • Conservationist: Naturalist
    • Music teacher or instrumentalist: Musical
    • Graphic designer: Spatial
    • Accountant: Mathematical
    • Writer, interpreter: Linguistic
    • Gym teacher, Personal trainer: Bodily Kinesthetic

Gardner's theory suggests that our choice of life's work is often influenced by our intelligences. This perspective is well-documented and explored in various sources and books. Above are some vocational examples. While it's common to think about intelligence in a vocational context, the avocational aspect is equally important. Gardner's theory emphasizes that as individuals move into adulthood, they tend to specialize. It's crucial to recognize the significance of leisure interests or play in personal development. As teenagers transition into adulthood, the tendency is to focus heavily on work, often neglecting the importance of downtime and relaxation.

Encouraging teenagers to reintegrate play or leisure into their lives can mitigate the risk of becoming over-focused on work. Play doesn't have to be perfect; it can be a form of exploration and enjoyment. For instance, a colleague's hobby of recreating Civil War battle enactments through painting figures serves as a creative outlet. Others may enjoy activities like pickleball, racquetball, or swimming to express their bodily kinesthetic intelligence.

It's essential to emphasize to teenagers and ourselves the importance of embracing leisure and play as integral components of a balanced and fulfilling life.

Resilience, Flexibility, and Focus

  • Entering with a touch of executive skills via a back door!

Let's look at the aspects of resilience, flexibility, and focus, with a touch of executive skills coming in through the backdoor. In my earlier years, my focus was primarily on executive function, especially when working with middle school and high school students. However, I've come to realize that the development of executive function begins as early as infancy, a realization that initially surprised me but has proven to be true.

In the context of early development, inhibition is a key aspect of executive function. It involves observing whether a child, even an infant, can hold back and wait. Reflecting on this, I recently had a conversation with my daughter about her own infancy. I shared how her brother would cry persistently until he was fed, contrasting it with her behavior. She had a remarkable ability to observe and anticipate. As soon as she saw me start to undo my blouse for feeding, she would stop crying, demonstrating an early form of inhibition and an ability to anticipate events. This early glimpse into executive function highlights its roots in infancy and underscores the importance of understanding and fostering these skills from an early age.


  • As therapists, we see this variability. Many of our students can’t bounce back and be flexible in their thinking or concentrate directly, so you may see symptoms of dysregulation.
    • Disorganization
    • High level of arousal
    • Disconnect between goal and response
    • Inappropriate behavior under instruction
    • Inability to tolerate the sensations of distress to meet a need

Understanding that the frontal lobe is still in the process of development during these years, we, as therapists, often observe a lack of resilience and flexibility in many of our adolescent clients. Instead of witnessing self-regulation, what often surfaces is dysregulation. This can manifest in various ways: teens may struggle with being prepared for each class, leading to a lack of necessary materials or a failure to turn in completed homework. Some may find it challenging to break down long-term assignments into manageable steps, hindering their ability to plan and execute. Adolescents may experience heightened arousal levels, making it difficult for them to focus and causing them to become easily distracted. Despite teachers providing instructions for the block schedule, students may not grasp the overall goal for the session, requiring more detailed task breakdowns. In some cases, inappropriate behavior may surface during instruction. This could be a coping mechanism if the material is beyond their understanding, prompting them to divert attention through disruptive actions. Teens might struggle to tolerate the distressing sensations associated with delaying immediate pleasures for the sake of meeting a need, such as completing a presentation rather than enjoying a beautiful day outside. These observations highlight the challenges adolescents face in developing executive skills, emphasizing the need for scaffolding and support from adults to foster resilience, flexibility, and focused attention.

Diffusing Situations

  • You don’t have to attend to every argument you’re invited to. Thingsweforget.blogspot.com
  • With the following tools, and information, we as educators may be able to diffuse situations…in different ways.

Another valuable perspective is encapsulated in the phrase, "You don't have to attend every argument you're invited to." Armed with the following tools and information, as occupational therapists, we can potentially defuse challenging situations in unique ways. We gain a broader perspective by reframing our approach and considering the underlying issues as potential self-regulatory challenges rather than solely behavior. This allows us to step back, identify nuances, and employ strategies that might look beyond the surface of the situation.

Definition of Resilience

  • Noun-the capacity to recover quickly from difficulties; toughness
  • the ability of a substance or object to spring back into shape; elasticity

Oxford Dictionary

The definition of resilience is "the capacity to recover quickly from difficulties and toughness." Resilient individuals are those who can bounce back swiftly from challenges. On the contrary, individuals lacking resilience might find their entire day derailed by a mishap at 8:15 AM. They struggle to regroup or reset, showcasing inflexibility. Their minds become entrenched in negative thoughts, creating a cycle of increasing anxiety. For example, a small mistake in the morning could lead to a persistent belief of having messed up, impacting their ability to move forward. In the context of focus, it is defined as a point from which attention or activity is directed and concentrated.

Definition of Focus

  • A point upon which attention or activity is directed or concentrated.
    • Our job is to help them be all they can be.
    • Our observations and insights regarding focus can be invaluable!

Collins Dictionary

Our job is to help them be all they can be. When we notice through our observations about resilience and focus, we can add those insights I just talked about.


  • Matching executive function to actual behaviors in the classroom allows us to better plan for treatment.

You received a handout detailing executive skills and their impact on classroom independence. The document illustrates a range of activities with two puzzle pieces at the top. There's another handout titled "Executive Skill Examples, Middle and High School." As we progress, feel free to fill in the details on these sheets. The answers are conveniently located at the bottom, allowing you to check your understanding as we proceed. If you're inclined, you can even fold the bottom piece and attempt to go through the exercise independently. 

Frontal Lobes: Executive Skills

  • The frontal lobes of the pre-teen and teen are responsible for executive skills.
    • Activation
    • Focusing
    • Effort
    • Emotion
    • Working Memory
    • Action
  • There are sub-categories under these. Look at the handout, Executive Skills and Abilities that Affect Classroom Performance.
  • Next, look at the handout, Executive Skills Examples.
  • Fold the bottom of this page back, out of view, and try to match the skills that are presented.

