Executive Function Flashcards
executive function
complex cognitive processing requiring the coordination of several sub-process
executive function is a prerequisite for..
successful functioning in any occupation
executive function involves higher order mental capacities that allow one to ____ to new situations and achieve goals
adapt
executive functions are housed in what lobe? what specific cortex?
frontal lobe
prefrontal cortex
Baddeley and Hitch working memory model
central executive -> phonological loop, visuo-spatial sketchpad, episodic buffer
phonological loop
auditory stimuli
episodic buffer
backup storage, helps long term and short term communicate
SAS - supervisory attentional system
housed in the frontal lobe/prefrontal cortex
higher control system needed to cope with planning, novelty, problem solving, and inhibition (multitasking)
template/schemas - new situations
SAS - supervisory attentional system - when/how to use
-when a routine action did not work for you
-need in situations where the routine selection of your action did not work
-need to carry out processes to figure out what to do (make a plan, goal-oriented action)
planning/organization
ability to plan/organize tasks, space, time, communication
efficiency is big here
emotional control
ability to manage and control emotions and emotional reactions
metacognition
awareness and understanding of one’s own thought process, thinking about thinking
inhibition
impulse control, response inhibition
working memory
simultaneously manipulate different information at the same time
cognitive flexibility
-the ability to adapt thoughts and/or behaviors in response to the environment
-being able to shift cognitively
task initiation
ability to begin a task without undue procrastination
time management
-understanding time, how to use time effectively, and how time affects ourselves and others
-time awareness and time estimation
sustained attention
-ability to maintain attention to an established task
-not the same as focus
cognitive dissonance
mental discomfort that results from holding 2 conflicting beliefs; what causes you to feel guilty after an action
EF difficulties are often symptoms of ____, ____, and/or ___
neurological
mental health
behavioral diagnoses
EF dysfunction (dysexecutive syndrome) is ____ in the DSMV
not
lateral orbitofrontal supplied by
anterior cerebral artery and middle cerebral artery
example of lateral orbitofrontal effected
euphoria, poor impulse control, disinhibition
dorsolateral supplied by
middle cerebral artery
example of dorsolateral effected
impaired higher order functions (dysexecutive syndrome)
medial cortex supplied by
anterior cerebral artery
example of medial cortex effected
apathy, reduced affect
classifying executive disorders
-volition and goal formulation
-planning
-purposive action
-performance effectiveness
-classification based on anatomy/evolutionary development
EF Disorders classification: volition and goal formulation
self-awareness, initiation, and motivation
EF Disorders classification: planning
ability to conceptualize change, be objective, think about alternatives
EF Disorders classification: purposive action
to implement plans for goal achievement, including: productivity, self-regulation, sequencing actions, monitoring
EF Disorders classification: performance effectiveness
monitoring, quality control, self-correction, time management
clinical presentation: inhibition
-difficulty sitting still, poor socialization, and maintenance of social relationships, difficulty in fully reading or listening to verbal or written instructions
-might be outspoke, yell out, not raise hand, interrupting others, safety awareness
clinical presentation: working memory
-difficulty with multi-step written or verbal directions
-studying, “lazy kid”, taking quizzes or tests, hard transferring what they know to what they are doing (too much in their mind at once)
clinical presentation: cognitive flexibility
-rigid thinking patterns, outburst with changes in routine, difficulty with open-ended tasks
-socialization - may be bossy
-not wanting to play with kids who have different ideas for how things can be used; fighting because a rule was changed
clinical presentation: planning/organization
-frequently loses track of materials, assignments, belongings, starts a task before finishing another
-might see procrastination, difficulty with multi-step
clinical presentation: time management
-requires more time to complete familiar, simple routines, struggles to complete timed tasks, overacts to quick or unexpected interruptions
-always wants to know “whats next”
executive function performance test (EFPT)
assesses EF via the performance of real-world tasks
-will help determine if they are safe to return home and live independently
behavioral assessment of the dysexecutive syndrome (BADS)
-designed to test capacities for everyday life
-predicting role competency
-problem-solving skills
dysexecutive questionnaire (DEX)
-contextually sensitive
-looks at a range of problems: emotional/personality, motivational, behavioral, cognitive
behavior rating inventory of executive function - adult version (BRIEF-A)
standardized measure of an adult’s executive functions or self-regulations in their everyday environment
behavior rating inventory of executive function (BRIEF)
-assesses EF performance in children
-parent report, teacher report, self-report forms
-subscales: inhibit, shift, emotional control, initiate, working memory, plan/organize, organization of materials, monitor
multiple errands test
-a naturalistic “shopping” setting
-3 tasks: buying items, being somewhere at a certain time, obtaining information
-scores based on errors: rule breaks, interpretation failure, task failure
kettle test
-high test-retest reliability
-top down
-general cognitive assessment, memory, executive functioning
top-down interventions
calendars, organizers, planners, visual timers, re-vibe watch, visual schedule, environmental mods
bottom up interventions
trail making test over and over, paper/pencil tasks
alternate EF intervention categories
-environmental mods
-compensatory strategies
-task specific training
-metacognitive strategy training
problem-solving training (PST)
-teaching clients to be more effective in using a slower, step wise approach, breaking down problems
-how to generate different steps
5 aspects of problem solving
- problem orientation and analyzing
- problem definition and formulation
- generating alternative and solutions
- decision making
- solution verification and evaluation
aspects of problem solving: problem orientation and analyzing
general recognition “this is the problem” help them identify
aspects of problem solving: problem definition and formulation
teach participants to discriminate between what is relevant and what is not related to their problem
aspects of problem solving: generating alternatives and solutions
goal here was to help the client understand there are more solutions than they thought
aspects of problem solving: decision making
making decisions; helping them look at pros and cons
aspects of problem solving: solution verification and evaluation
self-correction, look at solutions that worked and did not work
self-regulation strategies
-stop and think
-asking clear thinking questions
-thinking their way through each step
-defining the problem
-use clear thinking questions to produce, evaluate
-role plays**
everyday descriptions task
-uses cue cards
-have them practice retrieving certain memories for 30 minute
-used for people with TBIs
self-instruction training
-trained to verbalize a plan of behavior before and during execution of the training task
-overt then whispering then cover verbalization then inner talk
-initially given explicit training regarding generalization of the use of these strategies applied to real-life problems
self instruction training: WSTC
W - what (what are you going to do)
S - select (select strategy)
T - try (try strategy out)
C - check (check how the strategy is working; self-reflection)
goal management training stages
- orienting and assessing current state
- select the main goal
- partition the goals and make subgoals
- rehearse
- monitor the outcome
intervention: environmenet
-level of tolerated distractions
-structure required
intervention: external cuese
checklist, alternating tones (different alarm sounds for different things), modeling, tape recorder
