Mental Health Conditions Are Legitimate Health Conditions

It is widely accepted that if you have a health problem, you would see a medical professional who specializes in that problem’s proper treatment. If you have high cholesterol or are at risk of a heart attack, you see a cardiologist. If you have digestive problems, you see a gastroenterologist. If you have acne or other skin problems, you see a dermatologist.

But if you are faced with a mental health problem, is your first instinct to see a mental health professional?

Society has taught many of us to answer no. At least, this was the case for me when I was away at college. At the time, I attempted to balance academics, extracurricular activities and a part-time job—all while neglecting my own well-being. My solo circus act eventually came to a head one day in my foreign language class. I felt anxiety taking over my body, and I began crying uncontrollably. When my professor walked in, I rushed up to him and felt my throat tightening. Somehow, I managed to speak through my tears.

“I can’t be in class today,” I said between sobs. He nodded and encouraged me to speak with him during his office hours later that day. When we met, everything that had been going on in my mind poured out. I told my professor that my friend wanted to die and had attempted suicide over the weekend. I felt powerless and out of control. I couldn’t think straight. Then, my professor told me something that had honestly not occurred to me until that very moment.

“I am sorry to hear this. I really think you should go to the counseling center on campus. I think they can help you,” he recommended.

It was as if a wave of clarity hit me. Why didn’t I think of that? Why had I been isolating myself in my dorm room, sitting alone in fear? I hadn’t even considered going to the health center, let alone the counseling center. Looking back, I realize that it was because I never considered my mental health to be a health problem. I didn’t realize that my brain was just as important as the rest of the organs in my body.

The Brain And Mental Health

The brain is the most complex organ in our body and we’re constantly learning about how mental health conditions “live,” function and develop inside our brains. Additionally, mental health conditions can be hard to treat, as there is no one-size-fits-all treatment plan. Two individuals with bipolar disorder may respond very differently to the same medication. Mental illnesses are often far more nuanced than physical illnesses—they’re not a perfected science. Perhaps this is why society has a hard time considering mental health conditions “actual” health conditions.

What is indisputable is that mental health conditions are in fact legitimate health conditions, just like physical illnesses. Additionally, half of all mental health conditions begin by age 14, and 75% of mental health conditions develop by age 24. That is why early engagement and support are crucial to improving outcomes and increasing the promise of recovery. Additionally, mental health conditions can be lifelong conditions. However, with the right treatment plan, living well is possible.

Myself? After several years of pretending that I didn’t need help anymore, I decided to seek out a therapist. I’ve since been diagnosed with anxiety and depression. And with the support of loved ones, I go to therapy every week and am getting the treatment I need. I now see the importance of addressing any concerns with my health, especially my mental health, before they become serious.

Isn’t it time we all saw mental health conditions as legitimate health conditions?

 

Ryann Tanap is manager of social media and digital assets at NAMI.

https://www.nami.org/Blogs/NAMI-Blog/March-2018/Mental-Health-Conditions-are-Legitimate-Health-Con

Experiencing A Psychotic Break Doesn’t Mean You’re Broken

Each year, about 100,000 youth and young adults experience psychosis for the first time. They might see or hear things that aren’t there. They may believe things that aren’t true. It’s like “having a nightmare while you’re awake,” describes Elyn Saks, a legal scholar and mental health-policy advocate.

Unfortunately, when someone starts having these frightening experiences, doctors and medical professionals often tell them that their life won’t ever be the same. That they may never get better. That the best-case scenario is a sub-par existence where every goal they have is limited by their mental state.

Saks, for example, was diagnosed with schizophrenia as a young woman after multiple visits to a psychiatric hospital. “My doctors gave me a prognosis of ‘grave.’ That is, at best, I was expected to live in a boarding house and work at menial jobs.”

This narrative is not only exaggerated, but it’s also inaccurate. It’s akin to telling someone who recently went into diabetic shock that their life is pretty much over. Having diabetes does require proper treatment and lifestyle adjustments. It isn’t an easy health condition—nor is any illness—but you can still live a productive life. The same goes for psychosis and the mental health conditions it accompanies.

