Module 3E: Session Handouts Brain Power: How Language Nurtures and Trauma Impairs Contents Pre- and Post-Assessment...... 2 5 Steps for Brain-Building Serve and Return ...... 3 Enhancing and Practicing Executive Function Skills with Children from Infancy to Adolescence ...... 5 The Brain Architecture Game ...... 22 Understanding Adverse Childhood Experiences ...... 30 In addition to these handouts, you will need the list of materials included in the Brain Architecture Game Instructions. Brain Architecture Game Life Experience Cards may be ordered or downloaded for $99 at: dev.thebrainarchitecturegame.com/get-a-copy/buy-download.

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5 from Filming Interactions Steps for Brain-Building to Nurture Development Serve and Return (find)

Child-adult relationships that are responsive and attentive—with lots of back and forth interactions—build a strong foundation in a child’s brain for all future learning and development. This is called “serve and return,” and it takes two to play! Follow these 5 steps to practice serve and return with your child.

Serve and return 1 2 interactions make everyday moments fun Notice the serve and Return the serve and become second share the child’s focus by supporting and nature with practice. of attention. encouraging.

By taking small moments during Is the child looking or pointing at You can offer children comfort with a the day to do serve and return, something? Making a sound or facial hug and gentle words, help them, play you build up the foundation expression? Moving those little arms with them, or acknowledge them. You for children’s lifelong learning, and legs? That’s a serve. The key is can make a sound or facial expression— behavior, and health—and their to pay attention to what the child is like saying, “I see!” or smiling and skills for facing life’s challenges. focused on. You can’t spend all your nodding to let a child know you’re time doing this, so look for small noticing the same thing. Or you can pick For more on serve and return: tinyurl.com/serve-return opportunities throughout the day—like up an object a child is pointing to and while you’re getting them dressed or bring it closer. waiting in line at the store.

Filming Interactions to Nurture WHY? Supporting and encouraging

Development (FIND) is a video WHY? By noticing serves, you’ll rewards a child’s interests and curiosity. coaching program that aims to learn a lot about children’s abilities, Never getting a return can actually be strengthen positive interactions interests, and needs. You’ll encourage stressful for a child. When you return a between caregivers and children. them to explore and you’ll strengthen serve, children know that their thoughts FIND was developed by Dr. Phil Fisher the bond between you. and feelings are heard and understood. and colleagues in Eugene, Oregon. For more about FIND: tinyurl.com/find-program

developingchild.harvard.edu page 1 of 2 5 from Filming Interactions Steps for Brain-Building to Nurture Development Serve and Return (find) Did you know that building a child’s developing brain can be as simple as playing a game of peek-a-boo?

3 4 5 Give it Take turns…and wait. Practice a name! Keep the interaction endings and going back and forth. beginnings.

When you return a serve by naming Every time you return a serve, give the Children signal when they’re done or what a child is seeing, doing, or child a chance to respond. Taking turns ready to move on to a new activity. feeling, you make important language can be quick (from the child to you and They might let go of a toy, pick up a connections in their brain, even before back again) or go on for many turns. new one, or turn to look at something the child can talk or understand your Waiting is crucial. Children need time to else. Or they may walk away, start words. You can name anything—a form their responses, especially when to fuss, or say, “All done!” When you person, a thing, an action, a feeling, or they’re learning so many things at once. share a child’s focus, you’ll notice when a combination. If a child points to their Waiting helps keep the turns going. they’re ready to end the activity and feet, you can also point to them and say, begin something new.

“Yes, those are your feet!” WHY? Taking turns helps children learn self-control and how to get along WHY? When you can find moments WHY? When you name what children with others. By waiting, you give for children to take the lead, you are focused on, you help them children time to develop their own support them in exploring their world— understand the world around them ideas and build their confidence and and make more serve and return and know what to expect. Naming also independence. Waiting also helps you interactions possible. gives children words to use and lets understand their needs. them know you care.

developingchild.harvard.edu page 2 of 2 Enhancing and Practicing Executive Function Skills with Children from Infancy to Adolescence Introduction

