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Ep. 107: Adele Diamond – Becoming More Self-Possessed

April 16, 2020 Adele Diamond Season 1 Episode 107
Full PreFrontal
Ep. 107: Adele Diamond – Becoming More Self-Possessed
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Full PreFrontal
Ep. 107: Adele Diamond – Becoming More Self-Possessed
Apr 16, 2020 Season 1 Episode 107
Adele Diamond

The brain’s prefrontal cortex is often described as the “work in progress” intimating that there exists a continuum of neural development shaped by an interplay between biology and behavior; each influencing the other. Naturally, Executive Function, a set of skills controlled by the prefrontal cortex, emerges slowly allowing humans to form future goals and gain independence in order to become more and more self-possessed. Based on the past few decades of research, educational and cognitive scientists have confirmed that every aspect of modern life requires strong executive function including daily planning, workplace productivity, ability to make and keep friends, marital harmony, abiding by law, and warding of social and legal troubles. This understanding has created an urgency to address the disruptions in executive function as they interfere with students succeeding in school, employees at work, and individuals in their social circle.

On this episode, cognitive neuroscientist, Professor Adele Diamond, discusses how inhibition, self-control, mental flexibility, and many other Executive Function skills are valuable for everyday success. Her work suggests that “if we want children to do well in school and in life, we need to help them develop healthy executive functions.”

About Professor Adele Diamond, PhD, FRSC, FAPA, FAPS
Adele Diamond is the Canada Research Chair Professor of Developmental Cognitive Neuroscience at UBC in Vancouver.  She was educated at Swarthmore, Harvard, and Yale. Her specialty is “executive functions” (e.g., self-control, problem-solving, mentally playing with ideas, flexibly adjust to change, thinking outside the box) which depend on the brain’s prefrontal cortex and interrelated neural regions.  Her work has emphasized that executive functions can be improved even in the very young and very old, and anywhere in-between.  Dr. Diamond’s work on the unusual properties of the dopamine system in prefrontal cortex have improved medical treatment for ADHD and PKU, improving millions of children’s lives.

Dr. Diamond offers a markedly different perspective from mainstream education in hypothesizing that focusing exclusively on training cognitive skills is less efficient, and ultimately less successful, than also addressing emotional, social, spiritual, and physical needs. Dr. Diamond also offers a perspective markedly different from traditional medical practice in hypothesizing that treating physical health, without also addressing social and emotional health is less efficient or effective.

Recently, Dr. Diamond has turned her attention to the possible roles of music, dance, storytelling, martial arts, sports, and play in improving executive functions and academic and mental health outcomes.

Website:

  • http://www.devcogneuro.com/AdeleDiamond.html

Additional Resources:

Show Notes Transcript

The brain’s prefrontal cortex is often described as the “work in progress” intimating that there exists a continuum of neural development shaped by an interplay between biology and behavior; each influencing the other. Naturally, Executive Function, a set of skills controlled by the prefrontal cortex, emerges slowly allowing humans to form future goals and gain independence in order to become more and more self-possessed. Based on the past few decades of research, educational and cognitive scientists have confirmed that every aspect of modern life requires strong executive function including daily planning, workplace productivity, ability to make and keep friends, marital harmony, abiding by law, and warding of social and legal troubles. This understanding has created an urgency to address the disruptions in executive function as they interfere with students succeeding in school, employees at work, and individuals in their social circle.

On this episode, cognitive neuroscientist, Professor Adele Diamond, discusses how inhibition, self-control, mental flexibility, and many other Executive Function skills are valuable for everyday success. Her work suggests that “if we want children to do well in school and in life, we need to help them develop healthy executive functions.”

About Professor Adele Diamond, PhD, FRSC, FAPA, FAPS
Adele Diamond is the Canada Research Chair Professor of Developmental Cognitive Neuroscience at UBC in Vancouver.  She was educated at Swarthmore, Harvard, and Yale. Her specialty is “executive functions” (e.g., self-control, problem-solving, mentally playing with ideas, flexibly adjust to change, thinking outside the box) which depend on the brain’s prefrontal cortex and interrelated neural regions.  Her work has emphasized that executive functions can be improved even in the very young and very old, and anywhere in-between.  Dr. Diamond’s work on the unusual properties of the dopamine system in prefrontal cortex have improved medical treatment for ADHD and PKU, improving millions of children’s lives.

Dr. Diamond offers a markedly different perspective from mainstream education in hypothesizing that focusing exclusively on training cognitive skills is less efficient, and ultimately less successful, than also addressing emotional, social, spiritual, and physical needs. Dr. Diamond also offers a perspective markedly different from traditional medical practice in hypothesizing that treating physical health, without also addressing social and emotional health is less efficient or effective.