Understanding Recovery

There are two categories of recovery for mental health conditions that involve psychosis: clinical recovery, which refers to decreasing/eliminating symptoms and the time spent in the hospital, and personal recovery, which is “a unique process rather an end point with key recovery themes including hope, rebuilding self and rebuilding life.” This form of recovery involves personal goals and values that make life fulfilling.

Personal recovery has received more attention in recent research to help combat the myth that you can’t lead a good, fulfilling life with psychosis. Even if a person hasn’t achieved a complete clinical recovery (yet), they can still work towards personal recovery. According to a 2017 study, “We should make efforts to scientifically characterize the conceptual framework of personal recovery, so that users, family members, caregivers, and professionals can understand and contribute to the users’ personal recovery and subjective well-being.”

Clinical recovery takes time. And during that time, life shouldn’t be on hold. While a person is in treatment, they can still work towards theirs goals and do things that make them feel fulfilled. That way, once they leave a treatment program or a hospital visit, they have a foundation to continue building the life they want.

Setting Goals Leads To Better Outcomes

Clinical recovery and personal recovery work together and complement each other. According to NIMH’s research project, Recovery After Initial Schizophrenia Episode, it is essential for people experiencing psychosis to have personal goals that drive their treatment. For example, getting a degree for the career they want or getting involved with a specific cause. Working towards clinical recovery is incredibly hard, and having aspirations for the future helps individuals stay motivated and engaged in their recovery process.

This is why giving someone a “grave prognosis” can be harmful and counter-intuitive: Because people experiencing psychosis have better outcomes when they are focused on achieving future aspirations. That’s hard to do when you’re feeling hopeless about your future.

“Fortunately, I did not actually enact that grave prognosis” states Saks, who refused to accept that the psychosis associated with schizophrenia would define her life. “Instead, I’m a chair professor of law, psychology and psychiatry at the USC Gold School of Law; I have many close friends; and I have a beloved husband.” Saks isn’t an exception to the rule. In fact, many medical experts today believe there is potential for all individuals to recover from psychosis, to some extent.

Experiencing psychosis may feel like a nightmare, but being told your life is over after having your first episode is just as scary. Both personal recovery and clinical recovery are possible—that’s the message we should be spreading to the thousands of young people experiencing episodes of psychosis.

By Laura Greenstein

https://www.nami.org/Blogs/NAMI-Blog/March-2018/Experiencing-a-Psychotic-Break-Doesn-t-Mean-You-re

6 Ways You Can Help A Loved One On Their Healing Journey

Take a moment to consider all the people in your life: your coworkers, friends, family. At any given time, 1 in 5 of these individuals is living with a mental health condition. You may have noticed them struggling, but if you’re not a trained mental health professional, you may not have known how to help.

However, you can help. You can be supportive and encouraging during their mental health journey. Here are a few tips on supporting the mental health of those you love.

1) Educate Yourself

There are hundreds of mental health concerns; your job is not to become an expert in all of them. When you do notice potentially troublesome symptoms, it’s helpful to determine if those signs may indicate a mental illness. Familiarizing yourself with common symptoms can help you understand and convey your worries. You may also benefit from expanding your knowledge by taking a course or joining a support group of individuals who can relate to the hardships you and your loved one may be facing.

2) Remain Calm

Recognizing that a loved one might need help can be daunting, but try to remain calm—impulsively approaching the individual might make you seem insensitive or aggressive. Try to be mindful and patient. Take time to consider your loved one’s symptoms and your relationship before acting. Writing down how you feel and what you want to say may be useful to help you recognize and understand your thoughts and feelings, and help you slow down while connecting to your good intentions.

