Affiliation:
1. Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO, USA
2. Center for Autism Spectrum Disorders, Children's National Hospital, Washington, DC, USA
3. Inpatient Rehabilitation, Inova Fairfax Hospital, Fairfax, VA, USA
4. Pediatric Mental Health Institute, Children's Hospital of Colorado, Aurora, CO, USA
Abstract
Executive function (EF) challenges, including difficulties with cognitive flexibility, planning/ organization, and emotional control, are common in neurodivergent children. We developed the Behavioral Observation of Classroom Executive Functioning (BOCEF) tool to examine observable EF-related behaviors of elementary students and EF-supporting strategies of their teachers. The BOCEF student score correlated significantly with teacher-completed ratings of similar behaviors. Autistic students ( n = 48) and students with ADHD ( n = 98) were rated as having similar rates of several EF-related behaviors, while autistic students were rated as significantly more likely to get “stuck.” Teachers were found to be more likely to display strategies of planning, clear instructions, and visual supports, and less likely to utilize favorable praise to correction ratios, transition priming, flexibility, rule referencing, or behavioral reward systems. Praise was the teacher strategy found to have the greatest association with student behavior. Implications for student accommodation/support and teacher training are discussed. Lay abstract Autistic children and children with ADHD often have difficulties with thinking flexibility, planning, and managing frustration. We developed a tool called the Behavioral Observation of Classroom Executive Functioning (BOCEF) to evaluate how children struggle with these executive functioning behaviors in the classroom, and how often teachers are using strategies known to support these behaviors. Our ratings of students on the BOCEF were similar to how teachers rated these same types of behaviors in these students. Autistic students ( n = 48) and students with ADHD ( n = 98) were rated as having similar rates of difficulties in the classroom, with the exception that autistic students got “stuck” more often, meaning they had more difficulty moving on from specific ideas or topics. Teachers were found to be more likely to display strategies of planning, clear instructions, and visual supports, and less likely to utilize adequate praise, warnings prior to transitions, flexibility, rule referencing, or behavioral reward systems. Praise was the teacher strategy found to be most related to student behavior. Findings from this study indicate the BOCEF could be helpful for schools to determine how much these types of challenges are impacting neurodivergent students in the classroom. Additional teacher training on incorporating praise and other ways to support neurodivergent students in the classroom is also likely to be important moving forward.
Funder
Patient-Centered Outcomes Research Institute
NIMH