The frontal lobes of pre-teens and teenagers play a pivotal role in executive function. In the provided sheet with puzzle pieces, I've broken down executive function into various categories such as activation, focus, effort, emotion, and more. Subcategories under each of these titles further elucidate the components of executive function for a comprehensive understanding.

  • Many of your answers may overlap…that is normal…What is the best answer?
    • Harry? Planning and thinking ahead
    • Sera? Inhibition
    • Jill? Volition
    • Aaron? Frustration
    • Lauren? Accessing recall
    • Jeremy? Organizational skills
    • Jason? Processing speed
    • Anna? Activation
    • A.J.? Self-awareness
    • Eric? Flexibility

Look at the examples and executive skills and try to match the areas where people have issues. Some may overlap where there is no absolutely correct answer, but we'll try to be in the ballpark together.

In the first example, Harry says, "I didn't know I would need my folder. I left my book at home because I figured I could share with Corey." He went ahead and did assignments for the next chapter and got them all wrong because he hadn't done the assigned reading. Harry has challenges with planning and thinking ahead.

Sera continually blurts out answers during group discussions, even if the group is cued to raise their hands. She has trouble with inhibition. She also may be having problems with working memory. We don't know this, but that would be one of my questions. She's also disinhibited with the blurting of answers.

Jill doesn't seem to care about meeting deadlines or taking on any challenges. I only saw her homework every day when a day off of homework was offered for four days during Spirit Week. She lacks volition and cannot give herself that feeling of, "Wow, I got it done. That feels great." She needs a carrot dangled. This is an age where people go, "No reward system is needed." However, if you understand this part of executive function, specifically for kids with ADHD, carrot dangling is a necessary thing. It may not be something like a sticker, but rather, something to work towards because they don't have it inherently. 

Aaron often looks at paperwork, laying his head on the desk or crushing it into the ball. This is pure frustration. He cannot even attempt the activity because it is too much for him. Whether his lagging skills are cognitive or he has too much stuff going on at home, he cannot be fully present at school. I don't know the answer, but handling frustration is not there right now.

Lauren seems to grasp a math concept; she skips the crucial step the next day and can't find her way out. This executive skill is accessing recall. Sera and Lauren might have something similar, but it shows up differently.

Jeremy's backpack and folders are always overflowing. He can't find homework, often forgets materials, and misses deadlines. He has issues with organizational skills. Thus, he and Harry have things in common. This is when you start to look at maybe the top five skills with challenges, then you gather more information. What I might do with this executive skill puzzle sheet is I might say, "I'm going to circle five things I think you're challenged with, Jeremy. And then I want you to circle five things, and let's compare."

Jason performs well orally during lectures. The minute he's writing or keyboarding, his output is so slow, and often, he doesn't complete the assignment. He has trouble with processing speed. He is probably shutting down because he can't think and do the motoric output at the same time.

Anna can't seem to even start her work. She's putting on lip gloss, fiddling with her phone, or chatting with the kid beside her. I need to remind her to get going even after five minutes. This is activation. This kid works the room, talks to everybody, and gets dates to play on the playground. When you see this occur in middle and high school, you realize these kids also have trouble jumpstarting themselves.

AJ prefers to turn in his homework early in the morning to all his teachers before class. He claims if he doesn't, he will forget, and it seems to work for him. This is intrapersonal and self-awareness.

Finally, Eric expresses upset at missing class time when school-wide assembly is called, even if it's for something enjoyable. This is flexibility. He gets stuck, as he likes routine and ritual. He does not want to veer from it.

This is a list that I compiled from a variety of resources. I'm sure there are other lists out there for executive skills. But I would suggest that when you really are trying to analyze where you're seeing the breakdown or the lag, you can use something like this to separate executive function qualities and behaviors and then try to match with the student you're focusing on.

Brain Breaks

  • Brain Breaks or Attention Restoration Therapy (ART) will help with de-stressing and regrouping
  • *Taken from the book Boosting Executive Skills in the Classroom: A Practical Guide for Educators by Cooper-Kahn and Foster

Attention Restoration Therapy (ART), as described in the book "Boosting Executive Skills in the Classroom," emphasizes the importance of brain breaks or "art" in cleansing the mental slate. This approach focuses on maintaining attention and preventing the loss of focus, serving as a proactive measure rather than a reactive one. Even if brief, integrating moments of quiet and peace contributes to overall cognitive functioning.

As a mindful educator, creating opportunities for students to experience micro-moments of peace becomes crucial. The concept of "glimmers" represents these small instances of tranquility, acting as opposites to triggers that induce stress or discomfort. Implementing practices that allow students to identify and appreciate glimmers can positively impact their well-being and cognitive abilities.

Incorporating such strategies not only aids in maintaining attention but also enhances overall mental resilience and flexibility. It's essential to recognize and value these small moments of reprieve in the context of supporting students' executive skills and well-being.

Braintastic Ideas

  • Tangram designs
  • Joke of the day
  • Quote of the day
  • Riddle of the day
  • Word of the day
  • Theraband exercises
  • Theraputty sculpture
  • Mindfulness techniques
  • Throw Aways/Gathering the Goodies (from the Drive Thru Menus)

The Braintastic handouts offer a framework for structuring students' day to enhance their cognitive functioning and overall well-being. These strategies can be valuable tools when collaborating with teachers to create an optimal learning environment. Addressing how students are welcomed into the classroom is crucial, emphasizing the importance of a positive and supportive atmosphere throughout all grade levels.

These handouts also prompt considerations about the daily schedule and routines. How are transitions managed? Are there clear expectations for each subject or class? Establishing a predictable and organized framework helps students navigate different subjects, fostering a sense of stability and reducing anxiety.

These Braintastic handouts serve as practical guides for educators to implement strategies that support students' executive skills and contribute to a positive and effective learning experience.