3) Be Respectful And Patient

Before talking to someone about their mental health, reflect on your intention to promote healing and keep that in mind. Ask how you can help in their recovery process and be cautious not to come off as controlling. While encouraging a person to seek help is okay, it is not appropriate to demand it of them. Let them know that if they ever wish to talk in the future, you’re available.

4) Listen

Give your loved one the gift of having someone who cares about their unique experience. Don’t bypass their narrative by making connections to others’ experiences. You might recognize a connection to your own experience, however, sharing your story prematurely may undermine their experience. You may be prepared with hotlines, books, or a list of community providers, and although these are excellent sources of support, it’s important to take time to thoroughly listen before giving advice. It’s a privilege to have someone share intimate details of their mental health. Be present and listen before moving forward.

5) Provide Support

One of the best ways to help is to simply ask how. It’s not helpful to try to be someone’s therapist, but you can still help. People don’t like being told what to do—asking how you can help empowers them to take charge of their recovery, while also letting them know you are a source of support.

6) Establish Boundaries

As you support your struggling loved one, it’s important to consider both your boundaries and theirs. When trying to help, you are susceptible to neglecting yourself in the process; boundaries will help you maintain your self-care, while also empowering your loved one. Be sure you’re not working harder than they are at their own healing process.

As a caring person, you may grapple between wanting to encourage and support your loved one while wanting to honor their process and independence. Unfortunately, there are no foolproof guidelines for helping your loved one on their journey towards recovery. However, you can connect to your intentions, convey compassion and maintain your own self-care while empowering your loved one regardless of where they are in their healing journey.

By Shainna Ali

https://www.nami.org/Blogs/NAMI-Blog/March-2018/6-Ways-You-Can-Help-a-Loved-One-on-Their-Healing-J

Understanding Self-Harm

Self-harm is difficult to understand because it goes against the natural human instinct of self-preservation. Maybe that’s why some people react to it in a negative, judgmental way. They can’t imagine ever being in a state of mind where they would hurt themselves, so they can’t understand why anyone else would.

This lack of understanding can lead to insensitivity and stigma towards people who are often already struggling with serious emotional turmoil. Self-harm is usually a sign that a person is having a tough time coping with their emotions. It’s frequently “used” as a coping mechanism for unmanageable mental health symptoms, although the experts don’t completely understand why some might self-medicate with drugs or alcohol, while others self-harm.

Several mental health conditions are associated with self-harming behaviors, including borderline personality disorder, depression, eating disorders, anxiety or posttraumatic distress disorder. People experiencing these conditions might self-harm for one or more of the following reasons:

  • To help manage unbearable emotions and symptoms
  • To help regain a sense of feeling (for those experiencing numbness)
  • To help relieve stress and pressure
  • To help feel in control
  • To reenact a trauma in an attempt to resolve it
  • To protect others from emotional pain

Any person can self-harm, but the largest percentage of people who engage in these type behaviors are teenagers (17.2%) and young adults (13.4%). According to psychologist Dr. Jennifer Muehlenkamp, “Those are the key ages because youth are experiencing multiple changes at the same time. They’re becoming more independent and transitions such as from junior high into high school or to college creates a lot of change. There’s a lot of new stress and pressures.”

What Should I Do?

Self-harm seems to provide some level of relief from emotional pain, and can become addictive. Like alcohol and other drugs, self-harm is a behavior that a person might feel they need increasingly more of to feel the same effect. It could also lead to other self-destructive coping mechanisms. So, if you or someone you know self-harms, here are a few first steps you can take to change this behavior.

Seek Treatment

Self-harm is a serious mental health symptom that requires evaluation and treatment. If you are having difficulty coping with intense emotions without the use of self-harm, consider talking with a mental health professional about one of the following treatment methods:

  • Cognitive behavioral therapy (CBT) focuses on recognizing negative thought patterns and increasing coping skills.
  • Dialectical behavioral therapy (DBT) helps a person learn positive coping methods.
  • Psychodynamic therapy identifies how negative behaviors have been caused or influenced by past experiences and unresolved feelings.

