Download - BRS ADHD Workshop
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
hellipa challenge
Perspective of this workshophellip
ldquoTop ndash downrdquo dysfunction
ADHD Executive dysfunction
ldquoBottom - uprdquo dysfunction
Central auditory processing problems Sensory processing problems
Whatrsquos the kidrsquos deal
This Dense Pudding What Does Dopamine Feel Like Why You Arenrsquot Getting Exactly What Want All the Time Lend Me Your Brain
Overview
This Dense Pudding
Normal and Abnormal Sensory Processing and Attentional Functioning
Sensory Processing Disorder
S ensory In tegration
S ensory D iscrim ination
S ensory M odu lation
S ensory D etection
Sensory Integration Terminology
Sensory Processing
Developmental considerations Auditory Visual Tactile Proprioceptive Vestibular Motor
Sensory ProcessingIntegration Disorder and DSM-V
Whatrsquos the kidrsquos deal
Whatrsquos the kidrsquos deal
Strategies
Regulatory-Sensory Processing Disorders
Treatment ldquotop downrdquo
ldquobottom uprdquo
Regulatory-Sensory Processing Disorders
Treatment ldquotop downrdquo ldquobottom uprdquo
Central Auditory Processing Disorder
bull Auditory discrimination (samedifferent)bull Auditory closure (fill in missing bits)bull Auditory localisation (locate source of sound)bull Auditory performance with degraded acousticsignalbull Auditory figure-ground (perceiving sounds inbackground noise)
Central Auditory Processing Disorder
Central Auditory Processing Disorder
CAPD refers to a deficit observed in one or more of the central auditory processes responsible for generating the auditory evoked potentials and the following behaviors sound localization and lateralization auditory discrimination auditory pattern recognition
Central Auditory Processing Disorder
- Poor communicator (terse telegraphic) - Memorizes poorly- Hears better when watching the speaker - Problems with rapid speech - Interprets words too literally
Central Auditory Processing Disorder
- Often needs remarks repeated - Difficulty sounding out words- Confuses similar-sounding words- Difficulty following directions in a series - Speech developed late or unclearly
CAPD or ADHD
Whatrsquos the kidrsquos deal
Strategies
(C)APD
Treatment ldquotop downrdquo ldquobottom uprdquo
X
Treatment for CAPD
Environmental modifications
Treatment for CAPD
Compensatory Strategies
Self-assessment
hellipa challenge
Perspective of this workshophellip
ldquoTop ndash downrdquo dysfunction
ADHD Executive dysfunction
ldquoBottom - uprdquo dysfunction
Central auditory processing problems Sensory processing problems
Whatrsquos the kidrsquos deal
This Dense Pudding What Does Dopamine Feel Like Why You Arenrsquot Getting Exactly What Want All the Time Lend Me Your Brain
Overview
This Dense Pudding
Normal and Abnormal Sensory Processing and Attentional Functioning
Sensory Processing Disorder
S ensory In tegration
S ensory D iscrim ination
S ensory M odu lation
S ensory D etection
Sensory Integration Terminology
Sensory Processing
Developmental considerations Auditory Visual Tactile Proprioceptive Vestibular Motor
Sensory ProcessingIntegration Disorder and DSM-V
Whatrsquos the kidrsquos deal
Whatrsquos the kidrsquos deal
Strategies
Regulatory-Sensory Processing Disorders
Treatment ldquotop downrdquo
ldquobottom uprdquo
Regulatory-Sensory Processing Disorders
Treatment ldquotop downrdquo ldquobottom uprdquo
Central Auditory Processing Disorder
bull Auditory discrimination (samedifferent)bull Auditory closure (fill in missing bits)bull Auditory localisation (locate source of sound)bull Auditory performance with degraded acousticsignalbull Auditory figure-ground (perceiving sounds inbackground noise)
Central Auditory Processing Disorder
Central Auditory Processing Disorder
CAPD refers to a deficit observed in one or more of the central auditory processes responsible for generating the auditory evoked potentials and the following behaviors sound localization and lateralization auditory discrimination auditory pattern recognition
Central Auditory Processing Disorder
- Poor communicator (terse telegraphic) - Memorizes poorly- Hears better when watching the speaker - Problems with rapid speech - Interprets words too literally
Central Auditory Processing Disorder
- Often needs remarks repeated - Difficulty sounding out words- Confuses similar-sounding words- Difficulty following directions in a series - Speech developed late or unclearly
CAPD or ADHD
Whatrsquos the kidrsquos deal
Strategies
(C)APD
Treatment ldquotop downrdquo ldquobottom uprdquo
X
Treatment for CAPD
Environmental modifications
Treatment for CAPD
Compensatory Strategies
Self-assessment
Perspective of this workshophellip
ldquoTop ndash downrdquo dysfunction
ADHD Executive dysfunction
ldquoBottom - uprdquo dysfunction
Central auditory processing problems Sensory processing problems
Whatrsquos the kidrsquos deal
This Dense Pudding What Does Dopamine Feel Like Why You Arenrsquot Getting Exactly What Want All the Time Lend Me Your Brain
Overview
This Dense Pudding
Normal and Abnormal Sensory Processing and Attentional Functioning
Sensory Processing Disorder
S ensory In tegration
S ensory D iscrim ination
S ensory M odu lation
S ensory D etection
Sensory Integration Terminology
Sensory Processing
Developmental considerations Auditory Visual Tactile Proprioceptive Vestibular Motor
Sensory ProcessingIntegration Disorder and DSM-V
Whatrsquos the kidrsquos deal
Whatrsquos the kidrsquos deal
Strategies
Regulatory-Sensory Processing Disorders
Treatment ldquotop downrdquo
ldquobottom uprdquo
Regulatory-Sensory Processing Disorders
Treatment ldquotop downrdquo ldquobottom uprdquo
Central Auditory Processing Disorder
bull Auditory discrimination (samedifferent)bull Auditory closure (fill in missing bits)bull Auditory localisation (locate source of sound)bull Auditory performance with degraded acousticsignalbull Auditory figure-ground (perceiving sounds inbackground noise)
Central Auditory Processing Disorder
Central Auditory Processing Disorder
CAPD refers to a deficit observed in one or more of the central auditory processes responsible for generating the auditory evoked potentials and the following behaviors sound localization and lateralization auditory discrimination auditory pattern recognition
Central Auditory Processing Disorder
- Poor communicator (terse telegraphic) - Memorizes poorly- Hears better when watching the speaker - Problems with rapid speech - Interprets words too literally
Central Auditory Processing Disorder
- Often needs remarks repeated - Difficulty sounding out words- Confuses similar-sounding words- Difficulty following directions in a series - Speech developed late or unclearly
CAPD or ADHD
Whatrsquos the kidrsquos deal
Strategies
(C)APD
Treatment ldquotop downrdquo ldquobottom uprdquo
X
Treatment for CAPD
Environmental modifications
Treatment for CAPD
Compensatory Strategies
Self-assessment
ldquoTop ndash downrdquo dysfunction
ADHD Executive dysfunction
ldquoBottom - uprdquo dysfunction
Central auditory processing problems Sensory processing problems
Whatrsquos the kidrsquos deal
This Dense Pudding What Does Dopamine Feel Like Why You Arenrsquot Getting Exactly What Want All the Time Lend Me Your Brain
Overview
This Dense Pudding
Normal and Abnormal Sensory Processing and Attentional Functioning
Sensory Processing Disorder
S ensory In tegration
S ensory D iscrim ination
S ensory M odu lation
S ensory D etection
Sensory Integration Terminology
Sensory Processing
Developmental considerations Auditory Visual Tactile Proprioceptive Vestibular Motor
Sensory ProcessingIntegration Disorder and DSM-V
Whatrsquos the kidrsquos deal
Whatrsquos the kidrsquos deal
Strategies
Regulatory-Sensory Processing Disorders
Treatment ldquotop downrdquo
ldquobottom uprdquo
Regulatory-Sensory Processing Disorders
Treatment ldquotop downrdquo ldquobottom uprdquo
Central Auditory Processing Disorder
bull Auditory discrimination (samedifferent)bull Auditory closure (fill in missing bits)bull Auditory localisation (locate source of sound)bull Auditory performance with degraded acousticsignalbull Auditory figure-ground (perceiving sounds inbackground noise)
Central Auditory Processing Disorder
Central Auditory Processing Disorder
CAPD refers to a deficit observed in one or more of the central auditory processes responsible for generating the auditory evoked potentials and the following behaviors sound localization and lateralization auditory discrimination auditory pattern recognition
Central Auditory Processing Disorder
- Poor communicator (terse telegraphic) - Memorizes poorly- Hears better when watching the speaker - Problems with rapid speech - Interprets words too literally
Central Auditory Processing Disorder
- Often needs remarks repeated - Difficulty sounding out words- Confuses similar-sounding words- Difficulty following directions in a series - Speech developed late or unclearly
CAPD or ADHD
Whatrsquos the kidrsquos deal
Strategies
(C)APD
Treatment ldquotop downrdquo ldquobottom uprdquo
X
Treatment for CAPD
Environmental modifications
Treatment for CAPD
Compensatory Strategies
Self-assessment
ldquoBottom - uprdquo dysfunction
Central auditory processing problems Sensory processing problems
Whatrsquos the kidrsquos deal
This Dense Pudding What Does Dopamine Feel Like Why You Arenrsquot Getting Exactly What Want All the Time Lend Me Your Brain
Overview
This Dense Pudding
Normal and Abnormal Sensory Processing and Attentional Functioning
Sensory Processing Disorder
S ensory In tegration
S ensory D iscrim ination
S ensory M odu lation
S ensory D etection
Sensory Integration Terminology
Sensory Processing
Developmental considerations Auditory Visual Tactile Proprioceptive Vestibular Motor
Sensory ProcessingIntegration Disorder and DSM-V
Whatrsquos the kidrsquos deal
Whatrsquos the kidrsquos deal
Strategies
Regulatory-Sensory Processing Disorders
Treatment ldquotop downrdquo
ldquobottom uprdquo
Regulatory-Sensory Processing Disorders
Treatment ldquotop downrdquo ldquobottom uprdquo
Central Auditory Processing Disorder
bull Auditory discrimination (samedifferent)bull Auditory closure (fill in missing bits)bull Auditory localisation (locate source of sound)bull Auditory performance with degraded acousticsignalbull Auditory figure-ground (perceiving sounds inbackground noise)
Central Auditory Processing Disorder
Central Auditory Processing Disorder
CAPD refers to a deficit observed in one or more of the central auditory processes responsible for generating the auditory evoked potentials and the following behaviors sound localization and lateralization auditory discrimination auditory pattern recognition
Central Auditory Processing Disorder
- Poor communicator (terse telegraphic) - Memorizes poorly- Hears better when watching the speaker - Problems with rapid speech - Interprets words too literally
Central Auditory Processing Disorder
- Often needs remarks repeated - Difficulty sounding out words- Confuses similar-sounding words- Difficulty following directions in a series - Speech developed late or unclearly
CAPD or ADHD
Whatrsquos the kidrsquos deal
Strategies
(C)APD
Treatment ldquotop downrdquo ldquobottom uprdquo
X
Treatment for CAPD
Environmental modifications
Treatment for CAPD
Compensatory Strategies
Self-assessment
Whatrsquos the kidrsquos deal
This Dense Pudding What Does Dopamine Feel Like Why You Arenrsquot Getting Exactly What Want All the Time Lend Me Your Brain
Overview
This Dense Pudding
Normal and Abnormal Sensory Processing and Attentional Functioning
Sensory Processing Disorder
S ensory In tegration
S ensory D iscrim ination
S ensory M odu lation
S ensory D etection
Sensory Integration Terminology
Sensory Processing
Developmental considerations Auditory Visual Tactile Proprioceptive Vestibular Motor
Sensory ProcessingIntegration Disorder and DSM-V
Whatrsquos the kidrsquos deal
Whatrsquos the kidrsquos deal
Strategies
Regulatory-Sensory Processing Disorders
Treatment ldquotop downrdquo
ldquobottom uprdquo
Regulatory-Sensory Processing Disorders
Treatment ldquotop downrdquo ldquobottom uprdquo
Central Auditory Processing Disorder
bull Auditory discrimination (samedifferent)bull Auditory closure (fill in missing bits)bull Auditory localisation (locate source of sound)bull Auditory performance with degraded acousticsignalbull Auditory figure-ground (perceiving sounds inbackground noise)
Central Auditory Processing Disorder
Central Auditory Processing Disorder
CAPD refers to a deficit observed in one or more of the central auditory processes responsible for generating the auditory evoked potentials and the following behaviors sound localization and lateralization auditory discrimination auditory pattern recognition
Central Auditory Processing Disorder
- Poor communicator (terse telegraphic) - Memorizes poorly- Hears better when watching the speaker - Problems with rapid speech - Interprets words too literally
Central Auditory Processing Disorder
- Often needs remarks repeated - Difficulty sounding out words- Confuses similar-sounding words- Difficulty following directions in a series - Speech developed late or unclearly
CAPD or ADHD
Whatrsquos the kidrsquos deal
Strategies
(C)APD
Treatment ldquotop downrdquo ldquobottom uprdquo
X
Treatment for CAPD
Environmental modifications
Treatment for CAPD
Compensatory Strategies
Self-assessment
This Dense Pudding What Does Dopamine Feel Like Why You Arenrsquot Getting Exactly What Want All the Time Lend Me Your Brain
Overview
This Dense Pudding
Normal and Abnormal Sensory Processing and Attentional Functioning
Sensory Processing Disorder
S ensory In tegration
S ensory D iscrim ination
S ensory M odu lation
S ensory D etection
Sensory Integration Terminology
Sensory Processing
Developmental considerations Auditory Visual Tactile Proprioceptive Vestibular Motor
Sensory ProcessingIntegration Disorder and DSM-V
Whatrsquos the kidrsquos deal
Whatrsquos the kidrsquos deal
Strategies
Regulatory-Sensory Processing Disorders
Treatment ldquotop downrdquo
ldquobottom uprdquo
Regulatory-Sensory Processing Disorders
Treatment ldquotop downrdquo ldquobottom uprdquo
Central Auditory Processing Disorder
bull Auditory discrimination (samedifferent)bull Auditory closure (fill in missing bits)bull Auditory localisation (locate source of sound)bull Auditory performance with degraded acousticsignalbull Auditory figure-ground (perceiving sounds inbackground noise)
Central Auditory Processing Disorder
Central Auditory Processing Disorder
CAPD refers to a deficit observed in one or more of the central auditory processes responsible for generating the auditory evoked potentials and the following behaviors sound localization and lateralization auditory discrimination auditory pattern recognition
Central Auditory Processing Disorder
- Poor communicator (terse telegraphic) - Memorizes poorly- Hears better when watching the speaker - Problems with rapid speech - Interprets words too literally
Central Auditory Processing Disorder
- Often needs remarks repeated - Difficulty sounding out words- Confuses similar-sounding words- Difficulty following directions in a series - Speech developed late or unclearly
CAPD or ADHD
Whatrsquos the kidrsquos deal
Strategies
(C)APD
Treatment ldquotop downrdquo ldquobottom uprdquo
X
Treatment for CAPD
Environmental modifications
Treatment for CAPD
Compensatory Strategies
Self-assessment
This Dense Pudding
Normal and Abnormal Sensory Processing and Attentional Functioning
Sensory Processing Disorder
S ensory In tegration
S ensory D iscrim ination
S ensory M odu lation
S ensory D etection
Sensory Integration Terminology
Sensory Processing
Developmental considerations Auditory Visual Tactile Proprioceptive Vestibular Motor
Sensory ProcessingIntegration Disorder and DSM-V
Whatrsquos the kidrsquos deal
Whatrsquos the kidrsquos deal
Strategies
Regulatory-Sensory Processing Disorders
Treatment ldquotop downrdquo
ldquobottom uprdquo
Regulatory-Sensory Processing Disorders
Treatment ldquotop downrdquo ldquobottom uprdquo
Central Auditory Processing Disorder
bull Auditory discrimination (samedifferent)bull Auditory closure (fill in missing bits)bull Auditory localisation (locate source of sound)bull Auditory performance with degraded acousticsignalbull Auditory figure-ground (perceiving sounds inbackground noise)
Central Auditory Processing Disorder
Central Auditory Processing Disorder
CAPD refers to a deficit observed in one or more of the central auditory processes responsible for generating the auditory evoked potentials and the following behaviors sound localization and lateralization auditory discrimination auditory pattern recognition
Central Auditory Processing Disorder
- Poor communicator (terse telegraphic) - Memorizes poorly- Hears better when watching the speaker - Problems with rapid speech - Interprets words too literally
Central Auditory Processing Disorder
- Often needs remarks repeated - Difficulty sounding out words- Confuses similar-sounding words- Difficulty following directions in a series - Speech developed late or unclearly
CAPD or ADHD
Whatrsquos the kidrsquos deal
Strategies
(C)APD
Treatment ldquotop downrdquo ldquobottom uprdquo
X
Treatment for CAPD
Environmental modifications
Treatment for CAPD
Compensatory Strategies
Self-assessment
Sensory Processing Disorder
S ensory In tegration
S ensory D iscrim ination
S ensory M odu lation
S ensory D etection
Sensory Integration Terminology
Sensory Processing
Developmental considerations Auditory Visual Tactile Proprioceptive Vestibular Motor
Sensory ProcessingIntegration Disorder and DSM-V
Whatrsquos the kidrsquos deal
Whatrsquos the kidrsquos deal
Strategies
Regulatory-Sensory Processing Disorders
Treatment ldquotop downrdquo
ldquobottom uprdquo
Regulatory-Sensory Processing Disorders
Treatment ldquotop downrdquo ldquobottom uprdquo
Central Auditory Processing Disorder
bull Auditory discrimination (samedifferent)bull Auditory closure (fill in missing bits)bull Auditory localisation (locate source of sound)bull Auditory performance with degraded acousticsignalbull Auditory figure-ground (perceiving sounds inbackground noise)
Central Auditory Processing Disorder
Central Auditory Processing Disorder