  • Beyond these strategies…we need to advocate for awareness of both sensory and movement needs in our middle and high schools.
    • There are other educators who are pushing for these initiatives. I joined their bandwagons, as My Drive Thru Menus brings movement into the classroom, and was inspired by them.
    • Spark, Ratey (as mentioned in part one)
    • The Kinesthetic Classroom, Lengel and Kuczala
    • The Laughing Classroom, Loomans and Kolberg
    • Brain Rules, John Medina
    • Teaching the Moving Child, Berkey
      • “When the body is inactive for 20 minutes or longer, there is a decline in neural communication.”(Kinoshita, 1997)

When consulting with middle school and high school teachers, I introduce the concept of Braintastic ideas to be integrated into their daily schedules. I challenge them to reflect on whether they are consistent in their teaching approach from the first-morning class to the final class in the afternoon. Emphasizing the importance of creating routines and rituals within the classroom context, I encourage teachers to work smarter, fostering stability and reducing student anxiety.

One example is a teacher who uses Tangram exercises as a landing routine. Each student has a Dixie cup with blocks, and they spend a few silent minutes creating a Tangram design upon entering the class. This establishes a quiet moment for students to transition into the learning environment. Another teacher incorporates "throwaways" and "gathering the goodies" activities. During "throwaways," students release tension by physically tossing away something unimportant, while "gathering the goodies" involves stretching out to welcome positive thoughts or set intentions for the day's activities.

Other teachers have introduced humor with a joke of the day, or thoughtful quotes to set a positive tone. By implementing these rituals, teachers can create a sense of predictability and comfort for students. Additionally, I suggest TheraBand exercises, mindfulness techniques, and movement breaks, emphasizing that these strategies are not limited to elementary school but are equally beneficial for middle and high school students. Movement breaks help combat stress, release serotonin, and break the monotony of the day.

I also advocate for continued consideration of sensory needs and movement breaks beyond elementary school, emphasizing the importance of understanding students' needs. By incorporating these practices, we are addressing physical well-being and teaching valuable coping strategies that students can apply throughout their lives.

Sensory Processing

  • There is a great book called "The Highly Sensitive Person" by Elaine Aron
  • We know, the Sensory Profile for adolescents and adults is a test that an OT can give to determine how some sensory issues, specific to the student, may interfere with learning
  • This can be a unique contribution by therapists

I emphasize the importance of considering sensory processing in adolescent and adult populations. Despite the occasional surprised reactions, I find it crucial to utilize tools like the Sensory Profile for adults and adolescents. This enables me to gain a better understanding when observing unusual sensitivities in individuals. For example, in a recent yoga class, a 17-year-old student stood out by positioning her mat far away from the others, indicating a need for ample personal space. Recognizing this, I accommodated her preference during activities like mountain pose, ensuring her comfort by respecting her aversion to physical contact.

It's essential to acknowledge these sensory preferences and sensitivities, even in older age groups, as they can provide valuable insights into an individual's needs and potential challenges. The goal is to address any flags or signs that may affect performance or comfort, regardless of the age group, and adapt strategies accordingly.

Alert Program Activity

  • M  O  V  A  T
    • M: movement
    • O: olfactory and oral
    • V: visual
    • A: auditory
    • T: tactile
  • Questions I ask the teen…Let’s pretend you are going on a flight to Florida. You have to be at the airport at 5:00 am…What does it take to wake you up and get there on time?

I incorporate activities from "The Alert Program" by Williams and Shellenberger, particularly the "How Does Your Engine Run?" concept, which revolves around understanding and managing one's arousal levels. I find these techniques effective, often using humor by relating scenarios to popular characters like Garfield. This helps students identify and express their current arousal state, such as saying their engine is running high when feeling stressed about a missed assignment.

The program categorizes sensory strategies using the acronym "MOVAT," representing Movement, Olfactory and Oral, Visual, Auditory, and Tactile. For instance, I may discuss preparing for an early morning flight with a student, exploring their sensory preferences and needs. This could involve considering the visual aspect of setting an alarm, the tactile sensation of comfortable clothing, and the auditory stimulation of an alarm or someone waking them up.

By delving into their world and connecting sensory strategies to their daily routines, I aim to help students understand their sensory systems and apply this knowledge to enhance focus and well-being in various settings, including school. This approach fosters self-awareness and empowers them to make choices that support their unique sensory needs.

Emotional Intelligence

  • From the book "The Brain and Emotional Intelligence" by Daniel Goleman
  • He breaks down Emotional Intelligence into 4 domains:
    • Self Awareness
    • Self Management
    • Social Awareness
    • Relationship Awareness
      • All very necessary to cross the bridge towards adulthood

We've covered many issues that may interfere with success, but emotional intelligence is very important for us to consider developmentally. He breaks it down into four domains. Let's look at our teen and think of somebody that you treat right now.


  • “Positive moods help the person increase their creativity, problem-solving, mental flexibility, and efficiency in decision making.” States of disruption and feeling unsettled can cause issues with work output, participation, and attitude towards school.”
  • Predictable ritual/routine
  • Positive reinforcement opportunity for self-expression
  • Welcoming at-ease atmosphere

Self-awareness in teens involves understanding their emotions, recognizing how they impact their thoughts and behaviors, and being aware of their strengths and weaknesses. It also includes an awareness of their social interactions and relationships. To support self-awareness, I suggested activities like playing card games or challenges that provide opportunities for reflection and discussion about their actions in a group setting. This approach can help them recognize their strengths and areas for improvement in a non-confrontational manner.

Predictable routines and rituals are crucial for teens to maintain a positive mood and enhance their creativity, problem-solving skills, and mental flexibility. I encouraged parents or caregivers to sit down with their teens, discuss their typical school day, focus on when they feel most focused or less focused, and identify classes they enjoy or dislike. The goal is to reinforce open communication without judgment, fostering a collaborative problem-solving approach to address challenges and disruptions in their schedule.

By involving teens in co-active problem-solving, adults can empower them to take ownership of their schedules and work towards their academic goals. This collaborative approach helps teens develop self-awareness and build essential skills for managing emotions, relationships, and executive functions as they navigate the bridge toward adulthood.

  • Example of a staff or IEP meeting
    • If no one greets you, if there is no expected rubric to follow (which may cause a feeling of uncertainty), or a sense that your opinion is already tabled….How do you feel?
    • Have we become so product-oriented in classrooms that the social conventions are tabled?
      • Active process discussion can lead towards independence

In the dynamic settings of IEP meetings and therapy sessions, creating a positive and welcoming environment is pivotal in establishing connections with the children involved. Much like adults entering a meeting without warm greetings or clear expectations, children too can feel disengaged or unwelcome if these social conventions are overlooked.