Practice Positive Coping Mechanisms

It’s helpful to understand what triggers you (or your loved one) to self-harm. That way, you can implement healthy coping mechanisms to manage those triggers. Some examples are:

  • Direct the urge at something else – Use a punching bag, scream into a pillow or rip up a magazine
  • Self-soothe – Take deep breaths, take a bath or try meditation
  • Express yourself – Write how you feel or write creatively
  • Create something – Paint, draw or craft
  • Focus on music – Listen to your favorite song or play an instrument
  • Exercise – Run, dance or just go for a walk
  • Avoid alcohol and drugs – Substances can lower your self-control and increase risk of self-injury

Self-harm is a challenging mental health symptom to overcome—and lack of understanding only makes it that much more difficult to work through. When it comes to serious mental health symptoms like self-harm, we need to show others and ourselves compassion rather than judgement. There is no shame in needing support and help.

Managing Your Mental Health During The Holidays

During the holiday season, many look forward to festivities with friends and family. But for others, this time can bring on or worsen stress, anxiety and depression.

There are a variety of factors that can bring on holiday anxiety and depression. Some people experience increased financial burden due to travel, gift and/or hosting costs. Others may feel overwhelmed as the holiday season often includes a packed calendar of parties, performances and traveling that can be difficult to balance with everyday responsibilities and self-care. Not to mention: High expectations to give perfect gifts and plan perfect events, as well as loneliness for those who aren’t with loved ones.

If you are experiencing any of these challenges, here are some coping tips you can use to manage your increased levels of anxiety, stress and sadness.

Stay In Therapy

Although the holiday season is overwhelmingly busy, do not cancel your therapy sessions to make time for other activities. The holidays can bring up difficult emotions. If you can, keep your scheduled therapy sessions to ensure you have built-in time to explore anything that comes up.

Mindfulness

In addition to professional mental health care, mindfulness can be a valuable mental wellness tool. Certain practices can be particularly helpful if you are traveling or running on an unusual schedule. If you’re new to mindfulness, the online MSW program at the University of Southern California created a Mindfulness Toolkit featuring free mindfulness resources, like guided meditations for beginners.

Don’t Rely On Drugs And Alcohol

The Anxiety and Depression Association of America recommends avoiding drugs and alcohol for comfort. While the prospect of escape can be appealing, substance use can ultimately worsen your issues. There is a 20% overlap between people with anxiety or mood disorders and substance use disorders, and substances can exacerbate symptoms. When you feel you need a relaxation aid, you can instead turn to a mindfulness tactic or other healthy coping mechanism.

Soak Up The Sun

Some struggle with depression during the winter months because of Major Depressive Disorder with a Seasonal Pattern. Exposure to bright lights, including fluorescent lights, can help ease symptoms. Even for those without this form of depression, walking outside in the sun can be an effective centering and calming tool. Numerous studies have pointed to the mental health benefits of spending time in nature, including stress relief, better concentration, lower levels of inflammation and improved mental energy.

Set Realistic Expectations

Another major source of anxiety, stress and depression around the holidays can be examining accomplishments from the past year. Some may experience negative feelings over not being at a place they feel they “should be” in life. Get yourself out of this space by adjusting expectations and setting realistic goals. For example, if you’re trying to establish an exercise routine, try setting a goal of talking a walk three times a week rather than vowing to do CrossFit every day.

Managing mental illness is always challenging, but it can be particularly difficult during the holiday season. While the struggle can feel isolating, remember that you are far from alone. Seek help from professional mental health services, maintain your self-care routines and include mindfulness practices into your days as you approach 2018.

 

Colleen O’Day is a digital marketing manager and community outreach support for 2U Inc.’s social work, mental health and K-12 education programs. Find her on Twitter @ColleenMODay.

https://www.nami.org/Blogs/NAMI-Blog/December-2017/Managing-Your-Mental-Health-During-the-Holidays

Millennials And Mental Health

As a mother of two Millennials, I’ve noticed differences between their generation and mine. Like how they prefer to spend money on travel, amazing food and experiences rather than physical things like homes and cars. These aren’t negative qualities—just different.

