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Brown Efa Webinar Handouts 18 04 23
Brown Efa Webinar Handouts 18 04 23
An Overview of The
New Brown Executive
Function/Attention
Scales
(Brown EF/A Scales)
Welcome Everybody!
Change in
Understanding ADHD
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Attention Deficit
Hyperactivity Disorder
Executive Functions
Executive Functions:
“Will you do it and, if so, how
and when?”
(Lezak, 2004)
When?
Timing/Remembering
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Executive Functions:
Development and Demands
• EF capacity develops through childhood, into
adolescence, and beyond; it is not fully present in
early childhood
• Environmental demands for EF increase with
age, from preschool through adulthood
• EF impairments often are not noticeable
by age 12!
Model of Executive
Functions in ADHD
(Brown, Outside the Box: Rethinking ADD/ADHD. 2017, Attention Deficit Disorders, 2005)
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3
1. Organize, Prioritize, and Activate
(Brown, Outside the Box: Rethinking ADD/ADHD. 2017, Attention Deficit Disorders, 2005)
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• Easily distracted–internal/external
(Brown, Outside the Box: Rethinking ADD/ADHD. 2017, Attention Deficit Disorders, 2005)
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(Brown, Outside the Box: Rethinking ADD/ADHD. 2017, Attention Deficit Disorders, 2005)
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4
4. Manage Frustration, Modulate
Emotion
(Not included in DSM-V criteria)
(Brown, Outside the Box: Rethinking ADD/ADHD. 2017, Attention Deficit Disorders, 2005)
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(Brown, Outside the Box: Rethinking ADD/ADHD. 2017, Attention Deficit Disorders, 2005)
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(Brown, Outside the Box: Rethinking ADD/ADHD. 2017, Attention Deficit Disorders, 2005)
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Brown’s Model of Executive
Functions Impaired in ADHD
Symptom Characteristics
• Dimensional, not “all-or-nothing”
Everyone sometimes has some impairments in
these functions; in ADHD, it is a chronic,
severe impairment
• Situational variability: “If I’m interested”
Most persons with ADHD have a few activities
where ADHD impairments are absent
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Will Power
vs
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6
When Are ADHD
Impairments Noticeable
• Some are obvious very early and are
noticeable in preschool years
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Executive Functions
operate in dynamic, integrated
ways
• Most tasks requiring EF require integrated use of
multiple aspects of EF
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Assessing Executive
Function
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How Can Executive Function
Impairments of ADHD Be
Assessed?
• When ADHD was seen as just a disruptive
behavior disorder in childhood, diagnosis was
based on observing overt behavior
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What makes Brown EF/A Scales
different?
Focus on severity as opposed to frequency: Unlike other instruments,
items on the Brown EF/A scales focus on severity of specific problems
rather than frequency. This allow examinees to report more accurately
how much difficulty they experience with each specific symptom.
Available Forms
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Dimensions for Item Responses
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Cluster Items
The following slides illustrate the 6 clusters
included in the Brown EF/A Scales with some
items (similar to the Brown EF/A Scales) included
in each of the 6 clusters of executive functions
often impaired in individuals with ADHD more than
in most others of the same age.
1. Activation
• Feels overwhelmed
• Has difficulty setting priorities
• Procrastinates excessively
• Has difficulty getting organized
• Is slow to react
• Is excessively rigid; a perfectionist
• Is hard to wake up in the morning
• Misunderstands directions
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2. Focus
• Spaces out” when reading
• Becomes sidetracked easily
• Loses track in required reading; must reread
• Tries to pay attention but mind drifts
• Has difficulty grasping main idea in reading
• Gets lost in daydreaming
• Becomes distracted easily
• Stares off into spaced; seems “out of it”
• Doesn’t seem to be listening; gets complaints
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3. Effort
• Feels sleepy during day
• Needs extra time to complete tasks
• Is criticized as lazy
• Produces inconsistent quality of work
• Does not work to potential
• Begins but effort fades quickly
• Has sloppy, hard-to-read penmanship
• Needs reminders for tasks
• Does not finish tasks
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4. Emotion
• Is excessively impatient
• Is sensitive to criticism
• Becomes irritated easily; short-fused
• Has difficulty expressing anger
• Exhibits depressed mood
• Tends to be loner among peers
• Appears apathetic
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5. Memory
• Is excessively forgetful
• Intends to do things but forgets
• Makes repeated restarts in writing
• Misplaces words/letters in writing
• Loses track of items
• Has difficulty memorizing
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6. Monitoring and Self-Regulating
Action
• Hard to work on or play with one thing for a long
time, unless really fun
• Often butts in or interrupts
• Does papers too fast, hard to slow down enough
to be careful
• Often grabs things or starts without waiting for
permission or directions
• Parents complain about having to give same
direction repeatedly
• Does too much teasing, arguing, etc. after being
asked to stop it.
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www.BrownADHDclinic.com
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Questions or Comments
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http://www.pearsonclinical.com/brownefascales
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