In the realm of therapy and education, it becomes paramount to prioritize the social connection before delving into specific goals or tasks. This initial focus on building a connection opens the limbic system, fostering a sense of trust, safety, and camaraderie. The impact of this social connection is substantial, significantly influencing a child's willingness to engage and collaborate.

To enhance this social connection, the approach involves several key elements. Firstly, warm greetings set the tone for positive engagement. Upon entering the room, a friendly welcome ensures the child feels acknowledged and valued from the outset. Establishing clear expectations for the session or meeting provides a structured and predictable environment, which is crucial for children, especially those grappling with executive function challenges. Active listening becomes a cornerstone of the interaction, showing genuine interest in the child's thoughts and opinions. This active engagement fosters a sense of validation and respect. Incorporating the child into decision-making processes related to their goals or activities empowers them, reinforcing that their input holds significance. Flexibility and adaptability in approach recognize the child's varying emotional states and readiness to engage, emphasizing the importance of meeting them where they are. Positive reinforcement becomes a powerful tool, offering encouragement for the child's efforts and achievements. This positive feedback contributes significantly to building confidence and motivation.

By emphasizing the social and emotional dimensions of the interaction, educators and therapists can create an environment where children feel seen, heard, and supported. This, in turn, enhances their engagement and cooperation in the learning or therapeutic process, facilitating a more collaborative and effective journey toward their goals.

  • Dr. Hallowell’s Book: "Crazy Busy"
    • Try this exercise
    • He suggests we have created an ADHD-like world
      • Teaching kids about how to handle stress helps them be more aware

Dr. Ned Hallowell's book "Crazy Busy" offers a valuable exercise to enhance self-awareness and understand one's alerting and focus levels. The exercise involves a block with numbers 1 through 25 arranged in a mixed-up order. The challenge is to locate each number in sequential order, making a check mark when each number is found. While seemingly straightforward, the exercise prompts individuals to observe their internal reactions and emotional responses as they navigate the task.

Participants are encouraged to pay attention to any anxiety or frustration during the exercise. The goal is to complete the task and gain insights into one's cognitive and emotional processes. Dr. Hallowell, who himself has ADHD, provides this exercise as a means to promote self-awareness, particularly in understanding how individuals manage challenges related to attention and focus.

The exercise can be useful for therapists and educators working with teens or individuals struggling with attention-related issues. By experiencing the exercise, individuals may recognize moments of tension, learn to identify strategies for overcoming challenges and develop a greater understanding of their own cognitive processes. The exercise is a simple yet effective method to enhance self-awareness and foster mindfulness in the face of cognitive tasks.


  • This is tied to self-awareness, according to Goleman.
  • The student needs to be aware of their emotions, and then manage them, leading to focus and attainment of goals.
    • Strategies to handle emotions, upheaval, or disappointment
    • Education regarding outlets, basic needs
    • Time to simmer; let the information sink in

Self-management is intricately linked to self-awareness. The awareness of oneself lays the foundation for effective self-management. In understanding our emotions and their connection to our tasks, we equip ourselves with the tools to navigate challenges and focus on our goals. By teaching strategies to handle emotions, upheaval, and disappointment, we provide individuals, especially students, with a toolbox of coping mechanisms.

In the process of self-management, it's crucial for students to recognize and manage their emotions in relation to their responsibilities. This, in turn, contributes to enhanced focus and goal attainment. Employing scripts, such as acknowledging mistakes and forgiving oneself, can be powerful tools. For instance, a student saying, "I'm only human," as a way of self-forgiveness, demonstrates a healthy coping mechanism.

Addressing disappointment is a crucial aspect of self-management, and it requires tailored discussions based on the age group. Teens, facing social complexities, might grapple with rejection, judgment, or challenges in integrating into new activities. Providing forums for discussion and collaboration, possibly with the involvement of speech and language professionals or social workers, can offer valuable support.

An illustrative example involves a group of middle schoolers with executive skill challenges. They engaged in weekly sessions where they identified topics they wanted to learn more about and teach their peers. This innovative approach empowered the students to take on teaching roles, creating hands-on, practical therapy sessions. The experience facilitated real-time learning, adaptability, and continuous improvement.

The self-management journey encompasses understanding emotions, implementing coping strategies, and addressing disappointments. By fostering self-awareness and providing practical tools, individuals can develop the resilience to navigate life's challenges.

  • Let's bring it home to us...
    • Have you ever had an email, text or call asking for a report, IEP, or progress note on a “no notice” basis?
    • How do you react?...Or respond? Once you get your head around it, is your response different?
    • This can happen to the students we work with if there is a pop quiz, or an assignment that seems overwhelming either by quantity or deadlines. Teaching response versus reaction may be invaluable with self-management.
      • This just happened to me when someone gave me a food present.

Certainly, we've all experienced unexpected requests for reports or tasks through email or text, which can initially trigger a reactive response. This element of self-management is crucial, especially when confronted with unanticipated situations. Reacting impulsively to such requests may not always be the most effective approach.

Teaching individuals, including students, how to respond rather than react to unforeseen circumstances is a valuable lesson in self-management. For instance, if faced with an immediate request for a report, taking a moment to assess the situation, prioritize tasks, and respond thoughtfully can lead to a more effective outcome. It involves managing the initial emotional reaction and approaching the situation with a composed and strategic mindset.

A personal anecdote illustrates this concept. In a scenario where a colleague unknowingly presented a tray of peanut brittle, triggering a severe allergy, the initial emotional response was alarm and rejection. However, recognizing the emotional reaction, taking a moment to compose oneself, and responding with clarity and apology demonstrates the importance of managing unexpected situations.

This lesson is applicable not only to students but to individuals of all ages. Navigating and responding thoughtfully to unforeseen challenges contributes significantly to effective self-management and overall well-being.

  • Take a Soda from David Jee
    • Stop
    • Observe
    • Disconnect
    • Assess, Action

The "Take a Soda" strategy, introduced by meditation expert David Jee, offers a structured approach to help individuals, especially teens, manage their reactions in challenging situations. This acronym, "SODA," encapsulates a series of steps designed to encourage a thoughtful response rather than an impulsive reaction.