Recently, Dr. Diamond has turned her attention to the possible roles of music, dance, storytelling, martial arts, sports, and play in improving executive functions and academic and mental health outcomes.

Website:

  • http://www.devcogneuro.com/AdeleDiamond.html

Additional Resources:

Support the show (https://mailchi.mp/7c848462e96f/full-prefrontal-sign-up)

Producer: And welcome back to Full PreFrontal where we are exposing the mysteries of executive function. As always, I am here with our host, Sucheta Kamath.

Good morning, my good friend, always good to be with you, always enjoy your conversations. I’m looking forward to this one today.

Sucheta Kamath: Yes, you are in for a treat, Todd, it’s so great to be with you, and as we tee up this conversation with a renowned expert today, I thought I’ll share a story from my past. This is such a cute story that I have to share it. I have two boys, as you know, and when my firstborn was two years old, we bought him a giant floor puzzle, it was a foam puzzle that had kind of one elephant, an elephant cut out and a number 1, then two cat cut outs and number 2, and so on, and it went up to 10. There were a total of mayb 45 pieces and then 11 numbers. The reason there were 11 numbers is 1 and the 10 was made of 1 and 0. So, my son was so diligent — the reason I’m sharing is his incredible persistence was quite remarkable at age two. I was quite thrilled to see. I’m an SLP at heart so I had done some language development tests on him, but this was a great telling of his executive function, so he used to spend hours putting that puzzle together, and then something happened. We lost number 1, the foam number 1, and so I was watching him put this whole puzzle together. So, he puts the elephant, puts number 1, two cats, puts number 2, then three dogs, puts 3, goes on and on, and he comes to 10 fish and he has no 1. The mat is quite massive and he removes 1 from number 1 and puts it for 10, and I began to clap like a mad woman because that was so much flexibility, so much persistence, and great problem solving.

So, the reason I’m saying that, because the guest today we have has been talking about emergence of executive function and they are evident if we look around, and they may be showing up in baby steps but they are so essential and crucial for managing life. So, with great pleasure and honor, I am welcoming Adele Diamond. She is the Canada Research Chair Professor of Developmental Cognitive Neuroscience at UBC in Vancouver, she was educated in Swarthmore, Harvard, and Yale. Her specialty is executive function which involves self control, problem solving, mentally playing with ideas, and so on and so forth which we will be diving deep into, which depends on the brain’s prefrontal cortex and interrelated neural regions. Her work has emphasized that executive functions can be improved even in very young and very old, and even in between, and she is a remarkable researcher who I would say has single-handedly helped us change the perspective in terms of how to set up interventions particularly in very young children and how to help them develop these skills.

So, it’s my great honor and privilege to welcome Adele, so welcome to the podcast.

Adele Diamond: Thank you so much and thank you for that generous introduction.

Sucheta: Absolutely. Well, there’s so much more to talk about but I didn’t include all that, and let me start with this question that I asked many of my guests. Since we are talking about executive function, self-awareness, and self devised strategic thinking, what is your personal experience as a young learner and a thinker? When did you discover this part of your own abilities and how has that shaped or informed your own journey as a learner and a thinker?

Adele: I think I had pretty good executive function when I was little. I was a well-behaved kid, so I was able to inhibit doing all the things that you can get yelled at for. I was pretty good at cognitive flexibility and coming up with alternative solutions, but executive functions are the last in and the first to go, so the first to deteriorate with aging.

Sucheta: Yes.

Adele: So, I think now, my executive functions are less good, so I could see myself having problems with working memory, I could see myself having problems with self-control, I want to lose weight and do I have the self-control to not eat what I shouldn’t eat? So, I think they were good when I was little and I’m a little frustrated with them not being better now.

Sucheta: Well, you probably are one of those honest ones who has shared this frustration openly. My morning executive functioning skills are far superior than my evening executive functioning skills, my executive functioning skills on vacation or less refined than on regimented work routine, so yes, I’m glad to see you address this interpersonal variability, but even within the same person, there can be variability.

So, let’s dive into this idea of executive function. You are the guru of helping us define this. What is the best way to understand executive function as it relates to educating our children and raising them to be independent and self-sufficient?