Executive function and self-regulation skills provide critical supports for learning and development. Just as an air traffic control system at a busy airport manages the arrivals and departures of many aircraft on multiple runways, For more resources on executive function skills allow us to retain executive function from the Center on the De- and work with information in our brains, veloping Child, please focus our attention, filter distractions, go to: developingchild. harvard.edu and switch mental gears. There are three basic dimensions of these skills: n Working memory — The ability to hold informa- In infancy, interactions with adults help babies tion in mind and use it. focus attention, build working memory, and manage reactions to stimulating experiences. n Inhibitory control — The ability to master Through creative play, games, and schoolwork, thoughts and impulses so as to resist tempta- children practice integrating their attention, tions, distractions, and habits, and to pause and working memory, and self-control to support think before acting. planning, flexible problem-solving, and sus- n Cognitive flexibility— The capacity to switch tained engagement. By high school, students gears and adjust to changing demands, priorities, are expected to organize their time (largely) or perspectives. independently, keep track of their assignments, and manage projects to completion. These skills help us remember the information we need to complete a task, filter distractions, resist As children develop these capacities, they need inappropriate or non-productive impulses, and practice reflecting on their experiences, talking sustain attention during a particular activity. We about what they are doing and why, monitoring use them to set goals and plan ways to meet them, their actions, considering possible next steps, assess our progress along the way, and adjust the and evaluating the effectiveness of their deci- plan if necessary, while managing frustration so we sions. Adults play a critical role in supporting, or don’t act on it. “scaffolding,” the development of these skills, first by helping children complete challenging tasks, Although we aren’t born with executive function and then by gradually stepping back to let children skills, we are born with the potential to develop manage the process independently—and learn from them. The process is a slow one that begins in their mistakes—as they are ready and able to do so. infancy, continues into early adulthood, and is shaped by our experiences. Children build their The activities that follow have been identified skills through engagement in meaningful social as age-appropriate ways to strengthen various interactions and enjoyable activities that draw components of executive function. Although on self-regulatory skills at increasingly demand- scientific studies have not yet proven the effec- ing levels. tiveness of all these suggestions, their presence here reflects the judgment of experts in the field about activities that allow children to practice Acknowledgements their executive function skills. Practice leads to improvement. These activities are not the only The Center on the Developing Child wishes to ex- ones that may help; rather, they represent a tend deep thanks to Jocelyn Bowne for drafting sample of the many things children enjoy that this manuscript. Thanks also go to Maia Barrow, can support healthy development. Silvia Bunge, Deborah Leong, and Philip Zelazo for their thoughtful feedback and suggestions. Finally, please note that when websites and prod- Their expertise was invaluable in compiling ucts are referenced in these activity suggestions, these games and activities. Any errors or omis- it is because they are helpful resources or ex- sions are the sole responsibility of the Center on amples. Their inclusion does not imply endorse- the Developing Child. ment, nor does it imply that they are the only, or necessarily the best, resources. developingchild.harvard.edu 1 Executive Function Activities for 6- to 18-month-olds

These activities encourage infants to focus attention, use working memory, and practice basic self-control skills. During this stage of development, infants are actively developing their core executive function and self-regulation (EF/SR) skills. Supportive, responsive interactions with adults are the foundation for the healthy development of these skills. However, particular activities can strengthen key components of EF/SR. In using these activities, adults should attend to the infant’s interests and select activities that are enjoyable, while also allowing the infant to determine how long to play.

Lap games for younger infants to reveal him or herself. In other versions, the Generations of families have engaged babies baby controls the timing of the reveal; this pro- in games while holding them in the lap. Differ- vides important practice regulating the tension ent games practice different skills, but all are around an expected surprise. predictable and include some basic rules that n Trot, Trot to Boston; This is the Way the guide adult and child behavior. Repetition Farmer Rides; Pat-a-Cake — Predictable helps infants remember and manage their own rhymes that end with a stimulating yet ex- behavior to fit the game’s rules. pected surprise are well-loved. Infants exercise n Peekaboo — Hide-and-find games like this working memory as they develop familiarity exercise working memory, because they chal- with the rhyme and practice anticipating a lenge the baby to remember who is hiding, and surprise, inhibiting their anticipatory reactions they also practice basic self-control skills as, while managing high levels of stimulation. in some variations, the baby waits for the adult

Hiding games n Older infants may enjoy hiding themselves Hiding games are a great way to challenge and listening to you search loudly for them working memory. while they track your location mentally. n You can also hide an object without showing n Hide a toy under a cloth and encourage the an older infant where it is and then allow the infant to look for it. Once infants can find the infant to search for it. He or she will practice toy quickly, hide it, show the child that you keeping track of searched locations. have moved it, and encourage the child to find it. Make more moves to increase the challenge. n Another challenging version of these games As the child remembers what was there and involves putting a set of cups on a turntable (or mentally tracks the move, he or she exercises “lazy Susan”), hiding an object under a cup, working memory. then spinning the turntable. Hiding more than one object can also increase the challenge. developingchild.harvard.edu 2 Imitation or copying games animals in a barnyard) or building simple build- EXECUTIVE FUNCTION ACTIVITIES FOR Infants love to copy adults. When they imi- ings by putting one block on top of another 6- TO 18-MONTH-OLDS tate, they have to keep track of your actions, and perhaps knocking them down to rebuild. remember them, wait their turn, and then recall n As infants’ skills improve, make the patterns what you did. In doing so, they practice atten- they copy more complicated. tion, working memory, and self-control. n Adults can also demonstrate ways to play n These games have a variety of forms, from with toys, like making a toy horse gallop or taking turns making simple gestures (e.g., rocking a baby doll. This introduces the con- waving) to organizing toys in certain ways and cept of using toys as symbols for real objects. asking children to copy you (e.g., placing toy

Simple role play activity in mind to complete it while avoiding Older children in this age range enjoy doing the distractions and inhibiting the impulse to do tasks they see you do. other things. n Take turns with any activity that interests n Children can remember and play out more the child, such as sweeping the floor, picking complicated roles as they get older. They will up toys, dusting, etc. These games introduce also begin to initiate activities. Providing the the basics of imaginary play and practice necessary materials (e.g., a broom, a toy box, a working memory, self-control, and selective dustcloth) can help children enjoy and sustain attention, because the toddler must hold the this type of play.