Imagine a teenager encountering a situation where the initial urge is to react impulsively. The "Take a Soda" strategy guides them through a thoughtful process. Stop is the first step is to interrupt the immediate impulse to react. Take a brief pause, allowing a moment of reflection.

With the pause initiated, the individual is encouraged to turn inward and observe. Take note of the physical and emotional reactions occurring within. This step emphasizes the practice of mindfulness.

Following observation, the strategy calls for a mental detachment from the situation. This brief disconnection provides a valuable space to gain perspective and clarity.

With a mental buffer in place, it's time to reflect or assess the observed reactions and consider the broader context of the situation. What are the potential consequences of different actions? Then, armed with a clearer understanding, the final step involves choosing a deliberate and intentional action. This response could be crafted with thoughtfulness and purpose rather than a reactive outburst.

Teaching this strategy to teenagers empowers them to manage their emotional responses, make informed decisions, and avoid impulsive actions. By encouraging regular practice of the "Take a Soda" approach in various scenarios – from social interactions to potential conflicts – adolescents can develop emotional intelligence and enhance their ability to exercise self-control. It becomes a practical and memorable tool that they can carry with them, assisting in navigating the complexities of their lives.

  • Two parts of the brain that are involved
    • The amygdala and the prefrontal cortex
    • The amygdala is emotion- The student can be sensitive to criticism, gestures, and negative feedback
    • The prefrontal cortex is the reasoning –The student can use movement or mindful techniques to help regulate their emotions

In the intricate dance between emotions and reason, two key players in the brain come into focus: the amygdala and the prefrontal cortex. Understanding the dynamics between these two areas is crucial in helping students navigate their emotional responses.

The amygdala is the emotional center, sensitive to criticism, gestures, and negative feedback. The part of the brain can stir up a whirlwind of emotions in response to external stimuli. For students, this might manifest as heightened sensitivity or emotional turbulence when faced with challenging situations.

The prefrontal cortex is on the other side of this neural interplay, the region responsible for reasoning and thoughtful decision-making. It's the part that seeks to apply logic and consideration to emotions, providing a counterbalance to the impulsive reactions driven by the amygdala.

When students employ movement or mindfulness techniques to regulate their emotions, they are essentially engaging with these brain regions. Movement and mindfulness serve as tools to soothe the emotional turbulence generated by the amygdala, allowing the prefrontal cortex to play a more active role in the decision-making process.

However, it's essential to highlight the importance of self-awareness in this journey. Nurturing intrapersonal abilities, as proposed by Gardner, involves helping students understand themselves better. This self-awareness becomes the foundation for developing inhibition and emotional regulation skills. Students can take proactive steps to regulate and navigate their internal landscape by recognizing their emotional responses, fostering a more balanced interaction between the amygdala and the prefrontal cortex. Ultimately, this contributes to their overall emotional intelligence and ability to navigate the complexities of social and academic environments.

  • This may be when they flip their lid.
  • My brain has too many tabs open.

When life bombards you with challenges—bullying, yelling, feelings of inadequacy—the incoming barrage can overwhelm you. It's akin to having too many tabs open in your mental browser. The delicate balance tips in these moments, and you are on the verge of "flipping your lid."

  • From the book Smart but Scattered for Teens by Guare and Dawson. They break it down even further…
    • They believe there are two dimensions of Executive Skills:
      • Cognitive: memory, planning, organization, time management, and metacognition
      • Behavior: inhibition, emotional control, sustained attention, task initiation, goal-directed, and flexibility
        • So, as we use the checklist or look at test results…where are the challenges?

Delving deeper into the intricacies of executive function, Guare and Dawson's book "Smart but Scattered for Teens" sheds light on two dimensions of this cognitive process. This distinction proves invaluable when crafting assessments, analyses, and intervention strategies, guiding educators and therapists in providing targeted support.

The first dimension encompasses the cognitive aspects of executive function. Is the challenge rooted in memory, planning, organization, time management, or metacognition? Understanding whether the struggle lies in these cognitive domains helps tailor interventions to address specific weaknesses.

On the other hand, the second dimension shifts focus to behavioral components. Are there signs of disinhibition, emotional regulation difficulties, attentional challenges, or struggle initiating tasks? Observing these behavioral markers paints a picture of the individual's executive function challenges, particularly in the prefrontal cortex's developmental aspects.

The key takeaway is recognizing the pattern and understanding whether the hurdles are more cognitive or behavioral. This crucial insight informs the planning and implementation of effective strategies. With this knowledge, teachers can appropriately modulate stress levels to balance, making the work challenging and ensuring it remains achievable. Additionally, they can adapt tasks by breaking them down to suit the individual's executive function profile, fostering a more supportive learning environment.

  • Teachers also can provide the “right amount of stress” to make work challenging or break down the work to make the work achievable.
    • Goleman states:
      • “If students are cranky, off, bored, or unusually inattentive, they may be experiencing anxiety and can’t concentrate.”
      • “When a person is bored, there is scattered brain activity…when engaged, the relevant brain areas are activated.”
      • “And when stressed, much of the activity is in irrelevant emotional centers of the brain, indicating distractedness.”
        • Don't forget the incentives

Returning to Goleman's insights, he underscores the significance of recognizing behavioral cues as potential indicators of underlying emotions. When students exhibit crankiness, being off, or boredom, it could be a manifestation of concealed anxiety. These emotions may not be explicitly communicated but manifest as crankiness and inattention.

Boredom, in particular, reflects scattered brain activity. A focused brain engaged in a task displays specific and targeted activation areas, whereas a bored mind exhibits diffuse brain activity. Stress exacerbates this by diverting much of the cognitive focus to irrelevant emotional centers, resulting in distractedness.

For educators and therapists, understanding that external stressors, whether from challenging home environments or impending personal issues, can significantly impact a student's ability to concentrate is crucial. Instead of approaching the situation with demands, a more empathetic check-in becomes a valuable tool. By acknowledging observed changes in behavior and expressing genuine curiosity about the student's well-being, educators create a supportive space for dialogue. This approach goes beyond the surface-level symptoms, encouraging students to open up about what might affect their focus and concentration on a given day.

And we have to notice that.