CAPD refers to a deficit observed in one or more of the central auditory processes responsible for generating the auditory evoked potentials and the following behaviors sound localization and lateralization auditory discrimination auditory pattern recognition
Central Auditory Processing Disorder
- Poor communicator (terse telegraphic) - Memorizes poorly- Hears better when watching the speaker - Problems with rapid speech - Interprets words too literally
Central Auditory Processing Disorder
- Often needs remarks repeated - Difficulty sounding out words- Confuses similar-sounding words- Difficulty following directions in a series - Speech developed late or unclearly
CAPD or ADHD
Whatrsquos the kidrsquos deal
Strategies
(C)APD
Treatment ldquotop downrdquo ldquobottom uprdquo
X
Treatment for CAPD
Environmental modifications
Treatment for CAPD
Compensatory Strategies
Self-assessment
S ensory In tegration
S ensory D iscrim ination
S ensory M odu lation
S ensory D etection
Sensory Integration Terminology
Sensory Processing
Developmental considerations Auditory Visual Tactile Proprioceptive Vestibular Motor
Sensory ProcessingIntegration Disorder and DSM-V
Whatrsquos the kidrsquos deal
Whatrsquos the kidrsquos deal
Strategies
Regulatory-Sensory Processing Disorders
Treatment ldquotop downrdquo
ldquobottom uprdquo
Regulatory-Sensory Processing Disorders
Treatment ldquotop downrdquo ldquobottom uprdquo
Central Auditory Processing Disorder
bull Auditory discrimination (samedifferent)bull Auditory closure (fill in missing bits)bull Auditory localisation (locate source of sound)bull Auditory performance with degraded acousticsignalbull Auditory figure-ground (perceiving sounds inbackground noise)
Central Auditory Processing Disorder
Central Auditory Processing Disorder
CAPD refers to a deficit observed in one or more of the central auditory processes responsible for generating the auditory evoked potentials and the following behaviors sound localization and lateralization auditory discrimination auditory pattern recognition
Central Auditory Processing Disorder
- Poor communicator (terse telegraphic) - Memorizes poorly- Hears better when watching the speaker - Problems with rapid speech - Interprets words too literally
Central Auditory Processing Disorder
- Often needs remarks repeated - Difficulty sounding out words- Confuses similar-sounding words- Difficulty following directions in a series - Speech developed late or unclearly
CAPD or ADHD
Whatrsquos the kidrsquos deal
Strategies
(C)APD
Treatment ldquotop downrdquo ldquobottom uprdquo
X
Treatment for CAPD
Environmental modifications
Treatment for CAPD
Compensatory Strategies
Self-assessment
Developmental considerations Auditory Visual Tactile Proprioceptive Vestibular Motor
Sensory ProcessingIntegration Disorder and DSM-V
Whatrsquos the kidrsquos deal
Whatrsquos the kidrsquos deal
Strategies
Regulatory-Sensory Processing Disorders
Treatment ldquotop downrdquo
ldquobottom uprdquo
Regulatory-Sensory Processing Disorders
Treatment ldquotop downrdquo ldquobottom uprdquo
Central Auditory Processing Disorder
bull Auditory discrimination (samedifferent)bull Auditory closure (fill in missing bits)bull Auditory localisation (locate source of sound)bull Auditory performance with degraded acousticsignalbull Auditory figure-ground (perceiving sounds inbackground noise)
Central Auditory Processing Disorder
Central Auditory Processing Disorder
CAPD refers to a deficit observed in one or more of the central auditory processes responsible for generating the auditory evoked potentials and the following behaviors sound localization and lateralization auditory discrimination auditory pattern recognition
Central Auditory Processing Disorder
- Poor communicator (terse telegraphic) - Memorizes poorly- Hears better when watching the speaker - Problems with rapid speech - Interprets words too literally
Central Auditory Processing Disorder
- Often needs remarks repeated - Difficulty sounding out words- Confuses similar-sounding words- Difficulty following directions in a series - Speech developed late or unclearly
CAPD or ADHD
Whatrsquos the kidrsquos deal
Strategies
(C)APD
Treatment ldquotop downrdquo ldquobottom uprdquo
X
Treatment for CAPD
Environmental modifications
Treatment for CAPD
Compensatory Strategies
Self-assessment
Sensory ProcessingIntegration Disorder and DSM-V
Whatrsquos the kidrsquos deal
Whatrsquos the kidrsquos deal
Strategies
Regulatory-Sensory Processing Disorders
Treatment ldquotop downrdquo
ldquobottom uprdquo
Regulatory-Sensory Processing Disorders
Treatment ldquotop downrdquo ldquobottom uprdquo
Central Auditory Processing Disorder
bull Auditory discrimination (samedifferent)bull Auditory closure (fill in missing bits)bull Auditory localisation (locate source of sound)bull Auditory performance with degraded acousticsignalbull Auditory figure-ground (perceiving sounds inbackground noise)
Central Auditory Processing Disorder
Central Auditory Processing Disorder
CAPD refers to a deficit observed in one or more of the central auditory processes responsible for generating the auditory evoked potentials and the following behaviors sound localization and lateralization auditory discrimination auditory pattern recognition
Central Auditory Processing Disorder
- Poor communicator (terse telegraphic) - Memorizes poorly- Hears better when watching the speaker - Problems with rapid speech - Interprets words too literally
Central Auditory Processing Disorder
- Often needs remarks repeated - Difficulty sounding out words- Confuses similar-sounding words- Difficulty following directions in a series - Speech developed late or unclearly
CAPD or ADHD
Whatrsquos the kidrsquos deal
Strategies
(C)APD
Treatment ldquotop downrdquo ldquobottom uprdquo
X
Treatment for CAPD
Environmental modifications
Treatment for CAPD
Compensatory Strategies
Self-assessment
Whatrsquos the kidrsquos deal
Whatrsquos the kidrsquos deal
Strategies
Regulatory-Sensory Processing Disorders
Treatment ldquotop downrdquo
ldquobottom uprdquo
Regulatory-Sensory Processing Disorders
Treatment ldquotop downrdquo ldquobottom uprdquo
Central Auditory Processing Disorder
bull Auditory discrimination (samedifferent)bull Auditory closure (fill in missing bits)bull Auditory localisation (locate source of sound)bull Auditory performance with degraded acousticsignalbull Auditory figure-ground (perceiving sounds inbackground noise)
Central Auditory Processing Disorder
Central Auditory Processing Disorder
CAPD refers to a deficit observed in one or more of the central auditory processes responsible for generating the auditory evoked potentials and the following behaviors sound localization and lateralization auditory discrimination auditory pattern recognition
Central Auditory Processing Disorder
- Poor communicator (terse telegraphic) - Memorizes poorly- Hears better when watching the speaker - Problems with rapid speech - Interprets words too literally
Central Auditory Processing Disorder
- Often needs remarks repeated - Difficulty sounding out words- Confuses similar-sounding words- Difficulty following directions in a series - Speech developed late or unclearly
CAPD or ADHD
Whatrsquos the kidrsquos deal
Strategies
(C)APD
Treatment ldquotop downrdquo ldquobottom uprdquo
X
Treatment for CAPD
Environmental modifications
Treatment for CAPD
Compensatory Strategies
Self-assessment
Whatrsquos the kidrsquos deal
Strategies
Regulatory-Sensory Processing Disorders
Treatment ldquotop downrdquo
ldquobottom uprdquo
Regulatory-Sensory Processing Disorders
Treatment ldquotop downrdquo ldquobottom uprdquo
Central Auditory Processing Disorder
bull Auditory discrimination (samedifferent)bull Auditory closure (fill in missing bits)bull Auditory localisation (locate source of sound)bull Auditory performance with degraded acousticsignalbull Auditory figure-ground (perceiving sounds inbackground noise)
Central Auditory Processing Disorder
Central Auditory Processing Disorder
CAPD refers to a deficit observed in one or more of the central auditory processes responsible for generating the auditory evoked potentials and the following behaviors sound localization and lateralization auditory discrimination auditory pattern recognition
Central Auditory Processing Disorder
- Poor communicator (terse telegraphic) - Memorizes poorly- Hears better when watching the speaker - Problems with rapid speech - Interprets words too literally
Central Auditory Processing Disorder
- Often needs remarks repeated - Difficulty sounding out words- Confuses similar-sounding words- Difficulty following directions in a series - Speech developed late or unclearly
CAPD or ADHD
Whatrsquos the kidrsquos deal
Strategies
(C)APD
Treatment ldquotop downrdquo ldquobottom uprdquo
X
Treatment for CAPD
Environmental modifications
Treatment for CAPD
Compensatory Strategies
Self-assessment
Strategies
Regulatory-Sensory Processing Disorders
Treatment ldquotop downrdquo
ldquobottom uprdquo
Regulatory-Sensory Processing Disorders
Treatment ldquotop downrdquo ldquobottom uprdquo
Central Auditory Processing Disorder
bull Auditory discrimination (samedifferent)bull Auditory closure (fill in missing bits)bull Auditory localisation (locate source of sound)bull Auditory performance with degraded acousticsignalbull Auditory figure-ground (perceiving sounds inbackground noise)
Central Auditory Processing Disorder
Central Auditory Processing Disorder
CAPD refers to a deficit observed in one or more of the central auditory processes responsible for generating the auditory evoked potentials and the following behaviors sound localization and lateralization auditory discrimination auditory pattern recognition
Central Auditory Processing Disorder
- Poor communicator (terse telegraphic) - Memorizes poorly- Hears better when watching the speaker - Problems with rapid speech - Interprets words too literally
Central Auditory Processing Disorder
- Often needs remarks repeated - Difficulty sounding out words- Confuses similar-sounding words- Difficulty following directions in a series - Speech developed late or unclearly
CAPD or ADHD
Whatrsquos the kidrsquos deal
Strategies
(C)APD
Treatment ldquotop downrdquo ldquobottom uprdquo
X
Treatment for CAPD
Environmental modifications
Treatment for CAPD
Compensatory Strategies
Self-assessment
Regulatory-Sensory Processing Disorders
Treatment ldquotop downrdquo
ldquobottom uprdquo
Regulatory-Sensory Processing Disorders
Treatment ldquotop downrdquo ldquobottom uprdquo
Central Auditory Processing Disorder
bull Auditory discrimination (samedifferent)bull Auditory closure (fill in missing bits)bull Auditory localisation (locate source of sound)bull Auditory performance with degraded acousticsignalbull Auditory figure-ground (perceiving sounds inbackground noise)
Central Auditory Processing Disorder
Central Auditory Processing Disorder
CAPD refers to a deficit observed in one or more of the central auditory processes responsible for generating the auditory evoked potentials and the following behaviors sound localization and lateralization auditory discrimination auditory pattern recognition
Central Auditory Processing Disorder
- Poor communicator (terse telegraphic) - Memorizes poorly- Hears better when watching the speaker - Problems with rapid speech - Interprets words too literally
Central Auditory Processing Disorder
- Often needs remarks repeated - Difficulty sounding out words- Confuses similar-sounding words- Difficulty following directions in a series - Speech developed late or unclearly
CAPD or ADHD
Whatrsquos the kidrsquos deal
Strategies
(C)APD
Treatment ldquotop downrdquo ldquobottom uprdquo
X
Treatment for CAPD
Environmental modifications
Treatment for CAPD
Compensatory Strategies
Self-assessment
Regulatory-Sensory Processing Disorders
Treatment ldquotop downrdquo ldquobottom uprdquo
Central Auditory Processing Disorder
bull Auditory discrimination (samedifferent)bull Auditory closure (fill in missing bits)bull Auditory localisation (locate source of sound)bull Auditory performance with degraded acousticsignalbull Auditory figure-ground (perceiving sounds inbackground noise)
Central Auditory Processing Disorder
Central Auditory Processing Disorder
CAPD refers to a deficit observed in one or more of the central auditory processes responsible for generating the auditory evoked potentials and the following behaviors sound localization and lateralization auditory discrimination auditory pattern recognition
Central Auditory Processing Disorder
- Poor communicator (terse telegraphic) - Memorizes poorly- Hears better when watching the speaker - Problems with rapid speech - Interprets words too literally
Central Auditory Processing Disorder
- Often needs remarks repeated - Difficulty sounding out words- Confuses similar-sounding words- Difficulty following directions in a series - Speech developed late or unclearly
CAPD or ADHD
Whatrsquos the kidrsquos deal
Strategies
(C)APD
Treatment ldquotop downrdquo ldquobottom uprdquo
X
Treatment for CAPD
Environmental modifications
Treatment for CAPD
Compensatory Strategies
Self-assessment
Central Auditory Processing Disorder
bull Auditory discrimination (samedifferent)bull Auditory closure (fill in missing bits)bull Auditory localisation (locate source of sound)bull Auditory performance with degraded acousticsignalbull Auditory figure-ground (perceiving sounds inbackground noise)
Central Auditory Processing Disorder
Central Auditory Processing Disorder
CAPD refers to a deficit observed in one or more of the central auditory processes responsible for generating the auditory evoked potentials and the following behaviors sound localization and lateralization auditory discrimination auditory pattern recognition
Central Auditory Processing Disorder
- Poor communicator (terse telegraphic) - Memorizes poorly- Hears better when watching the speaker - Problems with rapid speech - Interprets words too literally
Central Auditory Processing Disorder
- Often needs remarks repeated - Difficulty sounding out words- Confuses similar-sounding words- Difficulty following directions in a series - Speech developed late or unclearly
CAPD or ADHD
Whatrsquos the kidrsquos deal
Strategies
(C)APD
Treatment ldquotop downrdquo ldquobottom uprdquo
X
Treatment for CAPD
Environmental modifications
Treatment for CAPD
Compensatory Strategies
Self-assessment
bull Auditory discrimination (samedifferent)bull Auditory closure (fill in missing bits)bull Auditory localisation (locate source of sound)bull Auditory performance with degraded acousticsignalbull Auditory figure-ground (perceiving sounds inbackground noise)
Central Auditory Processing Disorder
Central Auditory Processing Disorder
CAPD refers to a deficit observed in one or more of the central auditory processes responsible for generating the auditory evoked potentials and the following behaviors sound localization and lateralization auditory discrimination auditory pattern recognition
Central Auditory Processing Disorder
- Poor communicator (terse telegraphic) - Memorizes poorly- Hears better when watching the speaker - Problems with rapid speech - Interprets words too literally
Central Auditory Processing Disorder
- Often needs remarks repeated - Difficulty sounding out words- Confuses similar-sounding words- Difficulty following directions in a series - Speech developed late or unclearly
CAPD or ADHD
Whatrsquos the kidrsquos deal
Strategies
(C)APD
Treatment ldquotop downrdquo ldquobottom uprdquo
X
Treatment for CAPD
Environmental modifications
Treatment for CAPD
Compensatory Strategies
Self-assessment
Central Auditory Processing Disorder
CAPD refers to a deficit observed in one or more of the central auditory processes responsible for generating the auditory evoked potentials and the following behaviors sound localization and lateralization auditory discrimination auditory pattern recognition
Central Auditory Processing Disorder
- Poor communicator (terse telegraphic) - Memorizes poorly- Hears better when watching the speaker - Problems with rapid speech - Interprets words too literally
Central Auditory Processing Disorder
- Often needs remarks repeated - Difficulty sounding out words- Confuses similar-sounding words- Difficulty following directions in a series - Speech developed late or unclearly
CAPD or ADHD
Whatrsquos the kidrsquos deal
Strategies
(C)APD
Treatment ldquotop downrdquo ldquobottom uprdquo
X
Treatment for CAPD
Environmental modifications
Treatment for CAPD
Compensatory Strategies
Self-assessment
Central Auditory Processing Disorder
- Poor communicator (terse telegraphic) - Memorizes poorly- Hears better when watching the speaker - Problems with rapid speech - Interprets words too literally
Central Auditory Processing Disorder
- Often needs remarks repeated - Difficulty sounding out words- Confuses similar-sounding words- Difficulty following directions in a series - Speech developed late or unclearly
CAPD or ADHD
Whatrsquos the kidrsquos deal
Strategies
(C)APD
Treatment ldquotop downrdquo ldquobottom uprdquo
X
Treatment for CAPD
Environmental modifications
Treatment for CAPD
Compensatory Strategies
Self-assessment
Central Auditory Processing Disorder
- Often needs remarks repeated - Difficulty sounding out words- Confuses similar-sounding words- Difficulty following directions in a series - Speech developed late or unclearly
CAPD or ADHD
Whatrsquos the kidrsquos deal
Strategies
(C)APD
Treatment ldquotop downrdquo ldquobottom uprdquo
X
Treatment for CAPD
Environmental modifications
Treatment for CAPD
Compensatory Strategies
Self-assessment
CAPD or ADHD
Whatrsquos the kidrsquos deal
Strategies
(C)APD
Treatment ldquotop downrdquo ldquobottom uprdquo
X
Treatment for CAPD
Environmental modifications
Treatment for CAPD
Compensatory Strategies
Self-assessment
Whatrsquos the kidrsquos deal
Strategies
(C)APD
Treatment ldquotop downrdquo ldquobottom uprdquo
X
Treatment for CAPD
Environmental modifications
Treatment for CAPD
Compensatory Strategies
Self-assessment
Strategies
(C)APD
Treatment ldquotop downrdquo ldquobottom uprdquo
X
Treatment for CAPD
Environmental modifications
Treatment for CAPD
Compensatory Strategies
Self-assessment
(C)APD
Treatment ldquotop downrdquo ldquobottom uprdquo
X
