Bright Kids Who Cant Keep Up: Helping Children Conquer Slow - PDF document

Bright Kids Who Can’t Keep Up: Helping Children Conquer Slow Processing Speed and Succeed in a Fast-Paced World Brian Willoughby, Ph.D. Co-Director, Achieve New England Clinical Research Associate, University of Massachusetts Boston Introductions u Name? u Where you are from? u Current Position? u Favorite board game growing up? 1

Workshop Objectives u What is slow processing speed? u What does a student with slow processing speed look like? u What intervention strategies can be used in the classroom and at home? u What are the other “costs” of slow processing speed – and how can we manage these costs? Part One: What Is Slow Processing Speed? 2

Confession: I’m Obsessed with Board Games 3

What Kind of Kid Were You? Athlete Book Worm Make-Believer Games Guru Lego Manic Mad Scientist Processing Speed Defined u The amount of time to perceive information, process the information, and enact a response u The time required to perform an intellectual task u How long it takes to get stuff done 4

Processing Speed Defined Flash Match: The Best Game Ever 5

What skills were involved in Flash Match? Visual processing : How quickly our eyes perceive information and relay it to the brain 6

My Second Favorite Game: Taboo Refrigerator 7

Michelle Obama Comedy 8

Dragon Pretzel 9

Kyoto Madonna 10

The Titanic Priest 11

Blank The Simpsons 12

Peanut Butter Golf 13

Sadness Masculinity 14

Batman International School 15

Propaganda Prison 16

Restless Leg Syndrome Liver 17

Evolution Peace 18

Horse Wind 19

Meryl Streep Fashion 20

Tablecloth Fitness 21

Apology Magician 22

What skills were involved in Taboo? Verbal processing : How quickly we hear a stimulus and react to it and how quickly we retrieve verbal information from our brain 23

My Third Favorite Game: Hand Slap What skills were involved in Hand Slap? 24

Motor Speed : Fine motor agility, such as how fast we can copy something or put pegs in a board Types of Processing Speed u Visual processing u How quickly our eyes perceive information and relay it to the brain u Verbal Processing u How quickly we hear a stimulus and react to it and how quickly we retrieve verbal information from our brain u Motor Speed u Fine motor agility, such as how fast we can copy something or put pegs in a board 25

“Real World” Processing Speed Difficulties Visual Processing (Flash Match) u u Problems with attention to details u Difficulty proofreading work u Trouble with subtle visual cues of social relationships Verbal Processing (Taboo) u u Trouble following directions u Needs more time to answer a question u Problems keeping up with the pace of class discussions Motoric Processing (Hand Slap) u u Slow at the physical aspect of writing u Moves around at a slow pace u Slow to compete written tests Assessing Processing Speed u Who conducts assessments of processing speed ? u Neuropsychologist u Child Psychologist u School Psychologist u Others? u Types of Assessment u School-based assessment u Independent neuropsychological assessment 26

Measuring Processing Speed Measuring Processing Speed 27

Trail Making Tests: A and B Trail Making Tests: Trails A Norms 25 24.4 8.71 26 24.4 8.71 27 24.4 8.71 28 24.4 8.71 29 24.4 8.71 30 24.4 8.71 31 24.4 8.71 32 24.4 8.71 33 24.4 8.71 34 24.4 8.71 35 28.54 10.09 36 28.54 10.09 37 28.54 10.09 38 28.54 10.09 39 28.54 10.09 40 28.54 10.09 41 28.54 10.09 42 28.54 10.09 43 28.54 10.09 44 28.54 10.09 45 31.78 9.93 46 31.78 9.93 47 31.78 9.93 48 31.78 9.93 49 31.78 9.93 50 31.78 9.93 51 31.78 9.93 52 31.78 9.93 53 31.78 9.93 54 31.78 9.93 55 31.72 10.14 56 31.72 10.14 57 31.72 10.14 58 31.72 10.14 59 31.72 10.14 60 31.32 6.96 61 31.32 6.96 62 31.32 6.96 63 31.32 6.96 64 31.32 6.96 65 33.84 6.69 28

Trail Making Tests: Trails B Norms 25 50.68 12.36 26 50.68 12.36 27 50.68 12.36 28 50.68 12.36 29 50.68 12.36 30 50.68 12.36 31 50.68 12.36 32 50.68 12.36 33 50.68 12.36 34 50.68 12.36 35 58.46 16.41 36 58.46 16.41 37 58.46 16.41 38 58.46 16.41 39 58.46 16.41 40 58.46 16.41 41 58.46 16.41 42 58.46 16.41 43 58.46 16.41 44 58.46 16.41 45 63.76 14.42 46 63.76 14.42 47 63.76 14.42 48 63.76 14.42 49 63.76 14.42 50 63.76 14.42 51 63.76 14.42 52 63.76 14.42 53 63.76 14.42 54 63.76 14.42 55 68.74 21.02 56 68.74 21.02 57 68.74 21.02 58 68.74 21.02 59 68.74 21.02 60 64.58 18.59 61 64.58 18.59 62 64.58 18.59 63 64.58 18.59 64 64.58 18.59 65 67.12 9.31 Delis-Kaplan Executive Function System: Verbal Fluency Test 29