Adele: Well, executive functions refers to a whole family of different abilities that are needed when you have to concentrate and pay attention, so when you can go automatic, which you can rely on instinct or intuition, you don’t need executive functions. You need executive functions when there is change, when there’s something you, when you have to exert top-down control, and at the three-quarter executive functions include first, inhibitory control: being able to give a considered response rather than an impulsive one, to resist distraction, resist temptation, stay focused. So, for example, the strong inclination that you might be trying to resist might be something like reflexively striking back at somebody who’s hurt your feelings or blurting out an inappropriate remark or cutting in line, or for a child blurting out the answer without raising their hand. There are lots of instances when you need to exert some kind of self-control, then there’s working memory, holding information in mind and working with it, playing with ideas and, so translating instructions into action plans, considering alternatives, maybe you’ve written a to do list but now, you want to mentally reorder it so that you can do it the most efficient way. So, there are lots of times when you need to play with things in your mind. When you want to think about the past or the future, you have to do that in your mind because of course, they are not here now. That’s really important for anything that has to do with language because not all the words are available at the same time, whether you’re listening to somebody talking or your reading. You have to hold in mind what was said earlier or what was read earlier to relate that to what you are hearing now or seeing now. And the last quarter executive function is cognitive flexibility, being able to see things from different perspectives, being able to think outside the box, being able to flexibly adjust to the unexpected, so can you take advantage of a new opportunity or you’re going to even flexibly stay with what you plan? If a problem arises, can you figure out a way around that? I say if there’s a problem we haven’t been able to solve, can you conceive of the problem, frame the problem in a whole new way, so that you can come up with the way of solving it, or if you are disagreeing with somebody, can you maybe see things from that person’s perspective, change perspectives so that maybe you can resolve the disagreement? So, those are the three core executive functions and of course, you need inhibitory control to persevere, like you were talking about, because you have to resist all the temptations not to persevere, and it’s critical for reasoning and problem-solving, so all of those things depend on executive function, and it’s been shown that executive functions are more predictive of school readiness and how well somebody would do in school then even IQ or socioeconomic status, so they really have a big impact on how people do in school and after it in life.

Sucheta: I want to ask you some questions so maybe you can help our listeners understand this a little bit deeply. When we talk about impulse control, you emphasize here that their responses need to be socially appropriate which is really putting your self-interest aside and see what the shared goal or common goal is. I see that, that’s why disabilities like Asperger’s or on the spectrum, there can be a problem because you are missing the forest for the trees. Is that a good way to think about that socially appropriate inhibition of things that may not serve others but may be serving you is a good sign of impulse control also, right?

Adele: It’s interesting to think about impulse control as not necessarily doing what’s best for you at the moment but considering others. I like that idea. I think the problem with Asperger’s could be that they may not understand what the other perspective is, they may not understand what somebody else is trying to communicate, but people with Asperger’s can be incredibly good at selective attention, and focused attention, they can be very, very focused, so that’s often a real strength of somebody with Asperger’s. So, they may not pick up on social cues and so may not know how to adjust to the social situation, but in terms of being able to inhibit distraction, they can often focus very well.

Sucheta: So, the second part you were talking about was playing with ideas in mind which is such a beautiful way to describe holding information while applying the rules of operation to it, the technical ways of understanding working memory. Tell us a little bit, how does that working memory play an important role in creativity?

Adele: Well, one of the ways to be creative is to play with ideas and facts in your mind, and find different ways to relate them, to relate things that normally people wouldn’t relate together, to see connections between seemingly unconnected things. So, often, your creative moments come from playing with things in your head.

Sucheta: Got it, fabulous, and then the cognitive flexibility. So, is it a good way to understand that there is that affective and cognitive, so taking a perspective from somebody else’s point of view versus thinking about alternatives, and particularly in my work working with students and patients, I see that that important roadblock for people who are inflexible is that they are not quick to discard a strategy that is not working which is what you talked about, often, we describe as perseverance, so how these two different skill sets understood from the flexibility point of view, what is the affective thinking from thinking like somebody else versus you are the same person but thinking from another point of view in information?

Adele: Right.well, first, I want to pick up on something you said which is very interesting and very important which is if something isn’t working, you want to have the flexibility to discard it but you also want to have the inhibitory control and perseverance to continue working at something and not discarding it too fast, so you have to balance these two, right?

Sucheta: Ah, yes.

Adele:  You don’t want to give up on something too early but if it’s not working, you don’t want to continue persevering too late. Another example is if you have a really good selective attention, you might miss what’s most important because you were so good at focusing just on what you were looking for, but what you were looking for didn’t happen to be the most important thing in the environment.

Sucheta: Yes, gotcha, gotcha.

Adele: So, you’re always needing to balance the flexibility in the inhibitory control and focus.