Treatment for CAPD
Environmental modifications
Treatment for CAPD
Compensatory Strategies
Self-assessment
Treatment for CAPD
Environmental modifications
Treatment for CAPD
Compensatory Strategies
Self-assessment
Treatment for CAPD
Compensatory Strategies
Self-assessment
Self-assessment
Attention Deficit Hyperactivity Disorder
Increase salience
Attention Deficit Hyperactivity Disorder
(85 ndash X) x 365
ldquoIrsquom gonna eat all the gum and candy I wantrdquo
Core symptoms
Inattention distractibility
Core symptoms
Hyperactivity impulsivity
hellipand the rest of the criteriaB Onset before age 7C Impairment in 2 or more settingsD Significant functional impairmentE Not better accounted for by another
mental disorder
Functional impact of core symptoms
Arousal alertness Mental effort Determination of saliency Focal maintenance
Functional impact of core symptoms
Arousal alertness Mental effort Determination of saliency Focal maintenance
Functional impact of core symptoms
Arousal alertness Mental effort Determination of saliency Focal maintenance
Functional impact of core symptoms
Arousal alertness Mental effort Determination of saliency Focal maintenance
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Subtypes of ADHD
ADHD predominantly inattentive type ADHD predominantly hyperactive type ADHD combined type ADHD Not Otherwise Specifed
Subtypes of ADHD
ADHD predominantly inattentive type ADHD predominantly hyperactive type ADHD combined type ADHD Not Otherwise
Specifed
Common comorbidities with ADHD
Learning disorder Behavioral disorder Anxiety Depression Substance abuse Sensory processing and auditory
processing challenges
Common comorbidities with ADHD
Learning disorder Behavioral disorder Anxiety Depression Substance abuse Sensory processing and auditory
processing challenges
ADHD and girls
ADHD and women
ADHD and women
More tasks More diffuse More parental responsibility Less likely to have an ldquoexecutiverdquo
partner Less likely to have assistants at work Less likely to focus on a narrow area More likely to feel shame about
disorganization
Executive FunctioningAn Overarching Theme
Sensory Processing Disorder Central Auditory Processing
Disorder ADHD and Executive Dysfunction
The Executive Functions
Internalizing speech Previewing
Prioritizing Tempo control Inhibition
The Executive Functions
Determining salience (whatrsquos in it for me)
Blocking out distractions Self-monitoring and correcting Certain aspects of memory learning
Appropriate expectations
Age-appropriate expectations
Preschool 1-step errands Chores with cues Basic inhibition
Age-appropriate expectations
K ndash 2nd grade 2-3 step directions Bring papers home 20-30 minute assignments Simple spending decisions Follow rules inhibit no grabbing
3rd ndash 5th
Simple shopping list Keep track of personal items Longer homework assignments Simple project planing Keep track of variable daily schedule Save money Inhibit and regulate even wo teacher present Manners Simple delayed gratification (phone)
Age-appropriate expectations
6th ndash 8th
complex chores Babysitting Organizing system Complex schedule Longer term projects Time management Self soothe Manage conflict
Age-appropriate expectations
Teenage ndash mid 20s Independent with assignments Make adjustments based on feedback Longer term goal setting Managing leisure time Inhibit reckless behavior Easily walk away from provocation Say ldquonordquo to fun activity if other plans
already made Take othersrsquo perspective
Age-appropriate expectations
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
Inter-connectedness of systems Cortico-striatal system for example
Strategies
Pharmacotherapy
X
Behavioral Supports
A B C
A B C
behavior
A B C
consequences
A B C
antecedent
A B C
A B C
antecedent
A B C
antecedent
easy hard
A B C
consequences
R P
+
-
R+ P+
R- P-
Time Out
Select target behavior Set place Determine how much time Dress rehearsal Measure the time Withdraw attention Establish the cause and effect
Token economy
Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Increase salience
Attention Deficit Hyperactivity Disorder
(85 ndash X) x 365
ldquoIrsquom gonna eat all the gum and candy I wantrdquo
Core symptoms
Inattention distractibility
Core symptoms
Hyperactivity impulsivity
hellipand the rest of the criteriaB Onset before age 7C Impairment in 2 or more settingsD Significant functional impairmentE Not better accounted for by another
mental disorder
Functional impact of core symptoms
Arousal alertness Mental effort Determination of saliency Focal maintenance
Functional impact of core symptoms
Arousal alertness Mental effort Determination of saliency Focal maintenance
Functional impact of core symptoms
Arousal alertness Mental effort Determination of saliency Focal maintenance
Functional impact of core symptoms
Arousal alertness Mental effort Determination of saliency Focal maintenance
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Subtypes of ADHD
ADHD predominantly inattentive type ADHD predominantly hyperactive type ADHD combined type ADHD Not Otherwise Specifed
Subtypes of ADHD
ADHD predominantly inattentive type ADHD predominantly hyperactive type ADHD combined type ADHD Not Otherwise
Specifed
Common comorbidities with ADHD
Learning disorder Behavioral disorder Anxiety Depression Substance abuse Sensory processing and auditory
processing challenges
Common comorbidities with ADHD
Learning disorder Behavioral disorder Anxiety Depression Substance abuse Sensory processing and auditory
processing challenges
ADHD and girls
ADHD and women
ADHD and women
More tasks More diffuse More parental responsibility Less likely to have an ldquoexecutiverdquo
partner Less likely to have assistants at work Less likely to focus on a narrow area More likely to feel shame about
disorganization
Executive FunctioningAn Overarching Theme
Sensory Processing Disorder Central Auditory Processing
Disorder ADHD and Executive Dysfunction
The Executive Functions
Internalizing speech Previewing
Prioritizing Tempo control Inhibition
The Executive Functions
Determining salience (whatrsquos in it for me)
Blocking out distractions Self-monitoring and correcting Certain aspects of memory learning
Appropriate expectations
Age-appropriate expectations
Preschool 1-step errands Chores with cues Basic inhibition
Age-appropriate expectations
K ndash 2nd grade 2-3 step directions Bring papers home 20-30 minute assignments Simple spending decisions Follow rules inhibit no grabbing
3rd ndash 5th
Simple shopping list Keep track of personal items Longer homework assignments Simple project planing Keep track of variable daily schedule Save money Inhibit and regulate even wo teacher present Manners Simple delayed gratification (phone)
Age-appropriate expectations
6th ndash 8th
complex chores Babysitting Organizing system Complex schedule Longer term projects Time management Self soothe Manage conflict
Age-appropriate expectations
Teenage ndash mid 20s Independent with assignments Make adjustments based on feedback Longer term goal setting Managing leisure time Inhibit reckless behavior Easily walk away from provocation Say ldquonordquo to fun activity if other plans
already made Take othersrsquo perspective
Age-appropriate expectations
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
Inter-connectedness of systems Cortico-striatal system for example
Strategies
Pharmacotherapy
X
Behavioral Supports
A B C
A B C
behavior
A B C
consequences
A B C
antecedent
A B C
A B C
antecedent
A B C
antecedent
easy hard
A B C
consequences
R P
+
-
R+ P+
R- P-
Time Out
Select target behavior Set place Determine how much time Dress rehearsal Measure the time Withdraw attention Establish the cause and effect
Token economy
Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Attention Deficit Hyperactivity Disorder
(85 ndash X) x 365
ldquoIrsquom gonna eat all the gum and candy I wantrdquo
Core symptoms
Inattention distractibility
Core symptoms
Hyperactivity impulsivity
hellipand the rest of the criteriaB Onset before age 7C Impairment in 2 or more settingsD Significant functional impairmentE Not better accounted for by another
mental disorder
Functional impact of core symptoms
Arousal alertness Mental effort Determination of saliency Focal maintenance
Functional impact of core symptoms
Arousal alertness Mental effort Determination of saliency Focal maintenance
Functional impact of core symptoms
Arousal alertness Mental effort Determination of saliency Focal maintenance
Functional impact of core symptoms
Arousal alertness Mental effort Determination of saliency Focal maintenance
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Subtypes of ADHD
ADHD predominantly inattentive type ADHD predominantly hyperactive type ADHD combined type ADHD Not Otherwise Specifed
Subtypes of ADHD
ADHD predominantly inattentive type ADHD predominantly hyperactive type ADHD combined type ADHD Not Otherwise
Specifed
Common comorbidities with ADHD
Learning disorder Behavioral disorder Anxiety Depression Substance abuse Sensory processing and auditory
processing challenges
Common comorbidities with ADHD
Learning disorder Behavioral disorder Anxiety Depression Substance abuse Sensory processing and auditory
processing challenges
ADHD and girls
ADHD and women
ADHD and women
More tasks More diffuse More parental responsibility Less likely to have an ldquoexecutiverdquo
partner Less likely to have assistants at work Less likely to focus on a narrow area More likely to feel shame about
disorganization
Executive FunctioningAn Overarching Theme
Sensory Processing Disorder Central Auditory Processing
Disorder ADHD and Executive Dysfunction
The Executive Functions
Internalizing speech Previewing
Prioritizing Tempo control Inhibition
The Executive Functions
Determining salience (whatrsquos in it for me)
Blocking out distractions Self-monitoring and correcting Certain aspects of memory learning
Appropriate expectations
Age-appropriate expectations
Preschool 1-step errands Chores with cues Basic inhibition
Age-appropriate expectations
K ndash 2nd grade 2-3 step directions Bring papers home 20-30 minute assignments Simple spending decisions Follow rules inhibit no grabbing
3rd ndash 5th
Simple shopping list Keep track of personal items Longer homework assignments Simple project planing Keep track of variable daily schedule Save money Inhibit and regulate even wo teacher present Manners Simple delayed gratification (phone)
Age-appropriate expectations
6th ndash 8th
complex chores Babysitting Organizing system Complex schedule Longer term projects Time management Self soothe Manage conflict
Age-appropriate expectations
Teenage ndash mid 20s Independent with assignments Make adjustments based on feedback Longer term goal setting Managing leisure time Inhibit reckless behavior Easily walk away from provocation Say ldquonordquo to fun activity if other plans
already made Take othersrsquo perspective
Age-appropriate expectations
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
Inter-connectedness of systems Cortico-striatal system for example
Strategies
Pharmacotherapy
X
Behavioral Supports
A B C
A B C
behavior
A B C
consequences
A B C
antecedent
A B C
A B C
antecedent
A B C
antecedent
easy hard
A B C
consequences
R P
+
-
R+ P+
R- P-
Time Out
Select target behavior Set place Determine how much time Dress rehearsal Measure the time Withdraw attention Establish the cause and effect
Token economy
Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
(85 ndash X) x 365
ldquoIrsquom gonna eat all the gum and candy I wantrdquo
Core symptoms
Inattention distractibility
Core symptoms
Hyperactivity impulsivity
hellipand the rest of the criteriaB Onset before age 7C Impairment in 2 or more settingsD Significant functional impairmentE Not better accounted for by another
mental disorder
Functional impact of core symptoms
Arousal alertness Mental effort Determination of saliency Focal maintenance
Functional impact of core symptoms
Arousal alertness Mental effort Determination of saliency Focal maintenance
Functional impact of core symptoms
Arousal alertness Mental effort Determination of saliency Focal maintenance
Functional impact of core symptoms
Arousal alertness Mental effort Determination of saliency Focal maintenance
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Subtypes of ADHD
ADHD predominantly inattentive type ADHD predominantly hyperactive type ADHD combined type ADHD Not Otherwise Specifed
Subtypes of ADHD
ADHD predominantly inattentive type ADHD predominantly hyperactive type ADHD combined type ADHD Not Otherwise
Specifed
Common comorbidities with ADHD
Learning disorder Behavioral disorder Anxiety Depression Substance abuse Sensory processing and auditory
processing challenges
Common comorbidities with ADHD
Learning disorder Behavioral disorder Anxiety Depression Substance abuse Sensory processing and auditory
processing challenges
ADHD and girls
ADHD and women
ADHD and women
More tasks More diffuse More parental responsibility Less likely to have an ldquoexecutiverdquo
partner Less likely to have assistants at work Less likely to focus on a narrow area More likely to feel shame about
disorganization
Executive FunctioningAn Overarching Theme
Sensory Processing Disorder Central Auditory Processing
Disorder ADHD and Executive Dysfunction
The Executive Functions
Internalizing speech Previewing
Prioritizing Tempo control Inhibition
The Executive Functions
Determining salience (whatrsquos in it for me)
Blocking out distractions Self-monitoring and correcting Certain aspects of memory learning
Appropriate expectations
Age-appropriate expectations
Preschool 1-step errands Chores with cues Basic inhibition
Age-appropriate expectations
K ndash 2nd grade 2-3 step directions Bring papers home 20-30 minute assignments Simple spending decisions Follow rules inhibit no grabbing
3rd ndash 5th
Simple shopping list Keep track of personal items Longer homework assignments Simple project planing Keep track of variable daily schedule Save money Inhibit and regulate even wo teacher present Manners Simple delayed gratification (phone)
Age-appropriate expectations
6th ndash 8th
complex chores Babysitting Organizing system Complex schedule Longer term projects Time management Self soothe Manage conflict
Age-appropriate expectations
Teenage ndash mid 20s Independent with assignments Make adjustments based on feedback Longer term goal setting Managing leisure time Inhibit reckless behavior Easily walk away from provocation Say ldquonordquo to fun activity if other plans
already made Take othersrsquo perspective
Age-appropriate expectations
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
Inter-connectedness of systems Cortico-striatal system for example
Strategies
Pharmacotherapy
X
Behavioral Supports
A B C
A B C
behavior
A B C
consequences
A B C
antecedent
A B C
A B C
antecedent
A B C
antecedent
easy hard
A B C
consequences
R P
+
-
R+ P+
R- P-
Time Out
Select target behavior Set place Determine how much time Dress rehearsal Measure the time Withdraw attention Establish the cause and effect
Token economy
Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
ldquoIrsquom gonna eat all the gum and candy I wantrdquo
Core symptoms
Inattention distractibility
Core symptoms
Hyperactivity impulsivity
hellipand the rest of the criteriaB Onset before age 7C Impairment in 2 or more settingsD Significant functional impairmentE Not better accounted for by another
mental disorder
Functional impact of core symptoms
Arousal alertness Mental effort Determination of saliency Focal maintenance
Functional impact of core symptoms
Arousal alertness Mental effort Determination of saliency Focal maintenance
Functional impact of core symptoms
Arousal alertness Mental effort Determination of saliency Focal maintenance
Functional impact of core symptoms
Arousal alertness Mental effort Determination of saliency Focal maintenance
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Subtypes of ADHD
ADHD predominantly inattentive type ADHD predominantly hyperactive type ADHD combined type ADHD Not Otherwise Specifed
Subtypes of ADHD
ADHD predominantly inattentive type ADHD predominantly hyperactive type ADHD combined type ADHD Not Otherwise
Specifed
Common comorbidities with ADHD
Learning disorder Behavioral disorder Anxiety Depression Substance abuse Sensory processing and auditory
processing challenges
Common comorbidities with ADHD
Learning disorder Behavioral disorder Anxiety Depression Substance abuse Sensory processing and auditory
processing challenges
ADHD and girls
ADHD and women
ADHD and women
More tasks More diffuse More parental responsibility Less likely to have an ldquoexecutiverdquo
partner Less likely to have assistants at work Less likely to focus on a narrow area More likely to feel shame about
disorganization
Executive FunctioningAn Overarching Theme
Sensory Processing Disorder Central Auditory Processing
Disorder ADHD and Executive Dysfunction
The Executive Functions
Internalizing speech Previewing
Prioritizing Tempo control Inhibition
The Executive Functions
Determining salience (whatrsquos in it for me)
Blocking out distractions Self-monitoring and correcting Certain aspects of memory learning
Appropriate expectations
Age-appropriate expectations
Preschool 1-step errands Chores with cues Basic inhibition
Age-appropriate expectations
K ndash 2nd grade 2-3 step directions Bring papers home 20-30 minute assignments Simple spending decisions Follow rules inhibit no grabbing
3rd ndash 5th
Simple shopping list Keep track of personal items Longer homework assignments Simple project planing Keep track of variable daily schedule Save money Inhibit and regulate even wo teacher present Manners Simple delayed gratification (phone)
Age-appropriate expectations
6th ndash 8th
complex chores Babysitting Organizing system Complex schedule Longer term projects Time management Self soothe Manage conflict
Age-appropriate expectations
Teenage ndash mid 20s Independent with assignments Make adjustments based on feedback Longer term goal setting Managing leisure time Inhibit reckless behavior Easily walk away from provocation Say ldquonordquo to fun activity if other plans
already made Take othersrsquo perspective
