Month: January 2019

December Blues

December Blues

Why is December so hard for students with executive function challenges?

This time of year can be particularly challenging for young people with executive function challenges and their parents/carers. Low mood, coupled with academic pressure from school and general exhaustion can lead to heightened tensions at home and an emotional downward spiral. Hear from Connections in Mind Coaching’s Managing Director Victoria Bagnall about the science behind the December Blues, why they affect students with Executive Function (EF) challenges more than most and what we can do to help.
What are the December blues?

If you talk to any mental health professional in the Northern Hemisphere, they will tell you that the run up to Christmas is their busiest time of year. Many people experience low mood during this time of year. This low mood is thought to be linked to the impaired functioning of the hypothalamus – which can:
* Increase the production of melatonin – this is the hormone that makes you feel sleepy.
* Lower the production of serotonin – this is the hormone that promotes mood, appetite and sleep.
* Affect the body’s internal clock (circadian rhythm) – the body uses sunlight to time various functions (e.g. when to wake up) .

Why do the December blues affect students with executive function challenges more than others?

We have to remember that school life is particularly demanding for students with executive function challenges. They have been working hard all term to keep up with their peers and by the end of a long term they can be physically and mentally exhausted. We know that executive functions are impaired when we are tired and there the vicious cycle continues.

What is more, due to issues with emotional control and response inhibition, they might find it more difficult than others to regulate their emotions. Whilst others may find it easier to maintain a strong exterior despite feelings of low mood, often students with executive function challenges wear their heart on their sleeve so to speak and struggle to mask how they are feeling.

Indeed, this will be compounded by the fact that their challenges with metacognition (self awareness) result in them feeling more emotional, but not actually be aware of why, or even the impact this is having on their lives and those around them. They can seem like they are absorbed in themselves and not thinking about anyone else.
What can we do to help?
1. Normalise the December blues and share any feelings of low mood as a family to encourage young people to talk about how they are feeling.
2. Recognise and praise that they have been working hard all term, and empathise with them about how hard it is.
3. Encourage good rest and allow them to drop non-compulsory extra curricular activities if they are showing signs of exhaustion.
4. Encourage them to spend time outside in the fresh air and winter sun.
5. Encourage a healthy lifestyle including regular exercise and healthy eating.
6. Avoid energy drinks – see government/ Royal College of Paediatrics and Child Health report on the link between energy drinks and poor executive functions in adolescents.
7. Plan fun activities that the young person will enjoy and look forward to.
8. This video can help summarise what we can do to help with the winter blues.
9. Seek help from trained mental health professionals if you have any concerns about the their emotional state i.e. depression or anxiety.
10. Contact Connections in Mind for more support.

 

Connections in Mind is a family of organisations that is committed to raising awareness of executive function skills and their impact on children’s development and relationships. We offer coaching, parenting courses, revision skills courses and training and support for schools.

Click Here to book in to speak to one of the team about our Coaching Services

Click Here for more information about our Parenting Courses.

Click Here for more information about our revision skills courses run through The Code.

Click Here to find out more about our Training and Schools offering.

ADHD Lobbying

ADHD Lobbying

Co-founder of Connections in Mind and trustee of The Connections in Mind Foundation Dr Bettina Hohnen was invited to speak at an All Party Parliamentary Group for ADHD organised by ADHD Action.

Here are some of her reflections on the day.

One of the key aims of the Connections in Mind Foundation is to influence policy and to increase awareness of Executive Functions (EFs) at a national level. As part of this strategy we have established a working group of psychologists, teachers and coaches who feel passionate about this mission. One of the goals of the working group is to increase the training teachers receive when they are qualifying with regard to what executive functions are, the relationship between executive function learning and mental health, and related neurodevelopmental conditions, such as ADHD.

As the group work towards this goal, an opportunity arose last week to contribute to the All-Party Parliamentary Group (APPG) for Attention Deficit Hyperactivity Disorder (ADHD). This initiative was the result of many years of work by the devoted and inspirational Michelle Beckett from ADHD Action.

It was a bright autumn day and the queue to enter Westminster was a long one, but I soon began to talk to a mother, coach and young person standing behind me attending the same event. It became clear to me before I even walked into the room that this was going to be a well-attended event full of passionate individuals from all walks of life who had been affected by the condition.

I had been asked to give a five-minute presentation, with the invitation to cite scientific evidence for the causes and incidents of ADHD and its potential impact on mental health and well being. How is it possible, I wondered, to succinctly summarise a vast array of data with a meaningful message in five minutes? I chose to focus on three key myths about ADHD and offer three key solutions.

 

Misconceptions about ADHD

The first myth that needs busting before all else is that ADHD is a behavioural disorder, as some still believe. It is, in fact, one of a number of neurodevelopmental disorders where a child’s brain is developing differently to the majority of the population. Research has clearly demonstrated that people with ADHD have distinct structural, chemical and functional characteristics of their brains that emerge as they grow up. ADHD is strongly heritable and while no one likes the idea of medicating children and young people, a meta-analysis published in 2013 shows clearly that core symptoms of ADHD are most effectively treated with medical intervention.