In terms of what you ask, the social and the cognitive, executive functions is more related to the cognitive, and theory of mind is more related to the social but they are both talking about the same things, like seeing in a room from different angles or seeing a person from different angles. It’s really kind of similar but it’s observed by slightly different brain systems. My husband is incredibly good spatially. He can rotate things in three dimensions no problem. I am miserable spatially. I say to people, he’s as good spatially as I am terrible spatially, so I have very good cognitive flexibility when it comes to problem solving, can we think of alternative ways of solving a problem? But I have terrible cognitive flexibility when it comes to something in a spatial arrangement.

Sucheta: So then, I like to describe this as a Goldilocks effect, as you were saying, just right. It can be too much flexibility where you’re not anchoring or committing to one actual plan or too rigid where you are saying this way or die.

Adele: That’s right, that’s right, the Golden mean.

Sucheta: Yes, golden mean. So, how should we understand the relationship between executive function and self-regulation and where does self-awareness fit in all this?

Adele: It’s interesting because if he asked different people about the relationship between executive function and self-regulation, you’ll get different answers. So, my perspective is that self-regulation is most related to the subcategory of executive function which is inhibitory control. Self-regulation is about regulating or controlling your behavior and emotions. Self-regulation also has a component that people don’t talk about in terms of executive function which is how your emotions, how your motivation can be your ally, can help power you to be able to do things you want to do. People who talk about executive functions tend to talk about controlling your emotions as if they are only bad whereas self-regulation recognizes all the wonderful things that emotions can do for you.

Other people talk about executive functions as a subcategory under self-regulation, so they see self-regulation as a much larger concept than I do and they see executive functions as part of it. In terms of self-awareness, that’s a good question because certainly, babies can exercise all elements of all three of the executive functions. Inhibitory control and both aspects of it, response inhibition and selective attention, working memory and cognitive flexibility, even though they have no self-awareness really about what they’re doing. So, as adults, we often do this with self-awareness but what you want is for many of these things to become so much second nature that you don’t need self-awareness to execute them. For example, a four-year-old might know that you shouldn’t hit. He knows that, he’s learned that well, but in the heat of the moment, if he gets really mad at another child, he may hit that child and you could ask him, immediately ask, should you hit? And he’ll say no, so he knows that he shouldn’t hit, he has that understanding, but he hasn’t yet got it in his behavior, so it’s second nature, it’s automatic, and what we want is for children to practice a lot of these things so much that they don’t need self-awareness to executing. It’s just what your second nature is, it’s just what you do. If somebody says something that you disagree with her that hurt your feelings, your first reaction is not to hit that person. You have, now, it’s your second nature that that’s not even occurring to you and that’s what we need for children, we need these things to become so automatic that they don’t have to think about it.

Sucheta: I see, so that’s such an interesting thought process. In my work, we do a lot of metacognitive training and awareness of self as a performer and do work, and an evaluator of the doing of self and the other as a way to self-regulate, as a way to yield better outcomes. So, you’re saying talking about this other aspect where when things become automatic, you will not need to reflect so frequently because it’s second nature to you?

Adele: Right, so I think the metacognition is very helpful for the learning. So, let’s reflect on what you just did and what outcome you got. Did you get the outcome you wanted? How might you be able to act differently to get a better outcome? How would you feel if somebody did to you what you just did to somebody else? I think that’s an excellent way to help children understand and frame things and learn to do these. And then, you want them to practice it so much that they don’t have to go through any thinking process. It’s just become who they are.

Sucheta: Wow, gotcha, that’s beautiful. So, how should we think about, when we think about children who obviously are less competent in these areas of impulse control, working memory, cognitive flexibility as compared to their older counterparts or the future selves but we do need some competencies so that they can socially engage and continue to learn? So, when do we begin to differentiate between the normal executive function delay that exists in the developing brain versus dysfunction?

Adele: That’s a good question because children have very different developmental timetables, so somebody might be late in showing something but it doesn’t necessarily mean they have any disability or dysfunction. It may just be that they are on a different time schedule. I like to think of it as much as possible that the child doesn’t have a disability or dysfunction. The child just, we haven’t figured out the right way, the right hook so the child can do this yet, so the workload is on both of us to try to figure out you’re not getting this, you’re not behaving the way we’d like you to behave in this situation. What can we do to help you be able to get to that point? What would it take? And I think it’s better to say that we just haven’t figured out the right way to help you be able to do that than to think about that the child has a problem or a dysfunction. I think often, it’s just a mismatch between how we’re going about it and how that particular child needs somebody to go about it.