Age-appropriate expectations
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
Inter-connectedness of systems Cortico-striatal system for example
Strategies
Pharmacotherapy
X
Behavioral Supports
A B C
A B C
behavior
A B C
consequences
A B C
antecedent
A B C
A B C
antecedent
A B C
antecedent
easy hard
A B C
consequences
R P
+
-
R+ P+
R- P-
Time Out
Select target behavior Set place Determine how much time Dress rehearsal Measure the time Withdraw attention Establish the cause and effect
Token economy
Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Core symptoms
Inattention distractibility
Core symptoms
Hyperactivity impulsivity
hellipand the rest of the criteriaB Onset before age 7C Impairment in 2 or more settingsD Significant functional impairmentE Not better accounted for by another
mental disorder
Functional impact of core symptoms
Arousal alertness Mental effort Determination of saliency Focal maintenance
Functional impact of core symptoms
Arousal alertness Mental effort Determination of saliency Focal maintenance
Functional impact of core symptoms
Arousal alertness Mental effort Determination of saliency Focal maintenance
Functional impact of core symptoms
Arousal alertness Mental effort Determination of saliency Focal maintenance
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Subtypes of ADHD
ADHD predominantly inattentive type ADHD predominantly hyperactive type ADHD combined type ADHD Not Otherwise Specifed
Subtypes of ADHD
ADHD predominantly inattentive type ADHD predominantly hyperactive type ADHD combined type ADHD Not Otherwise
Specifed
Common comorbidities with ADHD
Learning disorder Behavioral disorder Anxiety Depression Substance abuse Sensory processing and auditory
processing challenges
Common comorbidities with ADHD
Learning disorder Behavioral disorder Anxiety Depression Substance abuse Sensory processing and auditory
processing challenges
ADHD and girls
ADHD and women
ADHD and women
More tasks More diffuse More parental responsibility Less likely to have an ldquoexecutiverdquo
partner Less likely to have assistants at work Less likely to focus on a narrow area More likely to feel shame about
disorganization
Executive FunctioningAn Overarching Theme
Sensory Processing Disorder Central Auditory Processing
Disorder ADHD and Executive Dysfunction
The Executive Functions
Internalizing speech Previewing
Prioritizing Tempo control Inhibition
The Executive Functions
Determining salience (whatrsquos in it for me)
Blocking out distractions Self-monitoring and correcting Certain aspects of memory learning
Appropriate expectations
Age-appropriate expectations
Preschool 1-step errands Chores with cues Basic inhibition
Age-appropriate expectations
K ndash 2nd grade 2-3 step directions Bring papers home 20-30 minute assignments Simple spending decisions Follow rules inhibit no grabbing
3rd ndash 5th
Simple shopping list Keep track of personal items Longer homework assignments Simple project planing Keep track of variable daily schedule Save money Inhibit and regulate even wo teacher present Manners Simple delayed gratification (phone)
Age-appropriate expectations
6th ndash 8th
complex chores Babysitting Organizing system Complex schedule Longer term projects Time management Self soothe Manage conflict
Age-appropriate expectations
Teenage ndash mid 20s Independent with assignments Make adjustments based on feedback Longer term goal setting Managing leisure time Inhibit reckless behavior Easily walk away from provocation Say ldquonordquo to fun activity if other plans
already made Take othersrsquo perspective
Age-appropriate expectations
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
Inter-connectedness of systems Cortico-striatal system for example
Strategies
Pharmacotherapy
X
Behavioral Supports
A B C
A B C
behavior
A B C
consequences
A B C
antecedent
A B C
A B C
antecedent
A B C
antecedent
easy hard
A B C
consequences
R P
+
-
R+ P+
R- P-
Time Out
Select target behavior Set place Determine how much time Dress rehearsal Measure the time Withdraw attention Establish the cause and effect
Token economy
Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Core symptoms
Hyperactivity impulsivity
hellipand the rest of the criteriaB Onset before age 7C Impairment in 2 or more settingsD Significant functional impairmentE Not better accounted for by another
mental disorder
Functional impact of core symptoms
Arousal alertness Mental effort Determination of saliency Focal maintenance
Functional impact of core symptoms
Arousal alertness Mental effort Determination of saliency Focal maintenance
Functional impact of core symptoms
Arousal alertness Mental effort Determination of saliency Focal maintenance
Functional impact of core symptoms
Arousal alertness Mental effort Determination of saliency Focal maintenance
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Subtypes of ADHD
ADHD predominantly inattentive type ADHD predominantly hyperactive type ADHD combined type ADHD Not Otherwise Specifed
Subtypes of ADHD
ADHD predominantly inattentive type ADHD predominantly hyperactive type ADHD combined type ADHD Not Otherwise
Specifed
Common comorbidities with ADHD
Learning disorder Behavioral disorder Anxiety Depression Substance abuse Sensory processing and auditory
processing challenges
Common comorbidities with ADHD
Learning disorder Behavioral disorder Anxiety Depression Substance abuse Sensory processing and auditory
processing challenges
ADHD and girls
ADHD and women
ADHD and women
More tasks More diffuse More parental responsibility Less likely to have an ldquoexecutiverdquo
partner Less likely to have assistants at work Less likely to focus on a narrow area More likely to feel shame about
disorganization
Executive FunctioningAn Overarching Theme
Sensory Processing Disorder Central Auditory Processing
Disorder ADHD and Executive Dysfunction
The Executive Functions
Internalizing speech Previewing
Prioritizing Tempo control Inhibition
The Executive Functions
Determining salience (whatrsquos in it for me)
Blocking out distractions Self-monitoring and correcting Certain aspects of memory learning
Appropriate expectations
Age-appropriate expectations
Preschool 1-step errands Chores with cues Basic inhibition
Age-appropriate expectations
K ndash 2nd grade 2-3 step directions Bring papers home 20-30 minute assignments Simple spending decisions Follow rules inhibit no grabbing
3rd ndash 5th
Simple shopping list Keep track of personal items Longer homework assignments Simple project planing Keep track of variable daily schedule Save money Inhibit and regulate even wo teacher present Manners Simple delayed gratification (phone)
Age-appropriate expectations
6th ndash 8th
complex chores Babysitting Organizing system Complex schedule Longer term projects Time management Self soothe Manage conflict
Age-appropriate expectations
Teenage ndash mid 20s Independent with assignments Make adjustments based on feedback Longer term goal setting Managing leisure time Inhibit reckless behavior Easily walk away from provocation Say ldquonordquo to fun activity if other plans
already made Take othersrsquo perspective
Age-appropriate expectations
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
Inter-connectedness of systems Cortico-striatal system for example
Strategies
Pharmacotherapy
X
Behavioral Supports
A B C
A B C
behavior
A B C
consequences
A B C
antecedent
A B C
A B C
antecedent
A B C
antecedent
easy hard
A B C
consequences
R P
+
-
R+ P+
R- P-
Time Out
Select target behavior Set place Determine how much time Dress rehearsal Measure the time Withdraw attention Establish the cause and effect
Token economy
Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
hellipand the rest of the criteriaB Onset before age 7C Impairment in 2 or more settingsD Significant functional impairmentE Not better accounted for by another
mental disorder
Functional impact of core symptoms
Arousal alertness Mental effort Determination of saliency Focal maintenance
Functional impact of core symptoms
Arousal alertness Mental effort Determination of saliency Focal maintenance
Functional impact of core symptoms
Arousal alertness Mental effort Determination of saliency Focal maintenance
Functional impact of core symptoms
Arousal alertness Mental effort Determination of saliency Focal maintenance
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Subtypes of ADHD
ADHD predominantly inattentive type ADHD predominantly hyperactive type ADHD combined type ADHD Not Otherwise Specifed
Subtypes of ADHD
ADHD predominantly inattentive type ADHD predominantly hyperactive type ADHD combined type ADHD Not Otherwise
Specifed
Common comorbidities with ADHD
Learning disorder Behavioral disorder Anxiety Depression Substance abuse Sensory processing and auditory
processing challenges
Common comorbidities with ADHD
Learning disorder Behavioral disorder Anxiety Depression Substance abuse Sensory processing and auditory
processing challenges
ADHD and girls
ADHD and women
ADHD and women
More tasks More diffuse More parental responsibility Less likely to have an ldquoexecutiverdquo
partner Less likely to have assistants at work Less likely to focus on a narrow area More likely to feel shame about
disorganization
Executive FunctioningAn Overarching Theme
Sensory Processing Disorder Central Auditory Processing
Disorder ADHD and Executive Dysfunction
The Executive Functions
Internalizing speech Previewing
Prioritizing Tempo control Inhibition
The Executive Functions
Determining salience (whatrsquos in it for me)
Blocking out distractions Self-monitoring and correcting Certain aspects of memory learning
Appropriate expectations
Age-appropriate expectations
Preschool 1-step errands Chores with cues Basic inhibition
Age-appropriate expectations
K ndash 2nd grade 2-3 step directions Bring papers home 20-30 minute assignments Simple spending decisions Follow rules inhibit no grabbing
3rd ndash 5th
Simple shopping list Keep track of personal items Longer homework assignments Simple project planing Keep track of variable daily schedule Save money Inhibit and regulate even wo teacher present Manners Simple delayed gratification (phone)
Age-appropriate expectations
6th ndash 8th
complex chores Babysitting Organizing system Complex schedule Longer term projects Time management Self soothe Manage conflict
Age-appropriate expectations
Teenage ndash mid 20s Independent with assignments Make adjustments based on feedback Longer term goal setting Managing leisure time Inhibit reckless behavior Easily walk away from provocation Say ldquonordquo to fun activity if other plans
already made Take othersrsquo perspective
Age-appropriate expectations
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
Inter-connectedness of systems Cortico-striatal system for example
Strategies
Pharmacotherapy
X
Behavioral Supports
A B C
A B C
behavior
A B C
consequences
A B C
antecedent
A B C
A B C
antecedent
A B C
antecedent
easy hard
A B C
consequences
R P
+
-
R+ P+
R- P-
Time Out
Select target behavior Set place Determine how much time Dress rehearsal Measure the time Withdraw attention Establish the cause and effect
Token economy
Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Functional impact of core symptoms
Arousal alertness Mental effort Determination of saliency Focal maintenance
Functional impact of core symptoms
Arousal alertness Mental effort Determination of saliency Focal maintenance
Functional impact of core symptoms
Arousal alertness Mental effort Determination of saliency Focal maintenance
Functional impact of core symptoms
Arousal alertness Mental effort Determination of saliency Focal maintenance
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Subtypes of ADHD
ADHD predominantly inattentive type ADHD predominantly hyperactive type ADHD combined type ADHD Not Otherwise Specifed
Subtypes of ADHD
ADHD predominantly inattentive type ADHD predominantly hyperactive type ADHD combined type ADHD Not Otherwise
Specifed
Common comorbidities with ADHD
Learning disorder Behavioral disorder Anxiety Depression Substance abuse Sensory processing and auditory
processing challenges
Common comorbidities with ADHD
Learning disorder Behavioral disorder Anxiety Depression Substance abuse Sensory processing and auditory
processing challenges
ADHD and girls
ADHD and women
ADHD and women
More tasks More diffuse More parental responsibility Less likely to have an ldquoexecutiverdquo
partner Less likely to have assistants at work Less likely to focus on a narrow area More likely to feel shame about
disorganization
Executive FunctioningAn Overarching Theme
Sensory Processing Disorder Central Auditory Processing
Disorder ADHD and Executive Dysfunction
The Executive Functions
Internalizing speech Previewing
Prioritizing Tempo control Inhibition
The Executive Functions
Determining salience (whatrsquos in it for me)
Blocking out distractions Self-monitoring and correcting Certain aspects of memory learning
Appropriate expectations
Age-appropriate expectations
Preschool 1-step errands Chores with cues Basic inhibition
Age-appropriate expectations
K ndash 2nd grade 2-3 step directions Bring papers home 20-30 minute assignments Simple spending decisions Follow rules inhibit no grabbing
3rd ndash 5th
Simple shopping list Keep track of personal items Longer homework assignments Simple project planing Keep track of variable daily schedule Save money Inhibit and regulate even wo teacher present Manners Simple delayed gratification (phone)
Age-appropriate expectations
6th ndash 8th
complex chores Babysitting Organizing system Complex schedule Longer term projects Time management Self soothe Manage conflict
Age-appropriate expectations
Teenage ndash mid 20s Independent with assignments Make adjustments based on feedback Longer term goal setting Managing leisure time Inhibit reckless behavior Easily walk away from provocation Say ldquonordquo to fun activity if other plans
already made Take othersrsquo perspective
Age-appropriate expectations
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
Inter-connectedness of systems Cortico-striatal system for example
Strategies
Pharmacotherapy
X
Behavioral Supports
A B C
A B C
behavior
A B C
consequences
A B C
antecedent
A B C
A B C
antecedent
A B C
antecedent
easy hard
A B C
consequences
R P
+
-
R+ P+
R- P-
Time Out
Select target behavior Set place Determine how much time Dress rehearsal Measure the time Withdraw attention Establish the cause and effect
Token economy
Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Functional impact of core symptoms
Arousal alertness Mental effort Determination of saliency Focal maintenance
Functional impact of core symptoms
Arousal alertness Mental effort Determination of saliency Focal maintenance
Functional impact of core symptoms
Arousal alertness Mental effort Determination of saliency Focal maintenance
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Subtypes of ADHD
ADHD predominantly inattentive type ADHD predominantly hyperactive type ADHD combined type ADHD Not Otherwise Specifed
Subtypes of ADHD
ADHD predominantly inattentive type ADHD predominantly hyperactive type ADHD combined type ADHD Not Otherwise
Specifed
Common comorbidities with ADHD
Learning disorder Behavioral disorder Anxiety Depression Substance abuse Sensory processing and auditory
processing challenges
Common comorbidities with ADHD
Learning disorder Behavioral disorder Anxiety Depression Substance abuse Sensory processing and auditory
processing challenges
ADHD and girls
ADHD and women
ADHD and women
More tasks More diffuse More parental responsibility Less likely to have an ldquoexecutiverdquo
partner Less likely to have assistants at work Less likely to focus on a narrow area More likely to feel shame about
disorganization
Executive FunctioningAn Overarching Theme
Sensory Processing Disorder Central Auditory Processing
Disorder ADHD and Executive Dysfunction
The Executive Functions
Internalizing speech Previewing
Prioritizing Tempo control Inhibition
The Executive Functions
Determining salience (whatrsquos in it for me)
Blocking out distractions Self-monitoring and correcting Certain aspects of memory learning
Appropriate expectations
Age-appropriate expectations
Preschool 1-step errands Chores with cues Basic inhibition
Age-appropriate expectations
K ndash 2nd grade 2-3 step directions Bring papers home 20-30 minute assignments Simple spending decisions Follow rules inhibit no grabbing
3rd ndash 5th
Simple shopping list Keep track of personal items Longer homework assignments Simple project planing Keep track of variable daily schedule Save money Inhibit and regulate even wo teacher present Manners Simple delayed gratification (phone)
Age-appropriate expectations
6th ndash 8th
complex chores Babysitting Organizing system Complex schedule Longer term projects Time management Self soothe Manage conflict
Age-appropriate expectations
Teenage ndash mid 20s Independent with assignments Make adjustments based on feedback Longer term goal setting Managing leisure time Inhibit reckless behavior Easily walk away from provocation Say ldquonordquo to fun activity if other plans
already made Take othersrsquo perspective
Age-appropriate expectations
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
Inter-connectedness of systems Cortico-striatal system for example
Strategies
Pharmacotherapy
X
Behavioral Supports
A B C
A B C
behavior
A B C
consequences
A B C
antecedent
A B C
A B C
antecedent
A B C
antecedent
easy hard
A B C
consequences
R P
+
-
R+ P+
R- P-
Time Out
Select target behavior Set place Determine how much time Dress rehearsal Measure the time Withdraw attention Establish the cause and effect
Token economy
Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Functional impact of core symptoms
Arousal alertness Mental effort Determination of saliency Focal maintenance
Functional impact of core symptoms
Arousal alertness Mental effort Determination of saliency Focal maintenance
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Subtypes of ADHD
ADHD predominantly inattentive type ADHD predominantly hyperactive type ADHD combined type ADHD Not Otherwise Specifed
Subtypes of ADHD