There is one difference I’ve noticed that is extremely positive: how they view mental health. I recently had a conversation with my oldest daughter, Mackenzie, who struggles with anxiety.

“Mom, you wouldn’t believe how many people my age talk about mental health,” she said. “It’s not a taboo subject anymore. I know a lot of people at work and friends outside of work who see therapists or take medication for anxiety and depression.”

I couldn’t hide my smile. Obviously, I’m not happy they’re dealing with mental illness, but I’m glad they’re not afraid to bring up the subject. My experience growing up was completely the opposite. I felt totally alone. My panic attacks began when I was 10 and I kept it a secret. I didn’t want to be seen as strange or different. By the time I was in my 20s, I panicked every time I drove or went to the grocery store. I knew my symptoms weren’t normal, but I still said nothing. Stigma and fear kept me quiet.

Meanwhile, Mackenzie was 23 when symptoms of anxiety first started to show. At first, I don’t think she wanted to admit she was having problems. She spent hours at the office, working her way up; she rarely took time to relax, never thinking much about her mental health. She blamed her lack of sleep on her motivation to get ahead, and her lack of appetite on acid reflux. But there was a deeper problem.

Mental health conditions run in our family. My mom had depression. My youngest daughter and I have recovered from panic disorder. Mackenzie was aware of our family history, and maybe that made it easier for her to talk about her symptoms. But I think the main reason she was encouraged to get professional help was that she heard her friends and coworkers openly discuss their mental health issues. Mackenzie didn’t feel ashamed or alone.

Millennials are often referred to as the “anxious generation.” They were the first to grow up with the constant overflow of the Internet and social media. The Internet can make life better, but it can also make life complicated, as Millennials often compare their personal and professional achievements to everyone else’s. This can result in low self-esteem and insecurity.

The world is at Millennials’ fingertips, but they also feel its immense weight. “Everything is so fast-paced and competitive. Part of that is social media,” Mackenzie told me. “The sense of immediacy—everything has to happen right away, at the click of a button. There’s pressure to constantly be ‘on.’ To look and sound perfect, and act like you have it all together. But you don’t.”

She continued, “I’m relieved my friends and I talk about being anxious and depressed. I don’t have to pretend anymore.”

2015 study by American University said that Millennials grew up hearing about anxiety, depression, eating disorders, and suicide, and they are more accepting of others with mental illness. Millennials are more likely to talk about mental health than their parents or grandparents. As more people speak out, the stigma surrounding mental illness is beginning to lessen.

Word is spreading through social media that mental health is an important part of overall well-being. Celebrities are openly sharing their struggles. The younger generation is learning about mental illness at an earlier age (thanks to programs like NAMI Ending the Silence).

It’s still difficult for many people to be open about their mental health issues—I’m not saying stigma is completely gone. But at least it’s not a totally taboo subject, like it was when I was growing up. I’m thankful Millennials are helping to break that stigma barrier a little further. I’m so glad my daughter doesn’t feel alone.

 

Jenny Marie is a mental health advocate and blogger. Jenny is married and has two daughters. Her blog is called Peace from Panic.

https://www.nami.org/Blogs/NAMI-Blog/December-2017/Millennials-and-Mental-Health

How To Encourage Someone To See A Therapist

It’s hard to watch someone you care about struggle with their mental health. It’s even worse when you know they could benefit from professional help. Approaching an individual and encouraging them to seek therapy can be a tricky situation. If done the wrong way, you could aggravate the person or turn them against the idea entirely. However, there is an effective way to have this conversation.

Here are some steps you can take to tell your loved one about the benefits of seeking therapy.

Show Support

Misconception about mental health and therapy has intensified stigma in society. Your loved one may be awarethat they need help, but may be afraid to seek it if they think you will judge or treat them differently. Therefore, it is essential to use non-stigmatizing language when talking with them about their mental health. Assure them that you will support them through the therapy process.