  • Guare and Dawson suggest:
    • Encouragement of teens to use tech solutions to help remember
    • Timing of directions with cueing
    • Advance notice for what is coming next
    • Maintenance of routines and rituals
    • Active problem solving
    • Use a Watchminder which helps with sustained attention
    • Praise
    • Incentive systems

Guare and Dawson emphasize several strategies to support teens in managing executive functions effectively. They suggest leveraging technology to aid in success, aligning the timing of directions with the importance of tasks, and providing advance notice for upcoming activities or changes. These approaches are relevant for younger children and remain important for adolescents navigating executive functioning challenges.

Maintaining routines and rituals is highlighted as crucial. The predictability of knowing when an activity will conclude or when a specific event will take place helps establish a sense of structure and security. The importance of adhering to routines is evident in the story of a student who expected a welcome quote on the board. The student felt disoriented when the routine was disrupted, underscoring the significance of consistent practices.

Active problem-solving and metacognition are integral in assisting teens with executive function challenges. Collaborative problem-solving sessions, where students can discuss and brainstorm solutions for managing their schedules and responsibilities, foster a sense of autonomy and responsibility. The goal is not to impose solutions but to co-actively arrive at compromises that work for the individual.

Lastly, various tools such as watchminders, praise, and incentive systems can effectively support teens with executive function difficulties. These tools provide additional structure, encouragement, and motivation to help adolescents navigate their responsibilities and tasks more effectively.

  • Real ideas from Dawson and Guare to help with working memory:
    • Eye contact when telling students what is important to remember
    • Minimize distractions
    • Write reminders
    • Rehearse expectations
    • Website information for homework, assignments

Guare and Dawson discuss eye contact, minimizing distractions, writing reminders, and decreasing the verbiage. If there is too much yak yak, no one will pay attention. You become Charlie Brown's mother. Modeling and rehearsing expectations and then having access to a website in case they miss assignments or need information with links may be helpful.

  • Guare and Dawson's Books
    • Smart but Scattered, 2009
    • Executive Skills for Children and Adolescents 2nd Edition, 2010
    • Smart but Scattered for Teens, 2014

Here are their books. They are local here in New Hampshire. They are neuropsychologists and are quite good.

Social Awareness

  • Goleman continued…Social Awareness and Relationship Management
    • Hopefully, this occurs in the classroom daily. If there are positive social interactions, a sense of community, and a predictable environment with ritual and routine amongst its members, then it flows.
      • A flow can be created, including all in the classroom.
      • The environment is comfortable for learning and expression.
      • There is dynamic understanding and problem-solving.
  • If not, there may be more disruption/chaos, both socially and in academics.

Goleman emphasizes integrating relationship management and social awareness into the daily classroom environment. He underscores the significance of positive interactions right from when students enter the room. This includes simple gestures like greetings, establishing a sense of community, and implementing predictable routines. Elements such as using tangram pieces, sharing a joke of the day, and having specific seating arrangements contribute to creating a comfortable and predictable learning environment.

A well-designed and structured classroom fosters a sense of security, making it conducive to learning and self-expression. This environment benefits not only the students with specific needs but also the entire class and educators involved in collaborative efforts. The idea is to move away from a rigid, authoritarian approach and instead cultivate an atmosphere of understanding and collaborative problem-solving. This approach promotes engagement and participation, contrasting with more restrictive teaching styles.

Goleman suggests that such a dynamic and open teaching environment can prevent disruptions and chaos, both socially and academically. The analogy is drawn to the discomfort one might feel without a clear daily schedule, highlighting the importance of structure and predictability for students, whether in elementary or high school. Ultimately, the goal is to empower students to create similar supportive structures, promoting autonomy and self-management skills.

Relationship Awareness

  • Once again, if we view our own Self Awareness and Relationship Management…we may be able to define it for teens.
    • If we enter a classroom and the teacher asks if they could use the restroom…
    • If a teacher asks you to stay in the classroom for a group activity versus a pull out…
    • Is there an opportunity to share an early morning coffee and sidewalk chat…
    • Do you feel respected as an OT in an educational setting?

In envisioning self-awareness and relationship management for teens, putting oneself in a collaborative work scenario with another educator is helpful. In this hypothetical situation, various aspects come into play, reflecting the human side of interactions. For instance, if a fellow teacher needs to use the restroom, a supportive response aligns with basic human courtesy. Similarly, when asked to stay in the classroom for group activities instead of a pullout, a positive relationship might lead to a willingness to participate, even if it means adjusting one's plans for the day.

Building rapport goes beyond professional settings. Sharing an early morning coffee or engaging in a sidewalk chat creates opportunities for genuine connection. Such moments provide insights into the teacher's perspective on individual students and classroom dynamics. This qualitative understanding fosters a sense of being an integral part of the educational community.

The importance of integration into the school environment is highlighted. Many therapists desire more involvement in school activities beyond their specific roles. Bridging this gap involves actively participating in meetings, school events, or yearbook pictures. By doing so, therapists can cultivate a sense of belonging and establish themselves as valuable contributors to the school community.

Looking toward the future, the speaker envisions occupational therapists playing a more significant role in regular education. This expanded role includes conducting developmental testing and preventing unnecessary referrals to special education. Additionally, there's a dream of occupational therapists integrating psychosocial elements to address behavioral challenges in middle and high schools. These aspirations aim to redefine the perception of occupational therapy and emphasize its holistic contribution to education.

  • With all this information…don’t forget that your relationship with the teacher will be the foundation of addressing a student’s needs!

With all this information, the relationship with the teacher will be the foundation of addressing.

  • This is a great question for teachers…and ourselves. What is expected?
    • What is the job of a middle schooler, high schooler?
    • Is this realistic based on age and dx?

In collaborative efforts with teachers, an essential question arises: What are the expectations for this student's role, considering their age and diagnosis? Understanding these expectations helps gauge whether teachers comprehend students' challenges, abilities, and limitations. If teachers express unrealistic expectations, it becomes an opportunity for education and discussion about the student's unique needs.

Another valuable inquiry involves exploring entrance and exit criteria for different grade levels. By asking teachers about their expectations for freshmen entering high school and the criteria for progressing to the sophomore year, disparities in expectations become evident. These variations underscore the importance of providing consistent and clear guidance to students. Bridging these gaps can enhance students' understanding of performance expectations, contributing to a more cohesive and supportive educational environment.