ADHD predominantly inattentive type ADHD predominantly hyperactive type ADHD combined type ADHD Not Otherwise
Specifed
Common comorbidities with ADHD
Learning disorder Behavioral disorder Anxiety Depression Substance abuse Sensory processing and auditory
processing challenges
Common comorbidities with ADHD
Learning disorder Behavioral disorder Anxiety Depression Substance abuse Sensory processing and auditory
processing challenges
ADHD and girls
ADHD and women
ADHD and women
More tasks More diffuse More parental responsibility Less likely to have an ldquoexecutiverdquo
partner Less likely to have assistants at work Less likely to focus on a narrow area More likely to feel shame about
disorganization
Executive FunctioningAn Overarching Theme
Sensory Processing Disorder Central Auditory Processing
Disorder ADHD and Executive Dysfunction
The Executive Functions
Internalizing speech Previewing
Prioritizing Tempo control Inhibition
The Executive Functions
Determining salience (whatrsquos in it for me)
Blocking out distractions Self-monitoring and correcting Certain aspects of memory learning
Appropriate expectations
Age-appropriate expectations
Preschool 1-step errands Chores with cues Basic inhibition
Age-appropriate expectations
K ndash 2nd grade 2-3 step directions Bring papers home 20-30 minute assignments Simple spending decisions Follow rules inhibit no grabbing
3rd ndash 5th
Simple shopping list Keep track of personal items Longer homework assignments Simple project planing Keep track of variable daily schedule Save money Inhibit and regulate even wo teacher present Manners Simple delayed gratification (phone)
Age-appropriate expectations
6th ndash 8th
complex chores Babysitting Organizing system Complex schedule Longer term projects Time management Self soothe Manage conflict
Age-appropriate expectations
Teenage ndash mid 20s Independent with assignments Make adjustments based on feedback Longer term goal setting Managing leisure time Inhibit reckless behavior Easily walk away from provocation Say ldquonordquo to fun activity if other plans
already made Take othersrsquo perspective
Age-appropriate expectations
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
Inter-connectedness of systems Cortico-striatal system for example
Strategies
Pharmacotherapy
X
Behavioral Supports
A B C
A B C
behavior
A B C
consequences
A B C
antecedent
A B C
A B C
antecedent
A B C
antecedent
easy hard
A B C
consequences
R P
+
-
R+ P+
R- P-
Time Out
Select target behavior Set place Determine how much time Dress rehearsal Measure the time Withdraw attention Establish the cause and effect
Token economy
Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Functional impact of core symptoms
Arousal alertness Mental effort Determination of saliency Focal maintenance
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Subtypes of ADHD
ADHD predominantly inattentive type ADHD predominantly hyperactive type ADHD combined type ADHD Not Otherwise Specifed
Subtypes of ADHD
ADHD predominantly inattentive type ADHD predominantly hyperactive type ADHD combined type ADHD Not Otherwise
Specifed
Common comorbidities with ADHD
Learning disorder Behavioral disorder Anxiety Depression Substance abuse Sensory processing and auditory
processing challenges
Common comorbidities with ADHD
Learning disorder Behavioral disorder Anxiety Depression Substance abuse Sensory processing and auditory
processing challenges
ADHD and girls
ADHD and women
ADHD and women
More tasks More diffuse More parental responsibility Less likely to have an ldquoexecutiverdquo
partner Less likely to have assistants at work Less likely to focus on a narrow area More likely to feel shame about
disorganization
Executive FunctioningAn Overarching Theme
Sensory Processing Disorder Central Auditory Processing
Disorder ADHD and Executive Dysfunction
The Executive Functions
Internalizing speech Previewing
Prioritizing Tempo control Inhibition
The Executive Functions
Determining salience (whatrsquos in it for me)
Blocking out distractions Self-monitoring and correcting Certain aspects of memory learning
Appropriate expectations
Age-appropriate expectations
Preschool 1-step errands Chores with cues Basic inhibition
Age-appropriate expectations
K ndash 2nd grade 2-3 step directions Bring papers home 20-30 minute assignments Simple spending decisions Follow rules inhibit no grabbing
3rd ndash 5th
Simple shopping list Keep track of personal items Longer homework assignments Simple project planing Keep track of variable daily schedule Save money Inhibit and regulate even wo teacher present Manners Simple delayed gratification (phone)
Age-appropriate expectations
6th ndash 8th
complex chores Babysitting Organizing system Complex schedule Longer term projects Time management Self soothe Manage conflict
Age-appropriate expectations
Teenage ndash mid 20s Independent with assignments Make adjustments based on feedback Longer term goal setting Managing leisure time Inhibit reckless behavior Easily walk away from provocation Say ldquonordquo to fun activity if other plans
already made Take othersrsquo perspective
Age-appropriate expectations
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
Inter-connectedness of systems Cortico-striatal system for example
Strategies
Pharmacotherapy
X
Behavioral Supports
A B C
A B C
behavior
A B C
consequences
A B C
antecedent
A B C
A B C
antecedent
A B C
antecedent
easy hard
A B C
consequences
R P
+
-
R+ P+
R- P-
Time Out
Select target behavior Set place Determine how much time Dress rehearsal Measure the time Withdraw attention Establish the cause and effect
Token economy
Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Subtypes of ADHD
ADHD predominantly inattentive type ADHD predominantly hyperactive type ADHD combined type ADHD Not Otherwise Specifed
Subtypes of ADHD
ADHD predominantly inattentive type ADHD predominantly hyperactive type ADHD combined type ADHD Not Otherwise
Specifed
Common comorbidities with ADHD
Learning disorder Behavioral disorder Anxiety Depression Substance abuse Sensory processing and auditory
processing challenges
Common comorbidities with ADHD
Learning disorder Behavioral disorder Anxiety Depression Substance abuse Sensory processing and auditory
processing challenges
ADHD and girls
ADHD and women
ADHD and women
More tasks More diffuse More parental responsibility Less likely to have an ldquoexecutiverdquo
partner Less likely to have assistants at work Less likely to focus on a narrow area More likely to feel shame about
disorganization
Executive FunctioningAn Overarching Theme
Sensory Processing Disorder Central Auditory Processing
Disorder ADHD and Executive Dysfunction
The Executive Functions
Internalizing speech Previewing
Prioritizing Tempo control Inhibition
The Executive Functions
Determining salience (whatrsquos in it for me)
Blocking out distractions Self-monitoring and correcting Certain aspects of memory learning
Appropriate expectations
Age-appropriate expectations
Preschool 1-step errands Chores with cues Basic inhibition
Age-appropriate expectations
K ndash 2nd grade 2-3 step directions Bring papers home 20-30 minute assignments Simple spending decisions Follow rules inhibit no grabbing
3rd ndash 5th
Simple shopping list Keep track of personal items Longer homework assignments Simple project planing Keep track of variable daily schedule Save money Inhibit and regulate even wo teacher present Manners Simple delayed gratification (phone)
Age-appropriate expectations
6th ndash 8th
complex chores Babysitting Organizing system Complex schedule Longer term projects Time management Self soothe Manage conflict
Age-appropriate expectations
Teenage ndash mid 20s Independent with assignments Make adjustments based on feedback Longer term goal setting Managing leisure time Inhibit reckless behavior Easily walk away from provocation Say ldquonordquo to fun activity if other plans
already made Take othersrsquo perspective
Age-appropriate expectations
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
Inter-connectedness of systems Cortico-striatal system for example
Strategies
Pharmacotherapy
X
Behavioral Supports
A B C
A B C
behavior
A B C
consequences
A B C
antecedent
A B C
A B C
antecedent
A B C
antecedent
easy hard
A B C
consequences
R P
+
-
R+ P+
R- P-
Time Out
Select target behavior Set place Determine how much time Dress rehearsal Measure the time Withdraw attention Establish the cause and effect
Token economy
Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Subtypes of ADHD
ADHD predominantly inattentive type ADHD predominantly hyperactive type ADHD combined type ADHD Not Otherwise Specifed
Subtypes of ADHD
ADHD predominantly inattentive type ADHD predominantly hyperactive type ADHD combined type ADHD Not Otherwise
Specifed
Common comorbidities with ADHD
Learning disorder Behavioral disorder Anxiety Depression Substance abuse Sensory processing and auditory
processing challenges
Common comorbidities with ADHD
Learning disorder Behavioral disorder Anxiety Depression Substance abuse Sensory processing and auditory
processing challenges
ADHD and girls
ADHD and women
ADHD and women
More tasks More diffuse More parental responsibility Less likely to have an ldquoexecutiverdquo
partner Less likely to have assistants at work Less likely to focus on a narrow area More likely to feel shame about
disorganization
Executive FunctioningAn Overarching Theme
Sensory Processing Disorder Central Auditory Processing
Disorder ADHD and Executive Dysfunction
The Executive Functions
Internalizing speech Previewing
Prioritizing Tempo control Inhibition
The Executive Functions
Determining salience (whatrsquos in it for me)
Blocking out distractions Self-monitoring and correcting Certain aspects of memory learning
Appropriate expectations
Age-appropriate expectations
Preschool 1-step errands Chores with cues Basic inhibition
Age-appropriate expectations
K ndash 2nd grade 2-3 step directions Bring papers home 20-30 minute assignments Simple spending decisions Follow rules inhibit no grabbing
3rd ndash 5th
Simple shopping list Keep track of personal items Longer homework assignments Simple project planing Keep track of variable daily schedule Save money Inhibit and regulate even wo teacher present Manners Simple delayed gratification (phone)
Age-appropriate expectations
6th ndash 8th
complex chores Babysitting Organizing system Complex schedule Longer term projects Time management Self soothe Manage conflict
Age-appropriate expectations
Teenage ndash mid 20s Independent with assignments Make adjustments based on feedback Longer term goal setting Managing leisure time Inhibit reckless behavior Easily walk away from provocation Say ldquonordquo to fun activity if other plans
already made Take othersrsquo perspective
Age-appropriate expectations
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
Inter-connectedness of systems Cortico-striatal system for example
Strategies
Pharmacotherapy
X
Behavioral Supports
A B C
A B C
behavior
A B C
consequences
A B C
antecedent
A B C
A B C
antecedent
A B C
antecedent
easy hard
A B C
consequences
R P
+
-
R+ P+
R- P-
Time Out
Select target behavior Set place Determine how much time Dress rehearsal Measure the time Withdraw attention Establish the cause and effect
Token economy
Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Subtypes of ADHD
ADHD predominantly inattentive type ADHD predominantly hyperactive type ADHD combined type ADHD Not Otherwise Specifed
Subtypes of ADHD
ADHD predominantly inattentive type ADHD predominantly hyperactive type ADHD combined type ADHD Not Otherwise
Specifed
Common comorbidities with ADHD
Learning disorder Behavioral disorder Anxiety Depression Substance abuse Sensory processing and auditory
processing challenges
Common comorbidities with ADHD
Learning disorder Behavioral disorder Anxiety Depression Substance abuse Sensory processing and auditory
processing challenges
ADHD and girls
ADHD and women
ADHD and women
More tasks More diffuse More parental responsibility Less likely to have an ldquoexecutiverdquo
partner Less likely to have assistants at work Less likely to focus on a narrow area More likely to feel shame about
disorganization
Executive FunctioningAn Overarching Theme
Sensory Processing Disorder Central Auditory Processing
Disorder ADHD and Executive Dysfunction
The Executive Functions
Internalizing speech Previewing
Prioritizing Tempo control Inhibition
The Executive Functions
Determining salience (whatrsquos in it for me)
Blocking out distractions Self-monitoring and correcting Certain aspects of memory learning
Appropriate expectations
Age-appropriate expectations
Preschool 1-step errands Chores with cues Basic inhibition
Age-appropriate expectations
K ndash 2nd grade 2-3 step directions Bring papers home 20-30 minute assignments Simple spending decisions Follow rules inhibit no grabbing
3rd ndash 5th
Simple shopping list Keep track of personal items Longer homework assignments Simple project planing Keep track of variable daily schedule Save money Inhibit and regulate even wo teacher present Manners Simple delayed gratification (phone)
Age-appropriate expectations
6th ndash 8th
complex chores Babysitting Organizing system Complex schedule Longer term projects Time management Self soothe Manage conflict
Age-appropriate expectations
Teenage ndash mid 20s Independent with assignments Make adjustments based on feedback Longer term goal setting Managing leisure time Inhibit reckless behavior Easily walk away from provocation Say ldquonordquo to fun activity if other plans
already made Take othersrsquo perspective
Age-appropriate expectations
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
Inter-connectedness of systems Cortico-striatal system for example
Strategies
Pharmacotherapy
X
Behavioral Supports
A B C
A B C
behavior
A B C
consequences
A B C
antecedent
A B C
A B C
antecedent
A B C
antecedent
easy hard
A B C
consequences
R P
+
-
R+ P+
R- P-
Time Out
Select target behavior Set place Determine how much time Dress rehearsal Measure the time Withdraw attention Establish the cause and effect
Token economy
Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Subtypes of ADHD
ADHD predominantly inattentive type ADHD predominantly hyperactive type ADHD combined type ADHD Not Otherwise Specifed
Subtypes of ADHD
ADHD predominantly inattentive type ADHD predominantly hyperactive type ADHD combined type ADHD Not Otherwise
Specifed
Common comorbidities with ADHD
Learning disorder Behavioral disorder Anxiety Depression Substance abuse Sensory processing and auditory
processing challenges
Common comorbidities with ADHD
Learning disorder Behavioral disorder Anxiety Depression Substance abuse Sensory processing and auditory
processing challenges
ADHD and girls
ADHD and women
ADHD and women
More tasks More diffuse More parental responsibility Less likely to have an ldquoexecutiverdquo
partner Less likely to have assistants at work Less likely to focus on a narrow area More likely to feel shame about
disorganization
Executive FunctioningAn Overarching Theme
Sensory Processing Disorder Central Auditory Processing
Disorder ADHD and Executive Dysfunction
The Executive Functions
Internalizing speech Previewing
Prioritizing Tempo control Inhibition
The Executive Functions
Determining salience (whatrsquos in it for me)
Blocking out distractions Self-monitoring and correcting Certain aspects of memory learning
Appropriate expectations
Age-appropriate expectations
Preschool 1-step errands Chores with cues Basic inhibition
Age-appropriate expectations
K ndash 2nd grade 2-3 step directions Bring papers home 20-30 minute assignments Simple spending decisions Follow rules inhibit no grabbing
3rd ndash 5th
Simple shopping list Keep track of personal items Longer homework assignments Simple project planing Keep track of variable daily schedule Save money Inhibit and regulate even wo teacher present Manners Simple delayed gratification (phone)
Age-appropriate expectations
6th ndash 8th
complex chores Babysitting Organizing system Complex schedule Longer term projects Time management Self soothe Manage conflict
Age-appropriate expectations
Teenage ndash mid 20s Independent with assignments Make adjustments based on feedback Longer term goal setting Managing leisure time Inhibit reckless behavior Easily walk away from provocation Say ldquonordquo to fun activity if other plans
already made Take othersrsquo perspective
Age-appropriate expectations
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
Inter-connectedness of systems Cortico-striatal system for example
Strategies
Pharmacotherapy
X
Behavioral Supports
A B C
A B C
behavior
A B C
consequences
A B C
antecedent
A B C
A B C
antecedent
A B C
antecedent
easy hard
A B C
consequences
R P
+
-
R+ P+
R- P-
Time Out
Select target behavior Set place Determine how much time Dress rehearsal Measure the time Withdraw attention Establish the cause and effect
Token economy
Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Functional impact of core symptoms
Satisfaction control Previewing Inhibition Tempo control Self-monitoring and correcting
Subtypes of ADHD
ADHD predominantly inattentive type ADHD predominantly hyperactive type ADHD combined type ADHD Not Otherwise Specifed
Subtypes of ADHD
ADHD predominantly inattentive type ADHD predominantly hyperactive type ADHD combined type ADHD Not Otherwise
Specifed
Common comorbidities with ADHD
Learning disorder Behavioral disorder Anxiety Depression Substance abuse Sensory processing and auditory
processing challenges
Common comorbidities with ADHD
Learning disorder Behavioral disorder Anxiety Depression Substance abuse Sensory processing and auditory
processing challenges
ADHD and girls
ADHD and women
ADHD and women
More tasks More diffuse More parental responsibility Less likely to have an ldquoexecutiverdquo
partner Less likely to have assistants at work Less likely to focus on a narrow area More likely to feel shame about
disorganization
Executive FunctioningAn Overarching Theme
Sensory Processing Disorder Central Auditory Processing
Disorder ADHD and Executive Dysfunction
The Executive Functions
Internalizing speech Previewing
Prioritizing Tempo control Inhibition