Demi Lovato is one of the most vocal celebrities about her mental health issues. She mentioned on multiple occasions how important it was for her to have people around that really care about her wellbeing. She credits her support group for being able to go through everyday life. Demi asks for advice from her loved ones and asks them to let her know when they feel something’s off: “So whether it’s with my management team or with my friends, every choice that I make, I run by people. And that’s what’s really helped me—vocalizing what you need.”

Be Sensitive To Timing And Place

Talking to someone about mental health requires emotional sensitivity as well as physical sensitivity. The “where” and “how” the topic is presented may determine how a person reacts to your suggestions. Your loved one may not be as bold as Kesha when she shared her condition and struggles with the world while receiving an award.

Don’t start this delicate conversation in front of other people or where others can hear as this may cause discomfort. And avoid grouping up in an intervention-style conversation as people do on TV shows. Allow the person struggling to decide whether they want others to know. This way, they feel respected and in control of their own treatment.

Also: Avoid talking to someone when they are in a bad mood, tired, have tight deadlines at work or if they’re doing something important. They may dismiss you or disregard the weight of the topic. Approach the person when they’re in a good mood, relaxed and undistracted. Try as much as possible to keep the conversation private, friendly and relaxed.

Prepare For Resistance

Not all people who hear about therapy will be willing to try it out. You need to be prepared to make your case if your loved one resists your suggestion. Here are some ideas that you can use to highlight the importance of therapy:

  • Try to use your relationship as leverage, in a loving way. Whether you’re their sibling, friend, spouse or relative, tell them how important your relationship with them is to you. And how it could benefit from their seeking therapy. However, avoid giving an ultimatum as it can cause emotional distress.
  • Name their admirable qualities. It’s easier to appeal to someone by pointing out what you like about them. When you point out someone’s positive qualities, they will be motivated to take the necessary steps to better themselves even further.
  • Explain specific areas of problematic behavior. Most people who refuse therapy may claim that they don’t have a problem. By pointing out specific problems without coming off as judgmental, you can help them see the need for seeking professional help.

Offer To Help

You can try to embolden someone to go to therapy, but unless you are willing to offer meaningful support, it’s not going to encourage them. Some people do not know where to start when seeking help. Guide them in finding a suitable therapist in the area, depending on their preferences. You can contact offices on their behalf or research various professionals, their credibility and reviews.

Some people are scared of seeing a therapist alone or signing up for group therapy. Offer to go with them until they’re comfortable. You can sit in the waiting room during their first few sessions. Make sure to assure them that you won’t ask prying questions about the counseling unless they want to share.

Seeking therapy is one of the best steps that a person with a mental health condition can take. However, it’s an effort that requires great strength and courage. Share your suggestions as openly as possible and leave them to make the decision that best suits their needs. Above all things, assure them of your continued love and support throughout the process.

By Mike Jones

https://www.nami.org/Blogs/NAMI-Blog/November-2017/How-to-Encourage-Someone-to-See-a-Therapist

 

Why Don’t Teachers Get Training On Mental Health Disorders?

To make it worse, most teachers are given very little training on how to detect mental health disorders in students. The National Institute of Mental Health estimates that one in five children has or will have a severe mental health disorder, so the lack of training is a huge disservice to teachers who are likely to encounter these issues in their students.

In an article published by The Atlantic, Jessica Lahey combines her personal experience dealing with mental health issues in the classroom with research on how teachers might be better prepared. She points out that often teachers aren’t even aware of mental health practices used by other staff in the building where they work. She writes:

As an increasing number of schools roll out evidence-based mental-health programs such as Positive Behavioral Interventions and Supports (PBIS), teaching that promotes appropriate student behavior by proactively defining, teaching, and supporting positive student conduct, and Trauma-Sensitive Schools, programs aimed at reducing the effects of trauma on children’s emotional and academic well-being, educators need to be at least minimally conversant in the terminology, methods, and thinking behind these strategies. These programs provide strategies that can be highly effective, but only if the teachers tasked with implementing them are sufficiently trained in the basics of mental-health interventions and treatment.