The second myth is that we don’t know what to do about the epidemic of mental health problems in young people and how to manage the behavioural crisis in school that results in startlingly high levels of exclusion. On the contrary, we have the answer staring us in the face. A very high proportion of children who present with mental health difficulties or cause disruption at school have a neurodevelopmental condition, such as ADHD (1-3 children in every classroom), which is currently under-recognised and under-diagnosed.

The third myth is that effective assessment and intervention in ADHD is prohibitively expensive and hard to implement. We do know how to assess and intervene in a cost-effective manner. The knowledge, expertise and evidence are there. We just need to know how and where to implement change.

 

Solutions

There are three key solutions that are effective, easy to implement and would make a real difference to young people with ADHD.

Firstly, we can equip teachers with the knowledge to recognise ADHD in all children. Teachers are dedicated and hard-working individuals who are currently in the dark. They are given the task of teaching large groups of children, all of whom are different, but a proportion of whom stand out and are struggling. Teachers know ‘one size fits all’ does not work in education but they don’t have the skills to identify what is really going on. This is particularly a problem for girls with ADHD who are systematically under-diagnosed and for children with ADHD in the context of high ability who under-achieve but go unnoticed as they perform at an average level, despite their enormous potential. We just need to train teachers on what to look for to identify ADHD. Iif you know what you’re looking for, it’s easy to identify.

Solution number two is to set up affordable but effective screening systems for ADHD for children who are underachieving at school, have mental health problems or have behavioural challenges. We are past the age of believing that children are inherently lazy or naughty. Behaviour is a communication that tells us that a child is struggling. We have a duty to investigate the why and act.

Solution number three is to train all teachers in the small but effective strategies for how to manage all children’s behaviour and to help them engage in learning in the classroom. Some of the most effective interventions in education have come about from relatively small changes in our perceptions and beliefs. Take the work around mindsets, for example. The intervention is small but powerful, as it is meaningful and integrated throughout a child’s life. It’s a change in the way behaviour is perceived by both the adult and child, and a change in how we communicate about success and respond to behaviour.

The current work around Executive Functions (EFs) and metacognition is another example of this kind of approach. Programmes exist that embed an awareness of EF skills in the curriculum, offering both teachers and children an understanding of the processes of learning that are getting in the way of performance. This demystifies children’s performance, reduces teacher and student stress and empowers them both to know how to change. In the UK, the Connections in Mind Foundation has been working with schools to train teachers on how to do this by adopting the Activated Learning approach. Laurie Faith (creator of Activated Learning) reminds us that this kind of intervention is ‘necessary for some and good for all’. With these types of approaches, we are handing children the key to their own success that will serve them now and for many years to come.

The point is that none of these solutions and approaches are expensive, onerous or difficult to implement. This is not about changing the entire education system; it’s about knowing what makes a difference for children.

“None of these solutions and approaches are expensive, onerous or difficult to implement. This is not about changing the entire education system; it’s about knowing what makes a difference for children.”

 

Passionate contribution for all

After my short presentation, Kit Messenger, former head teacher and head of education at Genius Within, spoke passionately about her experience as a teacher, echoing much of what I had said and reinforcing the negative impact in schools where there are cases of undiagnosed ADHD in children. She was followed by Stephanie Camilleri, lawyer, school governor and legal advocate for cases involving ADHD and schools, who talked about her work as a legal advocate as well as her experience of children with ADHD struggling within the school system. The floor then opened for questions and answers, chaired by Alex Sobel, along with Angela Rayner, shadow education secretary.

Passionate personal stories were recounted from parents, young people, professionals, lawyers, police officers and teachers. The strength of feeling was overwhelming. Of the very many important points and messages, what stands out for me are the following: the importance of remembering gender imbalance in diagnoses (girls are systematically under-diagnosed); the potential racial biases in diagnoses (young black boys are more likely to be seen as badly behaved); emotional regulation as a key symptom of ADHD, including heightened anxiety; that it is a child’s human right to have breaks in their school day (a point made with force by a young man who had consistently been held in at break time at school before getting his diagnosis); and that medication does work for some (as illustrated during a Q & A session with a psychiatrist and her 12-year-old patient).

One mother also pointed out that parents need support at home on being educated on what EFs are and how they impact on home life;there are currently no programmes showing them how. This is something that spoke volumes to us because, over the last few years, we have created a course called Connected Minds Parenting to do just this.

As a person waiting to take office who has the understanding and experience that inspires action, Angela Rayner gave us hope for change. Angela is current and cutting edge as a strong female MP, both as a teenage mother and a person with a self-disclosed diagnosis of ADHD, which she referred to as her ‘super-power’. She confirmed what we all know and fear, which is that there is a mighty discrepancy between the way we treat children with physical disabilities and those with neurodisabilities. Her child with visual impairment is well looked after by the NHS. Her child with ADHD has been sanctioned and labeled as naughty and his needs neglected, both before and since being diagnosed. If there is anyone who can champion the cause of the campaign, it’s Angela.