The Executive Functions
Determining salience (whatrsquos in it for me)
Blocking out distractions Self-monitoring and correcting Certain aspects of memory learning
Appropriate expectations
Age-appropriate expectations
Preschool 1-step errands Chores with cues Basic inhibition
Age-appropriate expectations
K ndash 2nd grade 2-3 step directions Bring papers home 20-30 minute assignments Simple spending decisions Follow rules inhibit no grabbing
3rd ndash 5th
Simple shopping list Keep track of personal items Longer homework assignments Simple project planing Keep track of variable daily schedule Save money Inhibit and regulate even wo teacher present Manners Simple delayed gratification (phone)
Age-appropriate expectations
6th ndash 8th
complex chores Babysitting Organizing system Complex schedule Longer term projects Time management Self soothe Manage conflict
Age-appropriate expectations
Teenage ndash mid 20s Independent with assignments Make adjustments based on feedback Longer term goal setting Managing leisure time Inhibit reckless behavior Easily walk away from provocation Say ldquonordquo to fun activity if other plans
already made Take othersrsquo perspective
Age-appropriate expectations
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
Inter-connectedness of systems Cortico-striatal system for example
Strategies
Pharmacotherapy
X
Behavioral Supports
A B C
A B C
behavior
A B C
consequences
A B C
antecedent
A B C
A B C
antecedent
A B C
antecedent
easy hard
A B C
consequences
R P
+
-
R+ P+
R- P-
Time Out
Select target behavior Set place Determine how much time Dress rehearsal Measure the time Withdraw attention Establish the cause and effect
Token economy
Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Subtypes of ADHD
ADHD predominantly inattentive type ADHD predominantly hyperactive type ADHD combined type ADHD Not Otherwise Specifed
Subtypes of ADHD
ADHD predominantly inattentive type ADHD predominantly hyperactive type ADHD combined type ADHD Not Otherwise
Specifed
Common comorbidities with ADHD
Learning disorder Behavioral disorder Anxiety Depression Substance abuse Sensory processing and auditory
processing challenges
Common comorbidities with ADHD
Learning disorder Behavioral disorder Anxiety Depression Substance abuse Sensory processing and auditory
processing challenges
ADHD and girls
ADHD and women
ADHD and women
More tasks More diffuse More parental responsibility Less likely to have an ldquoexecutiverdquo
partner Less likely to have assistants at work Less likely to focus on a narrow area More likely to feel shame about
disorganization
Executive FunctioningAn Overarching Theme
Sensory Processing Disorder Central Auditory Processing
Disorder ADHD and Executive Dysfunction
The Executive Functions
Internalizing speech Previewing
Prioritizing Tempo control Inhibition
The Executive Functions
Determining salience (whatrsquos in it for me)
Blocking out distractions Self-monitoring and correcting Certain aspects of memory learning
Appropriate expectations
Age-appropriate expectations
Preschool 1-step errands Chores with cues Basic inhibition
Age-appropriate expectations
K ndash 2nd grade 2-3 step directions Bring papers home 20-30 minute assignments Simple spending decisions Follow rules inhibit no grabbing
3rd ndash 5th
Simple shopping list Keep track of personal items Longer homework assignments Simple project planing Keep track of variable daily schedule Save money Inhibit and regulate even wo teacher present Manners Simple delayed gratification (phone)
Age-appropriate expectations
6th ndash 8th
complex chores Babysitting Organizing system Complex schedule Longer term projects Time management Self soothe Manage conflict
Age-appropriate expectations
Teenage ndash mid 20s Independent with assignments Make adjustments based on feedback Longer term goal setting Managing leisure time Inhibit reckless behavior Easily walk away from provocation Say ldquonordquo to fun activity if other plans
already made Take othersrsquo perspective
Age-appropriate expectations
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
Inter-connectedness of systems Cortico-striatal system for example
Strategies
Pharmacotherapy
X
Behavioral Supports
A B C
A B C
behavior
A B C
consequences
A B C
antecedent
A B C
A B C
antecedent
A B C
antecedent
easy hard
A B C
consequences
R P
+
-
R+ P+
R- P-
Time Out
Select target behavior Set place Determine how much time Dress rehearsal Measure the time Withdraw attention Establish the cause and effect
Token economy
Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Subtypes of ADHD
ADHD predominantly inattentive type ADHD predominantly hyperactive type ADHD combined type ADHD Not Otherwise
Specifed
Common comorbidities with ADHD
Learning disorder Behavioral disorder Anxiety Depression Substance abuse Sensory processing and auditory
processing challenges
Common comorbidities with ADHD
Learning disorder Behavioral disorder Anxiety Depression Substance abuse Sensory processing and auditory
processing challenges
ADHD and girls
ADHD and women
ADHD and women
More tasks More diffuse More parental responsibility Less likely to have an ldquoexecutiverdquo
partner Less likely to have assistants at work Less likely to focus on a narrow area More likely to feel shame about
disorganization
Executive FunctioningAn Overarching Theme
Sensory Processing Disorder Central Auditory Processing
Disorder ADHD and Executive Dysfunction
The Executive Functions
Internalizing speech Previewing
Prioritizing Tempo control Inhibition
The Executive Functions
Determining salience (whatrsquos in it for me)
Blocking out distractions Self-monitoring and correcting Certain aspects of memory learning
Appropriate expectations
Age-appropriate expectations
Preschool 1-step errands Chores with cues Basic inhibition
Age-appropriate expectations
K ndash 2nd grade 2-3 step directions Bring papers home 20-30 minute assignments Simple spending decisions Follow rules inhibit no grabbing
3rd ndash 5th
Simple shopping list Keep track of personal items Longer homework assignments Simple project planing Keep track of variable daily schedule Save money Inhibit and regulate even wo teacher present Manners Simple delayed gratification (phone)
Age-appropriate expectations
6th ndash 8th
complex chores Babysitting Organizing system Complex schedule Longer term projects Time management Self soothe Manage conflict
Age-appropriate expectations
Teenage ndash mid 20s Independent with assignments Make adjustments based on feedback Longer term goal setting Managing leisure time Inhibit reckless behavior Easily walk away from provocation Say ldquonordquo to fun activity if other plans
already made Take othersrsquo perspective
Age-appropriate expectations
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
Inter-connectedness of systems Cortico-striatal system for example
Strategies
Pharmacotherapy
X
Behavioral Supports
A B C
A B C
behavior
A B C
consequences
A B C
antecedent
A B C
A B C
antecedent
A B C
antecedent
easy hard
A B C
consequences
R P
+
-
R+ P+
R- P-
Time Out
Select target behavior Set place Determine how much time Dress rehearsal Measure the time Withdraw attention Establish the cause and effect
Token economy
Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Common comorbidities with ADHD
Learning disorder Behavioral disorder Anxiety Depression Substance abuse Sensory processing and auditory
processing challenges
Common comorbidities with ADHD
Learning disorder Behavioral disorder Anxiety Depression Substance abuse Sensory processing and auditory
processing challenges
ADHD and girls
ADHD and women
ADHD and women
More tasks More diffuse More parental responsibility Less likely to have an ldquoexecutiverdquo
partner Less likely to have assistants at work Less likely to focus on a narrow area More likely to feel shame about
disorganization
Executive FunctioningAn Overarching Theme
Sensory Processing Disorder Central Auditory Processing
Disorder ADHD and Executive Dysfunction
The Executive Functions
Internalizing speech Previewing
Prioritizing Tempo control Inhibition
The Executive Functions
Determining salience (whatrsquos in it for me)
Blocking out distractions Self-monitoring and correcting Certain aspects of memory learning
Appropriate expectations
Age-appropriate expectations
Preschool 1-step errands Chores with cues Basic inhibition
Age-appropriate expectations
K ndash 2nd grade 2-3 step directions Bring papers home 20-30 minute assignments Simple spending decisions Follow rules inhibit no grabbing
3rd ndash 5th
Simple shopping list Keep track of personal items Longer homework assignments Simple project planing Keep track of variable daily schedule Save money Inhibit and regulate even wo teacher present Manners Simple delayed gratification (phone)
Age-appropriate expectations
6th ndash 8th
complex chores Babysitting Organizing system Complex schedule Longer term projects Time management Self soothe Manage conflict
Age-appropriate expectations
Teenage ndash mid 20s Independent with assignments Make adjustments based on feedback Longer term goal setting Managing leisure time Inhibit reckless behavior Easily walk away from provocation Say ldquonordquo to fun activity if other plans
already made Take othersrsquo perspective
Age-appropriate expectations
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
Inter-connectedness of systems Cortico-striatal system for example
Strategies
Pharmacotherapy
X
Behavioral Supports
A B C
A B C
behavior
A B C
consequences
A B C
antecedent
A B C
A B C
antecedent
A B C
antecedent
easy hard
A B C
consequences
R P
+
-
R+ P+
R- P-
Time Out
Select target behavior Set place Determine how much time Dress rehearsal Measure the time Withdraw attention Establish the cause and effect
Token economy
Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Common comorbidities with ADHD
Learning disorder Behavioral disorder Anxiety Depression Substance abuse Sensory processing and auditory
processing challenges
ADHD and girls
ADHD and women
ADHD and women
More tasks More diffuse More parental responsibility Less likely to have an ldquoexecutiverdquo
partner Less likely to have assistants at work Less likely to focus on a narrow area More likely to feel shame about
disorganization
Executive FunctioningAn Overarching Theme
Sensory Processing Disorder Central Auditory Processing
Disorder ADHD and Executive Dysfunction
The Executive Functions
Internalizing speech Previewing
Prioritizing Tempo control Inhibition
The Executive Functions
Determining salience (whatrsquos in it for me)
Blocking out distractions Self-monitoring and correcting Certain aspects of memory learning
Appropriate expectations
Age-appropriate expectations
Preschool 1-step errands Chores with cues Basic inhibition
Age-appropriate expectations
K ndash 2nd grade 2-3 step directions Bring papers home 20-30 minute assignments Simple spending decisions Follow rules inhibit no grabbing
3rd ndash 5th
Simple shopping list Keep track of personal items Longer homework assignments Simple project planing Keep track of variable daily schedule Save money Inhibit and regulate even wo teacher present Manners Simple delayed gratification (phone)
Age-appropriate expectations
6th ndash 8th
complex chores Babysitting Organizing system Complex schedule Longer term projects Time management Self soothe Manage conflict
Age-appropriate expectations
Teenage ndash mid 20s Independent with assignments Make adjustments based on feedback Longer term goal setting Managing leisure time Inhibit reckless behavior Easily walk away from provocation Say ldquonordquo to fun activity if other plans
already made Take othersrsquo perspective
Age-appropriate expectations
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
Inter-connectedness of systems Cortico-striatal system for example
Strategies
Pharmacotherapy
X
Behavioral Supports
A B C
A B C
behavior
A B C
consequences
A B C
antecedent
A B C
A B C
antecedent
A B C
antecedent
easy hard
A B C
consequences
R P
+
-
R+ P+
R- P-
Time Out
Select target behavior Set place Determine how much time Dress rehearsal Measure the time Withdraw attention Establish the cause and effect
Token economy
Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
ADHD and girls
ADHD and women
ADHD and women
More tasks More diffuse More parental responsibility Less likely to have an ldquoexecutiverdquo
partner Less likely to have assistants at work Less likely to focus on a narrow area More likely to feel shame about
disorganization
Executive FunctioningAn Overarching Theme
Sensory Processing Disorder Central Auditory Processing
Disorder ADHD and Executive Dysfunction
The Executive Functions
Internalizing speech Previewing
Prioritizing Tempo control Inhibition
The Executive Functions
Determining salience (whatrsquos in it for me)
Blocking out distractions Self-monitoring and correcting Certain aspects of memory learning
Appropriate expectations
Age-appropriate expectations
Preschool 1-step errands Chores with cues Basic inhibition
Age-appropriate expectations
K ndash 2nd grade 2-3 step directions Bring papers home 20-30 minute assignments Simple spending decisions Follow rules inhibit no grabbing
3rd ndash 5th
Simple shopping list Keep track of personal items Longer homework assignments Simple project planing Keep track of variable daily schedule Save money Inhibit and regulate even wo teacher present Manners Simple delayed gratification (phone)
Age-appropriate expectations
6th ndash 8th
complex chores Babysitting Organizing system Complex schedule Longer term projects Time management Self soothe Manage conflict
Age-appropriate expectations
Teenage ndash mid 20s Independent with assignments Make adjustments based on feedback Longer term goal setting Managing leisure time Inhibit reckless behavior Easily walk away from provocation Say ldquonordquo to fun activity if other plans
already made Take othersrsquo perspective
Age-appropriate expectations
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
Inter-connectedness of systems Cortico-striatal system for example
Strategies
Pharmacotherapy
X
Behavioral Supports
A B C
A B C
behavior
A B C
consequences
A B C
antecedent
A B C
A B C
antecedent
A B C
antecedent
easy hard
A B C
consequences
R P
+
-
R+ P+
R- P-
Time Out
Select target behavior Set place Determine how much time Dress rehearsal Measure the time Withdraw attention Establish the cause and effect
Token economy
Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
ADHD and women
ADHD and women
More tasks More diffuse More parental responsibility Less likely to have an ldquoexecutiverdquo
partner Less likely to have assistants at work Less likely to focus on a narrow area More likely to feel shame about
disorganization
Executive FunctioningAn Overarching Theme
Sensory Processing Disorder Central Auditory Processing
Disorder ADHD and Executive Dysfunction
The Executive Functions
Internalizing speech Previewing
Prioritizing Tempo control Inhibition
The Executive Functions
Determining salience (whatrsquos in it for me)
Blocking out distractions Self-monitoring and correcting Certain aspects of memory learning
Appropriate expectations
Age-appropriate expectations
Preschool 1-step errands Chores with cues Basic inhibition
Age-appropriate expectations
K ndash 2nd grade 2-3 step directions Bring papers home 20-30 minute assignments Simple spending decisions Follow rules inhibit no grabbing
3rd ndash 5th
Simple shopping list Keep track of personal items Longer homework assignments Simple project planing Keep track of variable daily schedule Save money Inhibit and regulate even wo teacher present Manners Simple delayed gratification (phone)
Age-appropriate expectations
6th ndash 8th
complex chores Babysitting Organizing system Complex schedule Longer term projects Time management Self soothe Manage conflict
Age-appropriate expectations
Teenage ndash mid 20s Independent with assignments Make adjustments based on feedback Longer term goal setting Managing leisure time Inhibit reckless behavior Easily walk away from provocation Say ldquonordquo to fun activity if other plans
already made Take othersrsquo perspective
Age-appropriate expectations
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
Inter-connectedness of systems Cortico-striatal system for example
Strategies
Pharmacotherapy
X
Behavioral Supports
A B C
A B C
behavior
A B C
consequences
A B C
antecedent
A B C
A B C
antecedent
A B C
antecedent
easy hard
A B C
consequences
R P
+
-
R+ P+
R- P-
Time Out
Select target behavior Set place Determine how much time Dress rehearsal Measure the time Withdraw attention Establish the cause and effect
Token economy
Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
ADHD and women
More tasks More diffuse More parental responsibility Less likely to have an ldquoexecutiverdquo
partner Less likely to have assistants at work Less likely to focus on a narrow area More likely to feel shame about
disorganization
Executive FunctioningAn Overarching Theme
Sensory Processing Disorder Central Auditory Processing
Disorder ADHD and Executive Dysfunction
The Executive Functions
Internalizing speech Previewing
Prioritizing Tempo control Inhibition
The Executive Functions
Determining salience (whatrsquos in it for me)
Blocking out distractions Self-monitoring and correcting Certain aspects of memory learning
Appropriate expectations
Age-appropriate expectations
Preschool 1-step errands Chores with cues Basic inhibition
Age-appropriate expectations
K ndash 2nd grade 2-3 step directions Bring papers home 20-30 minute assignments Simple spending decisions Follow rules inhibit no grabbing
3rd ndash 5th
Simple shopping list Keep track of personal items Longer homework assignments Simple project planing Keep track of variable daily schedule Save money Inhibit and regulate even wo teacher present Manners Simple delayed gratification (phone)
Age-appropriate expectations
6th ndash 8th
complex chores Babysitting Organizing system Complex schedule Longer term projects Time management Self soothe Manage conflict
Age-appropriate expectations
Teenage ndash mid 20s Independent with assignments Make adjustments based on feedback Longer term goal setting Managing leisure time Inhibit reckless behavior Easily walk away from provocation Say ldquonordquo to fun activity if other plans