Sucheta: the reason I ask that, it’s such an interesting explanation that you’re giving, because the nature of executive function is deceptive. The way they show up is deceptive. That means you know more about executive function when they are missing or absent, or delayed rather than when they are present, so when somebody is competent and is successfully controlling impulses, flexibly shifting sets, then they are not creating hassles for themselves or the others, so only when somebody doesn’t show the skills that it becomes a problem. I’ll give you a quick example. We used to carpool with this family and my children who are in kindergarten and first grade and this mom used to come pick my kids up and one day, she showed up slightly early and I was packing their lunch and I put real stainless steel fork and spoon in his lunch bag, and she was so surprised. She said, “You put real forks and spoons?” I said, “Yeah, what do you mean?” She said, “Well, my son, when he finishes lunch, he empties his entire lunch bag in the trash, so I sent real spoons and forks and he just throws them,” so she stopped doing that and putting plastic ones, and so somehow, there was, of course, difference in competence but my son never through it and he was instructed not to and that was adequate for him, but at that age when we can’t really, as you were mentioning, can call the other kid having dysfunction but a lot of times in the educational context, I feel these skills are compared to the peers, so if the peer is showing competence and three kids out of 15 are not, then they become a burden on the teacher’s ability to teach, isn’t it?

Adele: I think that’s a real problem with their education system. Our education system right now really wants everybody to be the same. We should all start reading at the same age, we should all be able to inhibit impulses at the same age, etc., but that’s not the way the world is. Different kids walk in different ages, they talk at different ages, and they can be dramatically different for one baby to walk at nine months and another toddler to walk at 15 months. That six-month difference is huge in terms of the proportion of their lives, right? It’s like a third of their life but we don’t have any problem with that and we know by the age of two, they’re going to both be walking just as well, but in school, because we require the standard curriculum that everybody should do and standardized tests that everybody has to take at the end of the year, we put an artificial requirement on children which then causes some children to be labeled as problems when children just have different developmental timetables, and if we had a more individualized type of instruction, for example, like in Montessori, then there’s not a problem if kids are at different points in either reading or math, or self-regulation, or working memory, or whatever.

Sucheta: You’re right. In education, we’re applying this one mold fits all. Montessori is not an option for many but also, the uncertain age of learning, can we apply Montessori in seventh grade, for example or there’s of course some imposed structural rigidity that educators feel that they can’t escape, so how do we find a happy medium?

Adele: Well, you don’t have to do Montessori but you can do Montessori high school and you can certainly do it for seventh, eighth, and ninth grade. I think what you need to be able to do it, the kind of education I’m talking about is a modicum of executive function or self-regulation in the children. You need them and we can scaffold that, we can help them, so they don’t have to be very advanced but they need to be able, with scaffolding, to be able to work on their own or with one or two peers. Once the children can work on their own or with one or two peers, then you can have individualized education. Different children can work at different levels, the teacher can give individual instruction, everything is now open, it completely opens up the possibilities for the teacher. You can have hands-on learning instead of the whole class having to focus on the teacher, you can have children working on what interests them, so one child can do reading, another child can do math, all of this becomes possible when the children could work on their own, and you can scaffold that, so even children of five years of age can work on their own.

Sucheta: So, Adele, what I’m hearing you say is one of the best ways to see children deploy their executive function when they are required to meet a goal by facilitating all the skills that are required to achieve that goal by either creating a plan, following through the steps, and then seeing if the outcome matches the goals, and those opportunities, very often, if they’re created and that supervised, then that can actually lead to executive function development, correct?

Adele: No.

Sucheta: No?

Adele: No, that’s not what I was thinking. I was thinking, for example, for a four or five-year-old, one of the big problems is they forget right away what they’re supposed to do. So, if you have visual reminders, that scaffolds them, that helps them to be able to do what they are supposed to do because they don’t have to work so hard to remember it because they can look at a picture that reminds them of what they should do, so I’m thinking of simple scaffold, simple ways to just make it more accessible to children so that they can regulate themselves, and once they can regulate themselves, then the teacher doesn’t have to be the enforcer or the regulator.

Sucheta: Got it, okay, that’s beautiful. So, can I ask you the next tier of education which is middle school, high school, and college, let’s say? I feel executive functioning skills can be described as critical but subject diagnostic academic skills and they are not taught the way we teach math, science, and literature but instead they are very essential in managing math, science, and literature, so why not teach these skills intentionally and specifically and not just demand to see the present through a project that requires you to manage your time or organize your materials, or meet the deadlines, or remind yourself to remember to remember? What are your thoughts about the, again, you kind of explained this already but I feel like these skills are often written about in the comments section in a report card but there’s almost – the [inaudible] is on a child to have shown these skills and the absence of these skills somehow have become a roadblock for them, but it’s not necessarily a roadblock that teacher helped remove.