 

What the future holds

The Connections in Mind Foundation is devoted to helping all children flourish by increasing awareness of and intervention to develop executive function skills. While the foundation works hard on its mission, the seeds have already been planted that an executive function approach is an inexpensive, effective and accessible way in which we can support children both with and without ADHD, because at times we all struggle with our executive function skills. There is a lot of work to do, but the foundations have been laid, the motivation is there and the future looks bright. There can be no more excuses. This is not about money or a significant overhaul of our education system – it’s about the motivation to equip everyone in society with the knowledge needed to support all children.

Why We Are Setting up Our Foundation

Why We Are Setting up Our Foundation

At Connections in Mind, one of the struggles we have come across is the lack of awareness about executive functions, the science behind them and how they impact on learning and mental health. To recap – executive functions are the group of complex mental processes and cognitive abilities (such as working memory, impulse inhibition, and reasoning) that control the skills (such as organising tasks, remembering details, managing time, and solving problems) required for goal-directed behaviour.

These are skills we need to flourish in life and poor executive functions can negatively impact on academic achievement, emotional functioning, and job outcomes (Alloway & Alloway, 2010 ; Miller, Nevado‐Montenegro, & Hinshaw, 2012; Snyder, 2013.

We want to dedicate time and effort to: raising awareness with parents and schools; evaluating approaches to strengthen children and young people’s executive function skills; and initiating innovative projects with children and young people from all backgrounds. We think that launching a charity is the best vehicle for us to be able to achieve these aims

 

What We Will Focus On

Children’s relationships and interactions with their parents and caregivers can impact on the development of these skills and the home environment of children can be viewed as a mediator of the relations between the socio-economic conditions of families and children’s executive function development (Finegood & Blair, 2017).

We are acutely aware of the connections between poor executive function development and low socio-economic status (Fernald, Weber, Galasso, & Ratsifandrihamanana, 2011) ; (Hackman, Gallop, Evans, & Farah, 2015); (Haft S. L. & Hoeft F.2017)

When the home environment is negatively impacted by poverty, this can affect the levels of stress in the home and quality of interactions between parents and children. Therefore working with schools, families, children and young people from disadvantaged backgrounds to improve their executive function skills will be an area of priority for us.

 

Parenting in the 21st Century

Parenting in the 21st Century

Dr Bettina Hohnen one of the co-founders of Connections in Mind will be giving a workshop next week at our summit about parenting in the 21st century to support children and young people to develop executive functions skills.

Much has been written about how the world is changing and how our education system, which was invented in the 19th Century to meet the needs of industrialisation, is not necessarily equipping children with the skills they need to work in 21st century jobs. There is a growing consensus that new skills are needed to succeed in education and in the workplace as is shown in the figure below. Many of these skills are foundational and higher order executive functions (EF) skills such as persistence/grit, adaptability, initiative, critical thinking. It is said that employers are looking for individuals who can understand and analyse new information, know whether content is valid, collaborate and communicate with others while working towards a goal.

While educational professionals are busy working out how the curriculum in schools should change and adapt to incorporate this kind of learning (see Activated Learning for example, www.activatedlearning.org), there is much that parents can be doing at home to support the development of children’s EF skills. Connected Parenting is a programme that aims to equip parents with the knowledge and skills to do just that.

Students must know about their Executive Functioning skills

Connected parenting shows parents how to increase their child’s awareness of EF skills used in the home. Naming them and pointing them out is a crucial step in training them. Children use their EF skills successfully a lot of the time. For example, a child as young as 3 is able to inhibit a response (stop themselves doing things they have the urge to do), most children are able to sustain attention to a task that is not of inherent interest to them from age 5 and by the time they are 6 or 7 many children are able to plan for a trip and pack their bags ahead of time.
Yet children are not aware of the skills they are using.

By naming the skill and focusing on the process the child is going through when they are being successful, we can increase the child’s awareness or ‘metacognition’ (ability to reflect on ones own behaviour). We do not have the brain evidence (yet!), but we believe that by increasing awareness of when EF skills are being used we are stimulating the brain networks to strengthen pathways which will lead to greater competence in this area of functioning.

Of course a child’s EF skills don’t always ‘switch on’, which is perhaps not surprising given that the frontal lobes of the brain which house the EF skills are not yet developed until into the mid 20s. Inactivation of an EF skill underlies so many of the problematic behaviours that cause stress in a family, but if we can name the EF skill not being drawn on we have a chance of fixing the problem. Parents learn how important communication is and a strategy to tackle the problem in a stress-free manner.

The parent-child relationship must be the priority

Due to the nature of EF difficulties, despite parents’ best efforts, the parent-child relationship can become strained. For this reason, priority is given to helping parents to learn how to prioritise their relationship with their child while also changing their child’s behaviour for the better. Old school parenting is more about hierarchy and power with not a lot of questioning or collaborating. In old school parenting there is more of a focus on the goal and on achievement and not so much on the process, such as how we got there. New ideas in parenting focus more on dialogue and empathy, listening and deep learning. A focus on emotional intelligence and compassionate parenting, while naming the skills the child need to draw on to be more successful in that moment (the EF skill), is what Connected Parenting is all about.

 

Bettina Hohnen, Clinical Psychologist

June 2018

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