Tarnow Articles

How Parents can Support Development of Self-Management Skills in the Brain

· What Are Self-Management Skills?

Self-Management skills include planning, organization, time management, working memory, and emotional control. These skills are a significant factor in various social, academic, and home-related problems as well as specific difficulties, such as learning differences, attention deficits, poor impulse control, and emotional reactivity. Self-management skills encompass the well-known executive functioning skills which, at a basic level, can be described as thinking before we act and deciding how to respond. Deficits in these skills are related to various areas of the brain and are primarily linked to a lack of synaptic activity.

· How Do Self-Management Skills Develop in the Brain?

These skills typically begin their development at 5 to 12 months of age. Infants and toddlers continue developing executive functioning based upon different experiences in the environment. The brain goes through two major developmental periods and extensive learning around ages 5 and 12. Following these periods of intense absorption of information, there are periods of consolidation, which reduces unused or unneeded connections. These changes in the brain can dramatically affect self-management if certain learning experiences are not applied and practiced.

· When Will I Notice Problems in Self-Management?

By preschool, specific skills are established, such as following simple directions (e.g., “get your clothes from the bathroom”) and inhibiting behaviors (e.g., biting, hitting, pushing). In early elementary, completing simple chores with reminders is an important development. By late elementary, children should be increasingly able to inhibit behaviors, such as temper tantrums and rude behaviors, bring items to and from school, and complete chores without reminders. Problems or delays during these various stages of development complicate the learning process, creating barriers and often relate to self-management problems.

· What are other signs?

Problems in specific areas of self-management often lead to a negative cycle of frustration, resentment, and guilt with children and their caregivers. Children with executive functioning problems can be extremely challenging for parents, families, and teachers. The frustration of “why can’t my child do what he/she is told?” is an ongoing battle for caregivers. Deficits in these skills can lead to numerous problems and effective intervention is important in building and maintaining self-management skills.

· Now What?

Through our parent-management sessions, we establish and build connections to increase and practice self-management skills. Individual strengths and weaknesses are identified, and treatment goals are developed that are specific to the child and family structure. At home, children and parents benefit from setting individualized goals for each child to work towards. Creating lists and visual aids (calendars, pictures, charts) can be helpful in tracking progress or determining areas for improvement. Appropriate prompting facilitates effective learning, and incentives such as stickers, tokens, or prizes can increase motivation to learn. An added bonus is the positive time spent together as skill-building games and activities play an important role in the treatment process.

Children with self-management difficulties do their best when their learning occurs in multiple environments, and they will need support in the school as well as the home. Academic success will require accommodations that are specific to the child, and realistic goals that the child and his/her teacher can set and monitor together. The diagram below displays some examples of specific objectives.

At the Tarnow Center, we embrace a collaborative and supportive intervention process. Our focus in therapy is to help the child develop and build the skills they need, while also teaching parents how to foster this same growth at home. In time, parents develop the competencies to provide effective intervention at home to practice and maintain self-management skills. Parents are an instrumental aspect of treatment, as they can provide the prompts and reinforcement needed to maintain skills through various phases of development. Parent sessions and parent-focused groups apply a structured approach to building executive functioning in the home and school environments, while also processing various strategies from other parents and obtaining support from people with similar experiences. Parent-training in family sessions and group sessions are available with Dr. Desireé Gallagher. For more information, please contact the Tarnow Center for an initial consultation.

Group therapy is one of our favorite venues in which to teach self-management skills. Group provides social context and social feedback from peers, which is invaluable for the child wanting to learn new skills. An aspect of group that we are excited to expand this fall is the Parents’ Group. Traditionally, we do these every six weeks or so to give parents a chance to learn about what their children are doing in group, and also to learn what the therapists are doing that is facilitating new learning. But we’ve gotten such positive feedback from parents over the years that we’ve decided to offer a weekly parents’ group concurrent with the children groups. These parent groups are an option available to parents whose children are already in a social skills group, and they will run at the same time as the children’s groups for your convenience. Dr. Gallagher will run the parent groups for Dr. Peacock’s child and adolescent groups, and Dr. Peacock will run the parent groups for Dr. Gallagher’s child and adolescent groups. We will also offer a stand-alone Parents Group for those of you whose children are not enrolled in a group, but who would like to learn and get support from other parents and professionals.