  • When we consult with teachers regarding these students… One of the first questions I ask is… How is this student different than the norm in your classroom? Words such as distant, argumentative, checked out, disengaged, emotional, disinhibited, and so on…. Often show up.
    • Here are some questions I ask…
      • What routines and rituals occur in your classroom? Does this student adhere to these?
      • Look at this executive skill checklist, what would you consider the top three challenges this student has?
      • Does the student accept redirection, or do they adjust their behavior?
      • Are you the same for the day's first class as the last class? Which part of the day is toughest for you?
      • If the activity is product-oriented, is there inflexibility? Can they negotiate or compromise?
      • Are there certain ways of teaching that this student seems to be better at?

In the collaborative process with teachers, a key question to pose is: "How is this student different from the norm in your classroom?" Despite the aversion to the term 'typical,' understanding the context of what 80% of students accomplish provides valuable insights. When teachers express concerns about a student being distant, argumentative, or checked out, it offers a clearer picture of the challenges the teacher is facing.

Establishing a social connection with the teacher is crucial for building rapport, and asking about the routines and rituals in the classroom further solidifies this connection. Inquiring about expectations and utilizing checklists to identify the student's top three challenges not only enhances collaboration but also serves as a strategic investment of time. By taking the time to comprehend the teacher's perspective, occupational therapists can effectively integrate students into the curriculum, acknowledging the essential role of curriculum in their interventions. This approach ensures a more comprehensive understanding of the student within the classroom context, an aspect not always readily apparent.

  • Ask teachers what bothers them most about the students…You may find some of these answers…
    • “It’s like they are on another planet. They can’t focus at all.” “She is constantly blurting out when I lecture.” He never turns in his homework.”“ He is constantly humming while doing independent work.” “She thinks she is the class clown, making inappropriate comments.”
    • That is our cue to educate what executive, developmental, and sensory challenges that student may have…if we can help, then change occurs.

I ask them what bothers them the most. When we hear their complaints, our cue is to educate them as to why some of this might be occurring, and then can we work on just that behavior to start? Once the teacher starts to like this kid as much as we like this kid and know that they are in there, we're better able to ask for more later on.

  • “All students can learn and succeed, but not all on the same day in the same way.” - William G. Spady
  • We as therapists, have a unique perspective. We can facilitate learning via accommodations or modifications for student success!

Embracing the understanding that all students have the potential to learn and succeed, though not necessarily in the same way or on the same day, sets the stage for creating meaningful accommodations and modifications. As occupational therapists commit to actively engaging with these teenagers, regardless of changes in school settings, they recognize the enduring challenges these students face due to learning disabilities or diagnoses. The suggested accommodations include providing opportunities for fidgeting, adjusting lighting conditions, and incorporating a blend of hands-on and written output. Valuable advice is to ensure that any accommodations documented in the Individualized Education Program (IEP) are diligently implemented, emphasizing the commitment to supporting each student's unique needs.

Accommodations and Modifications Ideas

  • Opportunity to fidget
  • Decreased lighting/or use natural light
  • Pacing work output with a mixture of hands-on and written output
  • Easily accessible materials
  • Opportunity to settle in, simmer time
  • Movement or brain breaks sprinkled throughout the day
  • Dyad work
  • Break down of assignments
  • Don’t call on unless your hand is up
  • Use of tech to remind of assignments (e.g., class page, take picture of assignment)
  • Visual posters or cues for classroom conventions
  • Asking open-ended questions (metacognitive)
  • Leave class 5 minutes early, for a brisk walk or to avoid crowds
  • Remind students of the goal for that period
  • Novel activities to increase attention and focus
  • Provide alternative seating
  • Frequent check-ins as negotiated with students to signal for help or timing
  • Provide extra time for written output
  • Engage students in service/helping duties to establish relationships
  • Less verbiage
  • Matter of fact approach
  • Offer a variety of ways to demonstrate learning
  • Offering a space to regroup, reset
  • Offering incentives toward work completion

Embarking on the journey of implementing accommodations and modifications in a high school environment requires a well-thought-out strategy and a collaborative and hands-on approach. In my role as an occupational therapist, I find that proactive collaboration with educators and support staff is essential to ensure the successful application of these strategies. Let me share some experiences that highlight the tangible impact of these modifications.

At the start of the school year, I often bring a variety of fidget options into the classroom, presenting them as potential tools for students who might benefit from such sensory support. One particular student, Anthony, stands out. He would habitually fly his pen around during class, distracting himself and others. We recognized this behavior as a potential need for movement and worked together to find a suitable alternative. Anthony could fulfill his need for visual stimulation without disrupting the class by introducing a three-minute sand timer. The transformation was remarkable, and the teacher, Chris, noticed a significant improvement in Anthony's focus.

The success stories don't stop there. We've also explored students' organizational challenges, especially during class transitions. For instance, one student found solace in leaving class a few minutes early to navigate the bustling hallways more comfortably. This seemingly small adjustment significantly reduced the student's stress during transitions, showcasing how personalized modifications can make a substantial difference in a teenager's daily experience.

Moreover, the involvement of educational assistants is crucial in translating theoretical accommodations into practical, real-world applications. When modifications are introduced at the beginning of the school year, educational assistants are vital in ensuring these strategies are consistently applied and adjusted based on each student's evolving needs.

Consistency and routine are emphasized to create a supportive environment. An example is the introduction of movement breaks strategically incorporated into the day. Some high schools have implemented innovative solutions, like assigning students responsible for handling recycling duties during these breaks. This provides a functional movement break and instills a sense of responsibility and routine.

Acknowledging the multifaceted challenges of high school students, accommodations are tailored to meet their unique needs. Factors like processing speed, alternative seating, and additional time for written output are considered to create an inclusive learning environment. It's important to recognize that these accommodations are not one-size-fits-all; instead, they are carefully crafted to address individual requirements.

In navigating the diverse teaching styles of high school educators, a matter-of-fact approach is adopted, ensuring that accommodations align with each teacher's preferences. This adaptability and collaboration contribute to a cohesive learning environment that supports the dynamic needs of high school students.