Adele: That’s right, that’s right. So, executive functions are really critical, so teachers should work on helping children get better at them and shouldn’t just rely on if we do other things, that it will come along by doing them, and it doesn’t have to be another burden on the teacher. You can teach executive functioning skills in the course of doing academic subjects, and I think that’s the way to go, so instead of having another period here you work on executive functions, you can work on executive functions when you are doing literacy, you can work on executive functions when you’re doing math, when you’re doing science, and it can be a very explicit plan on the part of the teacher that I purposely organizing this lesson so it will help the students to be able to practice this executive function scale or that executive function scale. You’re absolutely right, we leave it too much a chance and then we find all these children, all these adults who are labeled as having problems because nobody ever helped them to develop the skill. It’s not necessarily that they are deficient; it’s often that nobody has helped them to develop the skill earlier, so for example, a child might go to you and you might help the child develop the skill, and then the child might pull away from having worked with you, having the skill be fine, so was the child a problem or was it that the instructions that the child got earlier was a problem?

Sucheta: Exactly, and I think again, I love that scaffold them, incorporate them in teaching of math and teaching of science, but do give special attention [inaudible] that are supporting the learning or not even learning that actually demonstrating that learning has occurred because all the test taking skills, for example, or producing a product such as a project or a paper is the result of strong and well-orchestrated executive function. So, it’s kind of now, I want to ask you an opposite question which you are a big proponent of, particularly to promote this problem-solving and cognitive flexibility, that watching the brain go do its magic is pure joy, of course, but you often say that when a child is exploring a problem, it’s important not to intervene to help. In other words, doing less is more. I would love for you to now talk a little bit about that, how to do that well, what do you exactly mean by this strategy and based on the child’s age group, would this wait-and-see approach change in every junction of transition?

Adele: Well, it requires good executive function on the part of the adult.

Sucheta: A-ha!

Adele: Because the adult needs to exercise good inhibitory control not to jump in and help because our natural first impulse when we see a child struggling is to get in there and try to relieve the struggling, try to help the child solve the problem, but if we solve the problem, then we are the hero and the child is still the weak one. We need to let the child have the chance to solve it themselves, and one way to help is may be for a teenager, for example, to just talk it through with you, for you to just be the sounding board and working it out in telling you, in talking with you, the adolescent is often come to the solution, the toddler who’s working on a puzzle or grated cylinders can often see for themselves when they are making a mistake and correct it if we just wait and let them try, so there’s no exact answer, just like there’s no exact answer about when you should keep persisting with something and when you should say, “This isn’t working and I’m going to switch to something else,” so there’s no clear answer and when you should intervene and say the child is not going to be able to solve this themselves. I need to do something. But the advice I would give is to wait longer than you are inclined to wait, to be patient and have faith in the child and if you do step in to help the child, to scaffold the child to problem-solve instead of going in there to suggest solutions or show the solution, or solve the problem for the child.

Sucheta: Gotcha. Did you ever, Adele, see Tom Hanks’s movie Cast Away?

Adele: No, I didn’t.

Sucheta: Well, it’s worth seeing it. I mean, it’s very boring – not boring but it’s quite arduous to watch it because I forget if it’s a ship or a plane crash but he’s the only person on the island and it shows how he survives until he is found. It’s so interesting because he is the problem solver and he is the feedback giver, and he is the one who is doing exploratory thinking. There is no meet back at all. It’s painful to see all the ways he struggles and all the ways he discovers. It’s painful, like the struggle but the discovery is so heartwarming and amazing because you are seeing on the other side and you’re like, wait, try this, try that, and there’s no feedback.

Adele: That’s right, but you wouldn’t have that huge pride and huge feeling of rush of endorphins if you solved it for him, right?

Sucheta: Exactly, yes.

Adele: The pride of having it solved it himself, and we rob kids of that if we rush in, like you have an appointment and the child is taking forever to get the boots on and the coat on. Our inclination is just put it on ourselves, but the child needs a chance to be able to do this and we need to just have some patience and say, “I know he knows how to do this, he’s going to figure it out, I’m going to let him do it.”

Sucheta: And you know, I feel like one of the reasons we are moving away in 21st century from such model of allowing things to come to natural discovery because people are rushing all the time.

Adele: Absolutely, absolutely.

Sucheta: They cannot give time to a child, like a decent amount of time that goes into a good problem solving is time, like [inaudible] time.

Adele: That’s right, that’s right.

Sucheta: [inaudible] to a child, poor thing.

Adele: That’s right.

Sucheta: This is great, this is exactly what I think our listeners are craving to hear. I now want to ask you formally, how do we go about improving executive function? You have said that if we want children to do well in school and in life, we need to help them develop healthy executive functions, so let’s talk about what methods were interventions work and what methods don’t work.