already made Take othersrsquo perspective
Age-appropriate expectations
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
Inter-connectedness of systems Cortico-striatal system for example
Strategies
Pharmacotherapy
X
Behavioral Supports
A B C
A B C
behavior
A B C
consequences
A B C
antecedent
A B C
A B C
antecedent
A B C
antecedent
easy hard
A B C
consequences
R P
+
-
R+ P+
R- P-
Time Out
Select target behavior Set place Determine how much time Dress rehearsal Measure the time Withdraw attention Establish the cause and effect
Token economy
Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Executive FunctioningAn Overarching Theme
Sensory Processing Disorder Central Auditory Processing
Disorder ADHD and Executive Dysfunction
The Executive Functions
Internalizing speech Previewing
Prioritizing Tempo control Inhibition
The Executive Functions
Determining salience (whatrsquos in it for me)
Blocking out distractions Self-monitoring and correcting Certain aspects of memory learning
Appropriate expectations
Age-appropriate expectations
Preschool 1-step errands Chores with cues Basic inhibition
Age-appropriate expectations
K ndash 2nd grade 2-3 step directions Bring papers home 20-30 minute assignments Simple spending decisions Follow rules inhibit no grabbing
3rd ndash 5th
Simple shopping list Keep track of personal items Longer homework assignments Simple project planing Keep track of variable daily schedule Save money Inhibit and regulate even wo teacher present Manners Simple delayed gratification (phone)
Age-appropriate expectations
6th ndash 8th
complex chores Babysitting Organizing system Complex schedule Longer term projects Time management Self soothe Manage conflict
Age-appropriate expectations
Teenage ndash mid 20s Independent with assignments Make adjustments based on feedback Longer term goal setting Managing leisure time Inhibit reckless behavior Easily walk away from provocation Say ldquonordquo to fun activity if other plans
already made Take othersrsquo perspective
Age-appropriate expectations
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
Inter-connectedness of systems Cortico-striatal system for example
Strategies
Pharmacotherapy
X
Behavioral Supports
A B C
A B C
behavior
A B C
consequences
A B C
antecedent
A B C
A B C
antecedent
A B C
antecedent
easy hard
A B C
consequences
R P
+
-
R+ P+
R- P-
Time Out
Select target behavior Set place Determine how much time Dress rehearsal Measure the time Withdraw attention Establish the cause and effect
Token economy
Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
The Executive Functions
Internalizing speech Previewing
Prioritizing Tempo control Inhibition
The Executive Functions
Determining salience (whatrsquos in it for me)
Blocking out distractions Self-monitoring and correcting Certain aspects of memory learning
Appropriate expectations
Age-appropriate expectations
Preschool 1-step errands Chores with cues Basic inhibition
Age-appropriate expectations
K ndash 2nd grade 2-3 step directions Bring papers home 20-30 minute assignments Simple spending decisions Follow rules inhibit no grabbing
3rd ndash 5th
Simple shopping list Keep track of personal items Longer homework assignments Simple project planing Keep track of variable daily schedule Save money Inhibit and regulate even wo teacher present Manners Simple delayed gratification (phone)
Age-appropriate expectations
6th ndash 8th
complex chores Babysitting Organizing system Complex schedule Longer term projects Time management Self soothe Manage conflict
Age-appropriate expectations
Teenage ndash mid 20s Independent with assignments Make adjustments based on feedback Longer term goal setting Managing leisure time Inhibit reckless behavior Easily walk away from provocation Say ldquonordquo to fun activity if other plans
already made Take othersrsquo perspective
Age-appropriate expectations
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
Inter-connectedness of systems Cortico-striatal system for example
Strategies
Pharmacotherapy
X
Behavioral Supports
A B C
A B C
behavior
A B C
consequences
A B C
antecedent
A B C
A B C
antecedent
A B C
antecedent
easy hard
A B C
consequences
R P
+
-
R+ P+
R- P-
Time Out
Select target behavior Set place Determine how much time Dress rehearsal Measure the time Withdraw attention Establish the cause and effect
Token economy
Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
The Executive Functions
Determining salience (whatrsquos in it for me)
Blocking out distractions Self-monitoring and correcting Certain aspects of memory learning
Appropriate expectations
Age-appropriate expectations
Preschool 1-step errands Chores with cues Basic inhibition
Age-appropriate expectations
K ndash 2nd grade 2-3 step directions Bring papers home 20-30 minute assignments Simple spending decisions Follow rules inhibit no grabbing
3rd ndash 5th
Simple shopping list Keep track of personal items Longer homework assignments Simple project planing Keep track of variable daily schedule Save money Inhibit and regulate even wo teacher present Manners Simple delayed gratification (phone)
Age-appropriate expectations
6th ndash 8th
complex chores Babysitting Organizing system Complex schedule Longer term projects Time management Self soothe Manage conflict
Age-appropriate expectations
Teenage ndash mid 20s Independent with assignments Make adjustments based on feedback Longer term goal setting Managing leisure time Inhibit reckless behavior Easily walk away from provocation Say ldquonordquo to fun activity if other plans
already made Take othersrsquo perspective
Age-appropriate expectations
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
Inter-connectedness of systems Cortico-striatal system for example
Strategies
Pharmacotherapy
X
Behavioral Supports
A B C
A B C
behavior
A B C
consequences
A B C
antecedent
A B C
A B C
antecedent
A B C
antecedent
easy hard
A B C
consequences
R P
+
-
R+ P+
R- P-
Time Out
Select target behavior Set place Determine how much time Dress rehearsal Measure the time Withdraw attention Establish the cause and effect
Token economy
Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Appropriate expectations
Age-appropriate expectations
Preschool 1-step errands Chores with cues Basic inhibition
Age-appropriate expectations
K ndash 2nd grade 2-3 step directions Bring papers home 20-30 minute assignments Simple spending decisions Follow rules inhibit no grabbing
3rd ndash 5th
Simple shopping list Keep track of personal items Longer homework assignments Simple project planing Keep track of variable daily schedule Save money Inhibit and regulate even wo teacher present Manners Simple delayed gratification (phone)
Age-appropriate expectations
6th ndash 8th
complex chores Babysitting Organizing system Complex schedule Longer term projects Time management Self soothe Manage conflict
Age-appropriate expectations
Teenage ndash mid 20s Independent with assignments Make adjustments based on feedback Longer term goal setting Managing leisure time Inhibit reckless behavior Easily walk away from provocation Say ldquonordquo to fun activity if other plans
already made Take othersrsquo perspective
Age-appropriate expectations
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
Inter-connectedness of systems Cortico-striatal system for example
Strategies
Pharmacotherapy
X
Behavioral Supports
A B C
A B C
behavior
A B C
consequences
A B C
antecedent
A B C
A B C
antecedent
A B C
antecedent
easy hard
A B C
consequences
R P
+
-
R+ P+
R- P-
Time Out
Select target behavior Set place Determine how much time Dress rehearsal Measure the time Withdraw attention Establish the cause and effect
Token economy
Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Age-appropriate expectations
Preschool 1-step errands Chores with cues Basic inhibition
Age-appropriate expectations
K ndash 2nd grade 2-3 step directions Bring papers home 20-30 minute assignments Simple spending decisions Follow rules inhibit no grabbing
3rd ndash 5th
Simple shopping list Keep track of personal items Longer homework assignments Simple project planing Keep track of variable daily schedule Save money Inhibit and regulate even wo teacher present Manners Simple delayed gratification (phone)
Age-appropriate expectations
6th ndash 8th
complex chores Babysitting Organizing system Complex schedule Longer term projects Time management Self soothe Manage conflict
Age-appropriate expectations
Teenage ndash mid 20s Independent with assignments Make adjustments based on feedback Longer term goal setting Managing leisure time Inhibit reckless behavior Easily walk away from provocation Say ldquonordquo to fun activity if other plans
already made Take othersrsquo perspective
Age-appropriate expectations
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
Inter-connectedness of systems Cortico-striatal system for example
Strategies
Pharmacotherapy
X
Behavioral Supports
A B C
A B C
behavior
A B C
consequences
A B C
antecedent
A B C
A B C
antecedent
A B C
antecedent
easy hard
A B C
consequences
R P
+
-
R+ P+
R- P-
Time Out
Select target behavior Set place Determine how much time Dress rehearsal Measure the time Withdraw attention Establish the cause and effect
Token economy
Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Age-appropriate expectations
K ndash 2nd grade 2-3 step directions Bring papers home 20-30 minute assignments Simple spending decisions Follow rules inhibit no grabbing
3rd ndash 5th
Simple shopping list Keep track of personal items Longer homework assignments Simple project planing Keep track of variable daily schedule Save money Inhibit and regulate even wo teacher present Manners Simple delayed gratification (phone)
Age-appropriate expectations
6th ndash 8th
complex chores Babysitting Organizing system Complex schedule Longer term projects Time management Self soothe Manage conflict
Age-appropriate expectations
Teenage ndash mid 20s Independent with assignments Make adjustments based on feedback Longer term goal setting Managing leisure time Inhibit reckless behavior Easily walk away from provocation Say ldquonordquo to fun activity if other plans
already made Take othersrsquo perspective
Age-appropriate expectations
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
Inter-connectedness of systems Cortico-striatal system for example
Strategies
Pharmacotherapy
X
Behavioral Supports
A B C
A B C
behavior
A B C
consequences
A B C
antecedent
A B C
A B C
antecedent
A B C
antecedent
easy hard
A B C
consequences
R P
+
-
R+ P+
R- P-
Time Out
Select target behavior Set place Determine how much time Dress rehearsal Measure the time Withdraw attention Establish the cause and effect
Token economy
Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
3rd ndash 5th
Simple shopping list Keep track of personal items Longer homework assignments Simple project planing Keep track of variable daily schedule Save money Inhibit and regulate even wo teacher present Manners Simple delayed gratification (phone)
Age-appropriate expectations
6th ndash 8th
complex chores Babysitting Organizing system Complex schedule Longer term projects Time management Self soothe Manage conflict
Age-appropriate expectations
Teenage ndash mid 20s Independent with assignments Make adjustments based on feedback Longer term goal setting Managing leisure time Inhibit reckless behavior Easily walk away from provocation Say ldquonordquo to fun activity if other plans
already made Take othersrsquo perspective
Age-appropriate expectations
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
Inter-connectedness of systems Cortico-striatal system for example
Strategies
Pharmacotherapy
X
Behavioral Supports
A B C
A B C
behavior
A B C
consequences
A B C
antecedent
A B C
A B C
antecedent
A B C
antecedent
easy hard
A B C
consequences
R P
+
-
R+ P+
R- P-
Time Out
Select target behavior Set place Determine how much time Dress rehearsal Measure the time Withdraw attention Establish the cause and effect
Token economy
Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
6th ndash 8th
complex chores Babysitting Organizing system Complex schedule Longer term projects Time management Self soothe Manage conflict
Age-appropriate expectations
Teenage ndash mid 20s Independent with assignments Make adjustments based on feedback Longer term goal setting Managing leisure time Inhibit reckless behavior Easily walk away from provocation Say ldquonordquo to fun activity if other plans
already made Take othersrsquo perspective
Age-appropriate expectations
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
Inter-connectedness of systems Cortico-striatal system for example
Strategies
Pharmacotherapy
X
Behavioral Supports
A B C
A B C
behavior
A B C
consequences
A B C
antecedent
A B C
A B C
antecedent
A B C
antecedent
easy hard
A B C
consequences
R P
+
-
R+ P+
R- P-
Time Out
Select target behavior Set place Determine how much time Dress rehearsal Measure the time Withdraw attention Establish the cause and effect
Token economy
Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Teenage ndash mid 20s Independent with assignments Make adjustments based on feedback Longer term goal setting Managing leisure time Inhibit reckless behavior Easily walk away from provocation Say ldquonordquo to fun activity if other plans
already made Take othersrsquo perspective
Age-appropriate expectations
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
Inter-connectedness of systems Cortico-striatal system for example
Strategies
Pharmacotherapy
X
Behavioral Supports
A B C
A B C
behavior
A B C
consequences
A B C
antecedent
A B C
A B C
antecedent
A B C
antecedent
easy hard
A B C
consequences
R P
+
-
R+ P+
R- P-
Time Out
Select target behavior Set place Determine how much time Dress rehearsal Measure the time Withdraw attention Establish the cause and effect
Token economy
Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
Inter-connectedness of systems Cortico-striatal system for example
Strategies
Pharmacotherapy
X
Behavioral Supports
A B C
A B C
behavior
A B C
consequences
A B C
antecedent
A B C
A B C
antecedent
A B C
antecedent
easy hard
A B C
consequences
R P
+
-
R+ P+
R- P-
Time Out
Select target behavior Set place Determine how much time Dress rehearsal Measure the time Withdraw attention Establish the cause and effect
Token economy
Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
ldquowhat isrdquo vs ldquowhat could berdquo
Inter-connectedness of systems Cortico-striatal system for example
Strategies
Pharmacotherapy
X
Behavioral Supports
A B C
A B C
behavior
A B C
consequences
A B C
antecedent
A B C
A B C
antecedent
A B C
antecedent
easy hard
A B C
consequences
R P
+
-
R+ P+
R- P-
Time Out
Select target behavior Set place Determine how much time Dress rehearsal Measure the time Withdraw attention Establish the cause and effect
Token economy
Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Inter-connectedness of systems Cortico-striatal system for example
Strategies
Pharmacotherapy
X
Behavioral Supports
A B C
A B C
behavior
A B C
consequences
A B C
antecedent
A B C
A B C
antecedent
A B C
antecedent
easy hard
A B C
consequences
R P
+
-
R+ P+
R- P-
Time Out
Select target behavior Set place Determine how much time Dress rehearsal Measure the time Withdraw attention Establish the cause and effect
Token economy
Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Strategies
Pharmacotherapy
X
Behavioral Supports
A B C
A B C
behavior
A B C
consequences
A B C
antecedent
A B C
A B C
antecedent
A B C
antecedent
easy hard
A B C
consequences
R P
+
-
R+ P+
R- P-
Time Out
Select target behavior Set place Determine how much time Dress rehearsal Measure the time Withdraw attention Establish the cause and effect
Token economy
Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Pharmacotherapy
X
Behavioral Supports
A B C
A B C
behavior
A B C
consequences
A B C
antecedent
A B C
A B C
antecedent
A B C
antecedent
easy hard
A B C
consequences
R P
+
-
R+ P+
R- P-
Time Out
Select target behavior Set place Determine how much time Dress rehearsal Measure the time Withdraw attention Establish the cause and effect
Token economy
Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Behavioral Supports
A B C
A B C
behavior
A B C
consequences
A B C
antecedent
A B C
A B C
antecedent
A B C
antecedent
easy hard
A B C
consequences
R P
+
-
R+ P+
R- P-
Time Out
Select target behavior Set place Determine how much time Dress rehearsal Measure the time Withdraw attention Establish the cause and effect
Token economy
Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
A B C
A B C
behavior
A B C
consequences
A B C
antecedent
A B C
A B C
antecedent
A B C
antecedent
easy hard
A B C
consequences
R P
+
-
R+ P+
R- P-
Time Out
Select target behavior Set place Determine how much time Dress rehearsal Measure the time Withdraw attention Establish the cause and effect
Token economy
Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
A B C
behavior
A B C
consequences
A B C
antecedent
A B C
A B C
antecedent
A B C
antecedent
easy hard
A B C
consequences
R P
+
-
R+ P+
R- P-
Time Out
Select target behavior Set place Determine how much time Dress rehearsal Measure the time Withdraw attention Establish the cause and effect
Token economy
Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
A B C
consequences
A B C
antecedent
A B C
A B C
antecedent
A B C
antecedent
easy hard
A B C
consequences
R P
+
-
R+ P+
R- P-
Time Out
Select target behavior Set place Determine how much time Dress rehearsal Measure the time Withdraw attention Establish the cause and effect
Token economy
Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
A B C
antecedent
A B C
A B C
antecedent
A B C
antecedent
easy hard
A B C
consequences
R P
+
-
R+ P+
R- P-
Time Out
Select target behavior Set place Determine how much time Dress rehearsal Measure the time Withdraw attention Establish the cause and effect
Token economy
Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
A B C
A B C
antecedent
A B C
antecedent
easy hard
A B C
consequences
R P
+
-
R+ P+
R- P-
Time Out