By integrating behavioral considerations with cognitive strategies, occupational therapists become essential contributors to fostering a supportive and inclusive educational space for teenagers. The anecdotes and examples shared highlight the transformative power of these accommodations in enhancing the high school experience for both students and educators.

Mildred Ross, OTR/L

  • This quote is a healthy reminder that we can influence attention, focus, and motivation based on environment input and classroom management.

Her words resonate with the essence of the learning process. The stimulation we encounter at the age of five, 15, or 18 is the key to unlocking the doors of learning. Intricately connected with our body, regulatory system, and nervous system, our brain welcomes and assimilates such stimulation, transforming the learning experience into a seamless and gratifying activity.


  • We have covered many areas of the 21st teenage brain.
    • Normal developmental needs
    • Brain research linked to motivation, learning, and focus
    • Universal Design in relationship to how to reach and teach
    • The importance of knowing your students
    • The need for a body/mind connection in direct relationship to learning
    • Strategies to intervene
    • Accommodations and modifications to help the student access their curriculum

In conclusion, we discussed the various facets of the 21st-century brain. It is crucial to consider normal developmental needs, including sleep, hydration, exercise, and nutrition, as these are foundational skills. The Maslow Hierarchy of Needs serves as a quick guide to identify potential issues if these fundamental needs are unmet.

Exploring brain research linked to motivation, learning, and focus has shed light on the distinctive nature of the teenage brain compared to its elementary counterpart. The process of pruning and reshaping neural connections is evident, emphasizing the importance of providing diverse stimuli for healthy brain development. Concerns arise when teenagers overly engage in activities that lack variety and fail to stimulate different brain areas, such as extended periods of video game play.

The universal model for design presents an intriguing theory to share with educators to enhance their approach to reaching and teaching teenagers effectively. The emphasis on knowing your students and fostering the body-mind connection is crucial for promoting self-awareness.

Throughout the discussion, numerous strategies, interventions, accommodations, and modifications have been offered to help students access their curriculum. By implementing these approaches, educators and professionals can better support teenagers' learning journey.

As we conclude, let's engage in a mindfulness exercise. Close or avert your eyes and envision the faces of the students who have come to mind during this discussion. Take note of the context surrounding them, like their expressions, whether a smile or a frown. Repeat to yourself, "May you be happy, may you be healthy, and may you be at ease."

I hope you've gathered valuable insights to bring back to the students in your care.


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Ernst, M., Benson, B., Artiges, E., Gorka, A. X., Lemaitre, H., Lago, T., Miranda, R., Banaschewski, T., Bokde, A. L. W., Bromberg, U., Brühl, R., Büchel, C., Cattrell, A., Conrod, P., Desrivières, S., Fadai, T., Flor, H., Grigis, A., Gallinat, J., Garavan, H., … IMAGEN Consortium (2019). Pubertal maturation and sex effects on the default-mode network connectivity implicated in mood dysregulation. Translational psychiatry, 9(1), 103. https://doi.org/10.1038/s41398-019-0433-6

Judd, N., Sauce, B., Wiedenhoeft, J., Tromp, J., Chaarani, B., Schliep, A., van Noort, B., Penttilä, J., Grimmer, Y., Insensee, C., Becker, A., Banaschewski, T., Bokde, A. L. W., Quinlan, E. B., Desrivières, S., Flor, H., Grigis, A., Gowland, P., Heinz, A., Ittermann, B., … Klingberg, T. (2020). Cognitive and brain development is independently influenced by socioeconomic status and polygenic scores for educational attainment. Proceedings of the National Academy of Sciences of the United States of America, 117(22), 12411–12418. https://doi.org/10.1073/pnas.2001228117

Kolskår, K. K., Alnæs, D., Kaufmann, T., Richard, G., Sanders, A. M., Ulrichsen, K. M., Moberget, T., Andreassen, O. A., Nordvik, J. E., & Westlye, L. T. (2018). Key brain network nodes show differential cognitive relevance and developmental trajectories during childhood and adolescence. eNeuro, 5(4), ENEURO.0092-18.2018. https://doi.org/10.1523/ENEURO.0092-18.2018  

Raschle, N. M., Fehlbaum, L. V., Menks, W. M., Martinelli, A., Prätzlich, M., Bernhard, A., Ackermann, K., Freitag, C., De Brito, S., Fairchild, G., & Stadler, C. (2019). Atypical dorsolateral prefrontal activity in female adolescents with conduct disorder during effortful emotion regulation. Biological psychiatry. Cognitive neuroscience and neuroimaging, 4(11), 984–994. https://doi.org/10.1016/j.bpsc.2019.05.003

Sheridan, M. A., Mukerji, C. E., Wade, M., Humphreys, K. L., Garrisi, K., Goel, S., Patel, K., Fox, N. A., Zeanah, C. H., Nelson, C. A., & McLaughlin, K. A. (2022). Early deprivation alters structural brain development from middle childhood to adolescence. Science advances, 8(40), eabn4316. https://doi.org/10.1126/sciadv.abn4316  


Bowen-Irish, T. (2024). Teenage interventions and helping teens build bridges, part 2. OccupationalTherapy.com, Article 5678. Available at www.occupationaltherapy.com

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tere bowen irish

Tere Bowen-Irish, OTR/L

Tere Bowen- Irish has practiced Occupational Therapy in pediatrics and psychiatry for over 40 years. Through her business, All the Possibilities, she continues to provide treatment, assessment, and consultation for clients. Workshops for therapists, educators, and parents are offered privately or publicly on a variety of topics such as inclusion, child development, classroom management, behavioral challenges, executive function, and other topics relevant to the 21st-century educational system. The focus is on common sense and a practical approach toward empowering educators and students to create a climate of learning, understanding, and inclusiveness for all abilities.

Tere is also the creator/author of The Drive Thru Menu Suite of Exercises, which is an initiative to bring movement and mindfulness into today’s classrooms. She is a certified YogaKids teacher and a Certified Mindful Schools Instructor. She is the author of Yoga and Me, Come be a Tree and co-authored My Mindful Music with Mary Ann Harman. Feel free to contact Tere at tereirish@gmail.com


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