Adele: Well, I think one thing that parents can do of young children even if they are illiterate is to tell stories. You don’t have to be a great storyteller. It can be some story from your own childhood for some family history story, or it can be a fairy tale that you remember, or you can get a book and look occasionally at the pages but do it as if you’re telling a story to the child because if you’re not showing pictures in the book, if you’re not having puppets acted out, if you don’t have a video, the child has to work to sustain attention on the story you are telling. The child has to work, to hold all of the story details in working memory, so you are enjoying this wonderful interaction with your child and at the same time, you’re working on sustained attention and working memory. So, that’s something that any parent can do and you don’t need to buy anything, you don’t need to have anything, it’s just you and the child.

In terms of interventions that people can use, it turns out that the best school programs like PATHS which was developed by Mark Greenberg, the Chicago School Readiness Program, Tools of the Mind in Montessori, and a couple of others show better results for improving executive functions than any computerized cognitive training. Cogmed is the best, shows the best results for working memory of any computerized cognitive approach but those promising school programs show better results than Cogmed or any of the others. A lot of people think that aerobic exercise or resistance training improves executive function and people who are more physically fit and more physically active show better executive functions but interventions that use aerobic exercise or resistance training generally do not help executive functions, so that’s kind of a contradiction. People who are more physically active or physically fit have better executive functions but aerobic interventions often do little to improve executive function, and I think one of the reasons you have that is because the people who are doing it as part of their life are doing something that they are committed to, that they are really enjoying. They are doing it because they are enjoying it whereas when we do aerobic exercise interventions, we randomly assign people to do what you could maybe care less and we often have them do arbitrary decontextualized things. They are not playing a sport but maybe they are dribbling a basketball in the gym but never playing basketball, so there’s not a lot of point to doing the exercises and we get better at anything when we have some reason for working at that. We’re going to use it to do something we care about, so I think that actual sports are going to show more benefits for executive function than isolated exercises in aerobic exercise intervention, but we don’t know. What we know so far is the things that seem to show the best results are promising school programs and mindfulness practices that involve movement like tai chi, tae kwon do, things like that. I don’t know why but they show much more benefit than physical activities that don’t have a mindfulness component and much more benefit than mindfulness activities that are primarily sedentary.

Sucheta: Can we break this down further a little bit? So, can you talk about these three programs, what is PATHS doing that is really working?

Adele: Well, PATHS does a lot of things but I’ll give you one example. So, it’s a socioemotional learning program that’s kind of an add on to the curriculum but one of the things they do in PATHS is they instruct the children, if they get upset at another child, set of hitting the other child, they should do like a turtle does get in there shall which means they should hold themselves very tightly, take a deep breath and think about what they should do, and that’s brilliant for two reasons: one is, if you tell a young child to wait and not do something, that does not compute. It doesn’t compute at all. You have to give the young child an alternative thing to do. So, if you say don’t do this but do that, they can do it, but if you say don’t do this, do nothing, just wait, they can’t. So, PATHS gives them something else to do, they get in a turtle. And the other thing is that what it tells them to do is actually a good way to calm yourself down, to hold yourself tightly, to take a deep breath are both things that help you calm down, and this works so well that the children take it home and when they see their parents start to get upset, they say, “Do turtle.”

Sucheta: That’s great.

Adele: So, the children really like it and it works very well. The Chicago School Readiness Program was originally done with Headstart teachers, so it had to be fairly easy because the Headstart teachers often don’t have very much training and again, it worked on socioemotional issues, it works specifically on training executive function, and the kids do better academically and have better executive function. Tools of the Mind is a program I’ve personally studied although I didn’t develop it. It was developed by Elena Bodrova and Deborah Leong, it’s based on the philosophy of Vygotsky and it has many components but one is the importance of play and developing executive function through play, especially social dramatic play, so for example, if you’re playing cops and robbers, you have to remember who is another robber and who’s the cop because you don’t want to accidentally tell the cop your plans for the robbery, and let’s say you are doing a family scenario and you picked that you’re going to be the baby in the family, you can’t all of a sudden get up and drive the fancy family car. You have to stay in character, you have to inhibit acting out of character, and your friends may take that play scenario in ways you never imagined, so on-the-fly in real time, you have to flexibly adjust. So, you’re using working memory, you’re using inhibitory control, you’re using cognitive flexibility, and you’re playing.

Sucheta: Wow. I love – I mean, of course, these are programs for younger children up to elementary, and of elementary school, but most of them are talking about these alternative ways of thinking, embedding emotional response to managing a real-life scenarios and also, I think these are some things, simple actions that are execution of double rather than just a philosophy of being a certain way.

Adele: Absolutely. Absolutely.

Sucheta: Right?