Measuring Processing Speed It’s Complicated! Familiarity Long-term Verbal Memory Processing Visual Attention Processing Processing Motor Shifting Speed Speed 30

Science of Processing Speed Summary of Part One u Processing speed: the amount of time to perceive information, process the information, and enact a response Three primary types of processing speed: u u Visual, Verbal, Motor u It’s complicated! u Measurement of processing speed does not account for other skills u Science of processing speed still poorly understood and likely multifactorial 31

Part Two: What do Students with Slow Processing Speed Look Like? Case Example: Joseph, 15 y/o, 10 th grade Mom: “Joseph may be the laziest person I know. He can’t get anything done. It’s strange… growing up, he was such a good kid – a leader. He would organize these big performances with his cousins. He was funny and such a bright student. Teacher’s always told me how smart he was. Then in 8 th grade, something just kind of changed. He stopped seeming to care about homework – and spent way more time playing those videogames. Ninth grade was the worst. He got an F in English and and F in History. He did get a B in Math, but basically everything else was a D or an F . Teachers comments are always the same, bright student who needs to put in more effort. Now, everyday is an argument about homework and I’m tearing my hair out!” Hypotheses? 32

Neuropsychological Assessment u Intelligence Case u Academic Skills Conceptualization u Language u Attention/Executive Functioning u Visual Motor Skills u Memory u Social, Emotional, and Behavioral Recommendations Joseph’s Intellectual Test Findings WISC-V Intellectual Skills 150 140 134 125 130 120 110 100 90 90 80 80 69 70 60 50 40 Verbal Visual Spatial Fluid Reasoning Working Memory Processing Speed 33

Joseph’s Academic Test Findings WIAT-III Academic Skills 150 140 125 130 120 110 100 92 92 90 80 79 80 70 60 50 40 Reading Reading Math Spelling Essay Writing Comprehension Joseph’s Language Test Findings Language and Phonological Processing 150 140 130 120 112 110 100 90 90 88 90 80 65 70 60 50 40 Receptive Language Expressive Langauge Phonological Rapid Naming Pragmatic Language Awareness 34

Receptive Language Joseph’s Attention/Exec. Function Tests Attention and Executive Functioning 150 140 130 120 109 110 100 93 90 85 80 72 70 70 60 50 40 Trails A: Sequencing Trails B: Set Shifting Verbal Fluency Sustained Attention Rey Complex Figure 35

Conners Continuous Performance Test - 3 A Conners Continuous Performance Test - 3 X 36

Key Neuropsychological Domains Rey Complex Figure 37

Rey Complex Figure Executive Functioning Tests CAUTION! 38

Joseph’s Visual Motor Test Findings Visual Motor Functioning 150 140 125 130 120 115 120 110 100 90 80 70 60 50 40 Visual Motor Integration Fine Motor Dexterity Visual Organzation Joseph’s Psychological Test Findings Self Report Parent Report Teacher Report Psychological Test Findings 150 140 140 135 140 129 125 130 120 117 115 120 114 110 110 100 100 100 90 90 90 76 80 70 60 50 40 Depression Anxiety Social Problems Conduct Problems Executive Functioning 39

Joseph: Case Conceptualization Strengths • Nonverbal Intelligence • Visual Spatial • Fluid Reasoning • Motor and Visual Motor • Math skills • Social/personable Language & Phonological Attention & Executive Functioning Processing • Poor sustained attention Slow processing speed • Relatively weak • rec/exp language • Poor working memory Poor phonological • Trouble shifting sets • awareness • Difficulty retrieving information • Trouble with rapid naming Reading/Comprehension Taking in material DEPRESSION ACADEMIC PROBLEMS Study Skills Task Initiation Processing Speed Checklist u Think of a student you know well – or your own child u Now, complete your own checklist u Small Groups u Anything surprising? u Are you a “match”? Why? Why Not? 40

The Importance of “Fit” u “Fit” is critical u Fast Parent/Teacher – Slow Child u Slow Parent/Teacher – Slow Child u Flexible Parent/Teacher – Slow Child u Fit of the whole family u Fit of the whole classroom Genetics and Processing Speed 41