Some teachers may feel this type of preparation is not their job, but it is easy to confuse the symptoms of a mental health disorder with run-of-the-mill misbehavior, and how a teacher handles those situations affects the learning of every child in the classroom. If the teacher’s job is to teach the whole child, mental well-being and support is part of the description.

https://ww2.kqed.org/mindshift/2016/10/19/why-dont-teachers-get-training-on-mental-health-disorders/

Why Executive Function Is A Vital Stepping-Stone For Kids’ Ability to Learn

Neuroscientists and educational psychologists are constantly learning more about how children learn and the various influences beyond IQ that affect cognition. Some research, like Carol Dweck’s on growth mindset or Angela Duckworth’s on grit, quickly became catch phrases among educators. At the same time, critics have pushed back against the notion that students underperform only because of cognitive deficits, pointing to an equally pressing need for big changes to teaching practice. Many teachers are trying to combine the research about cognitive skills with more effective teaching practices. They are finding that whether students are working on self-directed projects or worksheets, executive functioning skills are important.

Bruce Wexler has been studying executive functioning — a group of cognitive abilities crucial for managing oneself and information — for the past 20 years. He first worked with adults, but he began to wonder if he could design interventions specifically for young children to get them started down a positive path before any of the negative secondary qualities associated with under-achievement — like disengagement, low self-esteem and behavior problems — began to manifest at school.

“The data just keeps coming in about the importance of focus, self-control and working memory for learning and life,” Wexler said in an edWeb webinar. One meta-analysis of six studies found that a child’s executive functioning skills in kindergarten predicted reading and math achievement into middle school and beyond. This research is particularly important because students who have poor executive functioning skills because of trauma, poverty, or diagnosed disorders are missing out on learning. Often these children haven’t had a chance to develop executive functioning skills required for school before arriving there.

Many kinds of interventions can work to improve executive functioning, another reason researchers feel confident that this cognitive ability is not innate, but rather taught. Martial arts, yoga and exercise, among others, help improve students’ ability to focus and control themselves. Wexler helped design his own intervention, called Activate, which uses a mixture of online games and physical activities to target focus, self-control and working memory, the skills most closely linked with academic achievement.

To test whether the program works Wexler’s company, C8Sciences, took executive function tests designed by the National Institutes of Health and made them Web-based so teachers could use them in class. These tests helped Wexler’s team learn about the relative areas of cognitive weaknesses in students before using the Activate program.

“Soon it became evident that not only did we want that information, but that it was very valuable for teachers,” Wexler said. It’s often hard for a teacher to know when a student isn’t learning something because of a lack of executive functioning capacity, because it hasn’t been taught well enough, or because the student just needs more time with the content. The online diagnostic tests helped give them valuable insight to tailor their teaching.

After determining a baseline for students, Wexler’s team asked teachers to use the Activate program and then tested students after four months to see how it affected their cognitive abilities. Early tests showed the training improved working memory, but Wexler was more interested in whether the training would carry over into academic achievement, so he tested third-graders from a low-income school on reading proficiency. In the test group that used Activate, 83 percent of students reached third-grade reading proficiency, compared to 58 percent districtwide. On a first-grade math proficiency test, 92 percent of students in the test group reached proficiency, compared to 63 percent districtwide. In another first-grade class at the same school that did not receive the training, only 53 percent of students reached proficiency.

“Training these executive functions leads to improvement in achievement schools,” Wexler concluded. And the effects seemed to last through the summer. Another test showed kindergartners who received the training showed better executive functioning skills when they started first grade than their peers.

When Wexler compared the effects he was seeing to other interventions — like one-on-one tutoring, summer and after-school programming — improving executive functioning skills had a much bigger effect. “Training a whole classroom in focus, self-control, and memory has a bigger effect on math achievement than providing one-on-one tutoring,” Wexler said. Tutoring had the next strongest effect.