Adele: If you make it abstract, it really doesn’t help.

Sucheta: It’s lost.

Adele: You need concrete, you need specifics.

Sucheta: So, I work with children who are older than that and I see such a disconnect, so children get much more concrete instructions, opportunities to exercise and practice, and their multifaceted life management demands have not come on the scene yet, but when they enter middle school, high school, and college – I mean, enter middle school and then progress through higher grades, there is a lot of demand on multifaceted goal management and social emotional adjustments are more invisible, but demands on their skills is a way high, and I don’t see structured programs are processes being taught. There’s a lot more study skills kind of thing, there’s no discussion about emotional management in that. Secondly, that social interpersonal skill which eventually lead to self advocacy and strategy seeking or advice seeking are not embedded into everyday life but offered as a support, comments see me. Johnny, come and see me kind of prize, so what have you seen in older children? Do we know anything that works as successfully as the programs you were mentioning?

Adele: The Mindful Movement Activities,  so for example tai chi or tae kwon do, often, older children will really enjoy a martial art, it can be something that they are really invested in, they really care about,  and that can be excellent at teaching self-control, self-awareness, all of the executive functions. The real help with impulse control and thinking before you act can be so helpful in those programs, and the other thing again is to embed it in the academic subjects and you’re right, schools and teachers do this way too little. They just focus on content because content is what’s going to be on the exam instead of your ability to creatively problem-solve which we care about more but we don’t test for, but you have all kinds of teachable moments in your class, so when a child gets upset or a child does something to upset another child, that’s a teachable moment, and instead of doing it in a way that embarrasses a child or singles a child out, you can do it in a way where we can all learn. We are all struggling with things like this. How can we together problem-solve ways that would be better? Using your metacognition thing again, but now doing it as a class, let’s problem-solve here.

Sucheta: Wonderful. So, I know we are coming to the end of our time together, but as we close, have a very important question and I wish I had carved out more time, but you offer a unique perspective which you have been talking about which is markedly different from traditional medical practice, even like in hypothesizing the treating physical health without also addressing social and emotional health is less effective and efficient. So, the adults who are responsible for children should be really taking a look at their own executive function skills and their own adjustment to life pressures. What suggestions and advice do you have for parents and educators as they take care of dysfunction or moderately proficient function?

Adele: Well, for anybody, practice makes perfect, and often, as parents, we tend to say taking time to help ourselves feel selfish, we should just be doing for the family, and we need to appreciate that the family is going to be better if we take some time for ourselves because we’ll be able to be better parents and better spouses, and taking time to do some form of exercise, to do some form of mindfulness practice can really help with reducing stress and improving executive function. Stress is a real enemy to executive function and most of us are feeling stressed, and we need to take time to relieve that stress, to take time to decompress, to take time to just breathe deeply and relax, and it’s not being selfish, it’s not being self-centered, it’s making yourself be a better parent, be a better teacher, be more in the moment for being with the people you work with.

Sucheta: Well, thank you so much, I have not felt any stress as I have been with you and I feel I have – in fact, this has been my mindful moment, just to think about all the things I know about executive function and everything you have said, I’ve been thinking how does this match up with what I have conceptualized? Ooh, I need to tweak that or I need to add this perspective to it, so you’ve been an incredible asset to my own growth and my mindfulness. I’m going to pay more careful attention as I support those who rely on me to be their advisors and also, I think what’s so interesting that you mentioned, that the universality of these skills and how crucial they are for well-being beyond work, and we should be really taking the time to cultivate good habits, good mindset, and a collaborative thought process, I guess. So, truly, again, I’m so grateful for your time and your expertise and you finding time, I cannot tell you how happy that makes me, so thank you for being with me.

Adele: Oh, you’re very welcome, and you made some good points that made me think about things that I had been thinking about, and I think that all of us need to have more humility in the sense that none of us knows everything and all of us can contribute something and I think that’s been particularly important thinking about our students. As teachers, we tend to think that we have to solve the problems. Instead of thinking wait a minute, there may be 20 other minds in this room. Maybe together, we can come up with a better solution that I could have by myself. I think we need to open it up to hearing from everybody instead of just hearing from the so-called experts.

Sucheta: I love that. Well, thank you, my job for the day is done. I consulted a partner, so I’m set.

Adele: Well, thank you so much.

Producer: All right, that’s all the time we have for today. If you know of someone who will benefit from listening to this conversation, we would be most grateful if you would kindly forwarded to them, so on behalf of our host, Sucheta Kamath, today’s guest, Adele Diamond and all of us at Cerebral Matters, thanks for listening today and we look forward to seeing you again right here next week. We’ll see you then.