Select target behavior Set place Determine how much time Dress rehearsal Measure the time Withdraw attention Establish the cause and effect
Token economy
Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
A B C
antecedent
A B C
antecedent
easy hard
A B C
consequences
R P
+
-
R+ P+
R- P-
Time Out
Select target behavior Set place Determine how much time Dress rehearsal Measure the time Withdraw attention Establish the cause and effect
Token economy
Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
A B C
antecedent
easy hard
A B C
consequences
R P
+
-
R+ P+
R- P-
Time Out
Select target behavior Set place Determine how much time Dress rehearsal Measure the time Withdraw attention Establish the cause and effect
Token economy
Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
easy hard
A B C
consequences
R P
+
-
R+ P+
R- P-
Time Out
Select target behavior Set place Determine how much time Dress rehearsal Measure the time Withdraw attention Establish the cause and effect
Token economy
Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
A B C
consequences
R P
+
-
R+ P+
R- P-
Time Out
Select target behavior Set place Determine how much time Dress rehearsal Measure the time Withdraw attention Establish the cause and effect
Token economy
Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
R P
+
-
R+ P+
R- P-
Time Out
Select target behavior Set place Determine how much time Dress rehearsal Measure the time Withdraw attention Establish the cause and effect
Token economy
Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
+
-
R+ P+
R- P-
Time Out
Select target behavior Set place Determine how much time Dress rehearsal Measure the time Withdraw attention Establish the cause and effect
Token economy
Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
R+ P+
R- P-
Time Out
Select target behavior Set place Determine how much time Dress rehearsal Measure the time Withdraw attention Establish the cause and effect
Token economy
Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Time Out
Select target behavior Set place Determine how much time Dress rehearsal Measure the time Withdraw attention Establish the cause and effect
Token economy
Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Token economy
Good balance Precursor to adult reinforcement system Lots of work to do well Even more work to set up well
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Intrinsic motivation
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
A B C
consequencesX
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
A B C
behavior
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Metacognition
Metacognitive knowledge Metacognitive strategies
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
ldquoLend Me Your Brainrdquo
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
What Does Dopamine Feel Like
The Physiology of Motivation and Reward
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Preferred States What Does Dopamine Feel Like
1 Great experience2 Kodak moment3 The feeeeling
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
David D Nowell PhD189 May Street
Worcester Mass 01602DrNowellcom
PREFERRED STATES INVENTORY
wwwLulucom
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Identify 20 peak experiences For each peak experience identify the
highlight moment ndash the snapshot Go to the visceralhellipwhat was the feeling
of that moment Name it Check the 20 peak moment-feelings for
clusters groupings There will probably be 4 or 5
PREFERRED STATES INVENTORY
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Find a word a label for each of the groupings
Check for accuracy (ldquogutrdquo check) Those are your preferred states your
ldquovaluesrdquo ways that you really like to feel
Now you know your motivationhellipuse this knowledge to review your daily activities and planning
PREFERRED STATES INVENTORY
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
PREFERRED STATES INVENTORY
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Broaden and Build
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
ldquoNeuroMalleabilityrdquo
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Why You Arenrsquot Getting Exactly What You Want All the Time
The Brainrsquos Reward and Planning System - And How It Breaks Down
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
ldquowhat isrdquo vs ldquowhat could berdquo
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
ldquowhat isrdquo vs ldquowhat could berdquo
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
The reward-and-planning system
Anticipate goal Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Ways the reward-and-planning system can go wrong
Alicia R Ruelaz MD ldquothe biggest issue for me and others Ive seen has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completedrdquo
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Ways the reward-and-planning system can go wrong
Jacy a freelance artist from Connecticut I get so excited about a new idea I forget the zeal that I had once felt for an old one Thus creating my inevitable idea graveyardldquo
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Ways the reward-and-planning system can go wrong
Juzer ldquomy biggest problem is that I want to do everything all at oncerdquo
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Ways the reward-and-planning system can go wrong
Inna ldquoI just get blank I usually start sitting more slouched hold my head with my left hand hellipyou freeze and instead of being able to think of alternatives you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to yourdquo
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Lend Me Your Brain
Supporting Clients with Executive Dysfunction
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Ways the reward-and-planning system can go wrong
Hank ldquoI have things I need to do to improve my marriage my health and my financial situation but I honestly believe that I have zero chance of actually making any of those three things actually get better rdquo
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Ways the reward-and-planning system can go wrong
Alice a oach from Long Island The difference between a dream and a goal is a plan It is the myriad of steps BETWEEN point A and point B that fail to happen That is why a coach can be so important to folks with ADHD A coach can help the person develop a step-by-step plan and help the person decide which steps they can amp will complete (the exciting ones) and which steps they are best off hiring or asking someone else to do (the boring ones)
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Identify tasks Sequence problem-solve Block out distractions Get the reward
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Ways the reward-and-planning system can go wrong
Anticipate goal (state) Working memory Insight Alexithymia emotional intelligence Disconnect from values Diminished options Overly influenced by externals
Too busy with current activity
Field dependent
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Ways the reward-and-planning system can go wrong
Identify tasks Working memory Intelligence development Overly conventional thinking Insight Emotional intelligence
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Ways the reward-and-planning system can go wrong
Sequence problem-solve
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Ways the reward-and-planning system can go wrong
Sequence problem-solve Verbal working memory Nonverbal working memory Reconstitution Understanding of causality Self-efficacy Coping Learned helplessness
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Ways the reward-and-planning system can go wrong
Block out distractions
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
The best defense against the manipulation of our attention is to determine for ourselves ndash in advance - how we want to invest it
- E Goldberg
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Ways the reward-and-planning system can go wrong
Block out distractions Field dependent (sensitive to novelty) Saliency Working memory Easily discouraged
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Ways the reward-and-planning system can go wrong
Get the reward
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Ways the reward-and-planning system can go wrong
Get the reward Satisfaction control Picked wrong task Picked wrong goal (ldquostaterdquo) Sociopathy
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Instant gratification vs
executive gratification
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
A B C
behaviorx
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Self-Talk Proficiency
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Self-Talk Proficiency
bull -ldquoHow are you going to know when to be readyrdquo
bull -ldquoHow are you going to stop yourself fromhelliprdquo
bull -ldquoWhat is your goalrdquo bull -ldquoWhat do you want it to look likerdquo bull -ldquoHow long do you think it will
takerdquordquo
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Self-Talk Proficiency
bull -ldquoHow are you going to know what you needrdquo
bull -ldquoHow are you going to know what is most importantrdquo
bull -ldquoHow are you going to decide what to do firstrdquo
bull -ldquoHow will you know when you are donerdquo
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Self-Talk Proficiency
bull -ldquoHow will you continue when you are tiredrdquo
bull -ldquoHow did that work outrdquo bull -ldquoHow long do you think that tookrdquo bull -ldquoWould you do anything
differentlyrdquo ldquoWho will be the first person to notice
thathelliprdquo
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Match the Picture
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Distraction Delay Training
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Executive Estimates Training
X
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Learning Time
What is the ldquofeltrdquo experience of time What is the ldquofrontalrdquo aspect of time
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Learning Time
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Learning Time
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Learning Time
Theres no such thing as procrastinationhelliptherersquos just choosing And choosing again
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Asking two questionshellip
Am I having fun now And is this what I set out to do
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Am I having fun nowIs
this
what
I se
t out
to
do
bullYesbullYes
bullNobullYes
bullYesbullNo
bullNobullNo
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Am I having fun nowIs
this
what
I se
t out
to
do
bullFunbullOn-task
bullNot funbullOn-task
bullFunbullNot on-task
bullNot funbullNot on-task
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Key Features of Video Games
Clear expectations Behavioral specificity Build on small changes in behavior Irrelevant behaviors ignored Reward appropriate behavior and punish
inappropriate behavior ndash never reverse this
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Key Features of Video Games
Always follow up on rules no exceptions Consequences are immediate Punishment is mild Stimuli are exciting and multi-sensory Conduct expensive and time-consuming
focus groups to determine what really ldquograbs lsquoemrdquo
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Methylphenidate Enhances the Saliency of a Mathematical Task by Increasing Dopamine in the Human Brain
Volkow et al 2004
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Increase salience
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Increase salience
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Quarterly QI review
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
The post-mortem
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Your 1 Organizational Tool
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Your 1 Organizational Tool
Yoga read
Staff meeting
Planningsession
Phone calls
billing
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Your 1 Organizational Tool
Vh jeff w puritan oilVc kate re brimfieldTC umass dermatology Spoke w cindy 508 8564000
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Your 1 Organizational Tool
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
Learn French
Stop smoking
Be a better spouse
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
The ldquoBig Fiverdquo
Daily focus time Valuesmotivational clarity Nutrition Movement Connection
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
A CHALLENGEhellip
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-
wwwDrNowellcom
Lend Me Your BrainPractical Strategies for Managing ADDADHDExecutive Dysfunction and Processing Disorders
DavidNowellSeminars
DavidNowell
- Slide 1
- hellipa challenge
- Slide 3
- Perspective of this workshophellip
- ldquoTop ndash downrdquo dysfunction
- ldquoBottom - uprdquo dysfunction
- Slide 7
- Whatrsquos the kidrsquos deal
- Overview
- This Dense Pudding
- Sensory Processing Disorder
- Slide 12
- Slide 13
- Developmental considerations
- Sensory ProcessingIntegration Disorder and DSM-V
- Whatrsquos the kidrsquos deal (2)
- Slide 17
- Whatrsquos the kidrsquos deal (3)
- Slide 19
- Strategies
- Regulatory-Sensory Processing Disorders
- Slide 22
- Slide 23
- Regulatory-Sensory Processing Disorders (2)
- Slide 25
- Central Auditory Processing Disorder
- Slide 27
- Slide 28
- Slide 29
- Central Auditory Processing Disorder (2)
- Central Auditory Processing Disorder (3)
- Central Auditory Processing Disorder (4)
- CAPD or ADHD
- Whatrsquos the kidrsquos deal (4)
- Slide 35
- Strategies (2)
- (C)APD
- Treatment for CAPD
- Treatment for CAPD (2)
- Self-assessment
- Attention Deficit Hyperactivity Disorder
- Slide 42
- Attention Deficit Hyperactivity Disorder (2)
- (85 ndash X) x 365
- ldquoIrsquom gonna eat all the gum and candy I wantrdquo
- Core symptoms
- Core symptoms (2)
- hellipand the rest of the criteria
- Slide 49
- Functional impact of core symptoms
- Functional impact of core symptoms (2)
- Functional impact of core symptoms (3)
- Slide 53
- Functional impact of core symptoms (4)
- Functional impact of core symptoms (5)
- Functional impact of core symptoms (6)
- Functional impact of core symptoms (7)
- Functional impact of core symptoms (8)
- Functional impact of core symptoms (9)
- Subtypes of ADHD
- Subtypes of ADHD (2)
- Common comorbidities with ADHD
- Slide 63
- Common comorbidities with ADHD (2)
- ADHD and girls
- Slide 66
- Slide 67
- ADHD and women
- Slide 69
- ADHD and women (2)
- Executive Functioning An Overarching Theme
- The Executive Functions
- The Executive Functions (2)
- Slide 74
- Slide 75
- Appropriate expectations
- Age-appropriate expectations
- Age-appropriate expectations (2)
- Age-appropriate expectations (3)
- Age-appropriate expectations (4)
- Age-appropriate expectations (5)
- ldquowhat isrdquo vs ldquowhat could berdquo
- ldquowhat isrdquo vs ldquowhat could berdquo (2)
- Slide 84
- Slide 85
- Strategies (3)
- Pharmacotherapy
- Behavioral Supports
- Slide 89
- Slide 90
- Slide 91
- Slide 92
- Slide 93
- Slide 94
- Slide 95
- Slide 96
- Slide 97
- Slide 98
- Slide 99
- Slide 100
- Slide 101
- Slide 102
- Slide 103
- Slide 104
- Slide 105
- Slide 106
- Slide 107
- Slide 108
- Slide 109
- Slide 110
- Time Out
- Token economy
- Slide 113
- Slide 114
- Slide 115
- Intrinsic motivation
- Slide 117
- Slide 118
- Slide 119
- Metacognition
- ldquoLend Me Your Brainrdquo
- What Does Dopamine Feel Like
- Preferred States What Does Dopamine Feel Like
- Slide 124
- PREFERRED STATES INVENTORY
- PREFERRED STATES INVENTORY (2)
- PREFERRED STATES INVENTORY (3)
- Slide 128
- Slide 129
- Broaden and Build
- ldquoNeuroMalleabilityrdquo
- Why You Arenrsquot Getting Exactly What You Want All the Time
- The reward-and-planning system
- ldquowhat isrdquo vs ldquowhat could berdquo (3)
- ldquowhat isrdquo vs ldquowhat could berdquo (4)
- The reward-and-planning system (2)
- Ways the reward-and-planning system can go wrong
- Ways the reward-and-planning system can go wrong (2)
- Ways the reward-and-planning system can go wrong (3)
- Ways the reward-and-planning system can go wrong (4)
- Slide 141
- Lend Me Your Brain
- Ways the reward-and-planning system can go wrong (5)
- Ways the reward-and-planning system can go wrong (6)
- Ways the reward-and-planning system can go wrong (7)
- Slide 146
- Ways the reward-and-planning system can go wrong (8)
- Ways the reward-and-planning system can go wrong (9)
- Slide 149
- Ways the reward-and-planning system can go wrong (10)
- Ways the reward-and-planning system can go wrong (11)
- Slide 152
- Ways the reward-and-planning system can go wrong (12)
- Slide 154
- Ways the reward-and-planning system can go wrong (13)
- Ways the reward-and-planning system can go wrong (14)
- Slide 157
- Slide 158
- Slide 159
- Ways the reward-and-planning system can go wrong (15)
- Ways the reward-and-planning system can go wrong (16)
- Slide 162
- Ways the reward-and-planning system can go wrong (17)
- Slide 164
- Instant gratification vs executive gratification
- Slide 166
- Slide 167
- Slide 168
- Slide 169
- Slide 170
- Self-Talk Proficiency
- Self-Talk Proficiency (2)
- Self-Talk Proficiency (3)
- Self-Talk Proficiency (4)
- Match the Picture
- Slide 176
- Slide 177
- Distraction Delay Training
- Slide 179
- Slide 180
- Executive Estimates Training
- Learning Time
- Learning Time (2)
- Learning Time (3)
- Slide 185
- Slide 186
- Learning Time (4)
- Asking two questionshellip
- Slide 189
- Slide 190
- Key Features of Video Games
- Key Features of Video Games (2)
- Methylphenidate Enhances the Saliency of a Mathematical Task by
- Slide 194
- Slide 195
- Slide 196
- Slide 197
- Slide 198
- Slide 199
- Slide 200
- Slide 201
- Quarterly QI review
- The post-mortem
- Slide 204
- Slide 205
- Slide 206
- Slide 207
- Slide 208
- Slide 209
- Slide 210
- The ldquoBig Fiverdquo
- Slide 212
- Slide 213
- The ldquoBig Fiverdquo (2)
- Slide 215
- Slide 216
- Slide 217
- The ldquoBig Fiverdquo (3)
- The ldquoBig Fiverdquo (4)
- The ldquoBig Fiverdquo (5)
- A challengehellip
- Slide 222
-