Executive functioning training also seems to make a difference regardless of student IQ. “Its effect was four times as big as the differences in IQ,” Wexler said. “Of course IQ is important, but executive functioning is something we can do something about.”

SCHOOLS FOCUSING ON EXECUTIVE FUNCTIONING

Carlisle Area School District has taken the research on executive function and put it into practice, especially in K-5 schools where educators hope to improve these cognitive skills early so students don’t fall behind. District leaders started by educating teachers about different neural pathways and why problems with executive functioning could lead to problems with learning. In trainings, they give teachers scenarios, and ask them to identify a student’s cognitive weakness based on behavior, and then design an intervention. They also ask teachers to reflect on their own cognitive weaknesses and where they might be able to identify with a disorganized student or one who has a hard time staying on task.

Carlisle teachers also have a long list of strategies they integrate into the day with the whole class that emphasize brain breaks, exercise and routines. Additionally, some children need more help developing executive functioning, and educators differentiate strategies for them as well. They often talk to students about how their brain works and emphasize that when their “amygdala is hijacked,” they need to stop and think about the next action rather than lashing out.

STRATEGIES

  • Breathing buddies: Students lie down on the floor with a favorite stuffed animal on their chests. They slowly breathe in and out, watching the animal rise and fall. This helps students calm down when they are upset and gives them a strategy to implement when they feel themselves getting worked up.
  • Teachers keep “meta boxes” in their classrooms full of fidget toys students can use to help them pay attention when they feel like they need to move.
  • When transitioning between subjects or recess, teachers often play calming music and let only five kids in at a time to limit the chaos.
  • Many elementary school teachers have had the experience of asking a question, seeing many hands in the air, but then calling on a student who says he forgot. That could be a working memory problem. Some Carlisle teachers are proactively addressing this by letting those kids record their thoughts on paper or a device so they can contribute when they’re called on.
  • Carlisle was an early adopter of Wexler’s Activate program, too. The iPad lessons focus on typical working memory games that require students to remember the order of things, progressively getting harder as the game develops. The physical games reinforce the online learning with social interactions that help embed the memories in movement. Mass ball is one game that requires students to throw a ball in a specific sequence. Students have to juggle paying attention to the order and catching the ball.
  • Carlisle teachers also have students do a lot of balancing games, which help with executive functioning. Teachers might ask students to walk on a line balancing bean bags on their heads or to do the same walk on tiptoe. Teachers also use relay races to get kids moving, since exercise alone helps with executive functioning.

Adults have an attention span of about 12 minutes with a fully developed executive functioning system, so it’s no wonder kids can’t focus without a break. “It cannot be overemphasized that all of us need to be thinking about taking information in smaller chunks,” said Malinda Mikesell, the reading supervisor for the Carlisle Area School District. She said kids need an opportunity to do something with the information on their own before having the chance to reset for the next chunk of information.

“We have mature executive function systems as adults, so we have to be careful that we’re not putting our perspective onto very immature executive functioning systems,” Mikesell said. She also emphasized that teachers in her district have successfully involved parents in their effort to improve executive functions, educating the adults about the brain and what cognitive weaknesses look like. Often parents have noticed the same lack of short-term memory, difficulty focusing, and disorganization affecting kids at school, and are happy to learn tips to help their child.

Mikesell said Carlisle is in the early stages of evaluating data on how well their approach is working. Early data showed that kids in the Activate program were outperforming peers not in the program on reading tests. Teachers are also reporting stories about disorganized students improving, who never had what they needed for the day or activity. Now those students are able to follow the classroom routines and are benefiting from checklists and visual organizers that teachers put together to help them with their working memory weaknesses.

https://ww2.kqed.org/mindshift/2016/12/13/why-executive-function-is-a-vital-stepping-stone-for-kids-ability-to-learn/