Fingerplays Songs or chants with simple hand motions are a lot of fun for infants, and develop self-control and working memory as well as language. Infants can learn to copy the movements to a song and, with practice, will remember the se- quence. Eensy Weensy Spider; Where is Thumb- kin?; and Open, Shut Them are examples, but these fingerplays can be found in many languages and cultures.

Conversations talking about interesting objects or events Simply talking with an infant is a wonderful can help them learn to focus their attention way to build attention, working memory, and on something the adult has identified. As self-control. babies learn language, they also develop their memory of what is said, eventually mapping n With younger infants, start by following words to objects and actions. the infant’s attention and naming aloud the things holding his or her attention. The infant n Conversations in any language besides will likely maintain his or her attention a little English are also helpful. It has been found that longer, practicing actively focusing and sustain- bilingual children of many ages have better ing attention. executive function skills than monolingual children, so experience using an additional n As infants get older, pointing out and language is an important skill.

Resources Songs and games n www.piercecountylibrary.org/files/library/wigglesticklesall.pdf n www.turben.com/media-library/8702756_infanttoddlerplaybook.pdf n www.zerotothree.org/child-development/grandparents/play-0-12-mths-final.pdf developingchild.harvard.edu 3 Executive Function Activities for 18- to 36-month-olds

During this stage of development, children are rapidly expanding their language skills. Language plays an important role in the development of executive function and self-regulation (EF/SR), as it helps children identify their thoughts and actions, reflect on them, and make plans that they hold in mind and use. Language also helps children understand and follow increasingly complex rules—both those that regulate behavior and those that apply to simple games. Additionally, bilingualism is associated with better EF/SR, so parents who are fluent in more than one language should use those languages with their children.

Active games song games that require children to start and At this age, toddlers are actively developing stop, or slow down and speed up, such as Jack many important physical skills, and they love in the Box; Popcorn; Ring Around the Rosie; or physical challenges. The following activities Motorboat, Motorboat. require toddlers to focus and sustain their n Song games with many movements are also attention on a goal, inhibit unnecessary and in- fun. Examples include The Hokey Pokey; Teddy effective actions, and try things in new ways if Bear; I’m a Little Teapot; or Head, Shoulders, a first attempt fails. They may not always suc- Knees, and Toes. These require children to ceed, but the practice is very important. This is attend to the song’s words and hold them in a learning process. Many of these activities will working memory, using the song to guide their require frequent reminders from adult organiz- actions. ers, and they may not last very long! n Fingerplays, or songs and rhymes with n Provide many materials and opportunities hand gestures to match, continue to be popu- to try new skills, such as throwing and catching lar with children this age, similarly challenging balls, walking a balance beam, running up and children’s attention, working memory, and down an incline, jumping, etc. Set up simple inhibitory control. rules to follow for added working memory and inhibition challenges—for example, take turns running to a “finish line” and back. n Older toddlers can enjoy simple imita- tion games, such as Follow the Leader, or song games like Punchinella or Follow, Follow (“Follow, follow, follow [child’s name], follow, follow, follow [child’s name]”—all children imi- tate [child]). These are great tests of working memory as well as attention and inhibition. n Games that require active inhibition can be fun, too, like freeze dance (musical statues), although don’t expect children to “freeze” without a few reminders. Also effective are developingchild.harvard.edu 4 Conversation and storytelling experience must be held in working memory EXECUTIVE FUNCTION ACTIVITIES FOR As children develop more spoken language while the child considers the order in which 18- TO 36-MONTH-OLDS skills, they can begin to engage actively in con- things happened, why things happened the versation with adults and tell simple stories. way they did, and what the experience meant. These stories can also be written or drawn into n Simply watching and narrating their play simple books and revisited. can be a great way to help very young children understand how language can describe their n Talking about feelings is also important, actions. As children get older, questions can either by labeling children’s feelings as they are be added, such as “What will you do next?” or noticed (“It looks like you are really angry right “I see you want to put the ball inside the jar. Is now”) or by telling the story of a time a child there another way to do that?” These com- became upset. By giving children language to ments help children pause to reflect on what reflect on their feelings, these conversations they are trying to do, how what they have tried can support the development of emotional has worked, and how to plan their next move. regulation, which is essential for engaging executive function. n Telling stories about shared events can be a great way to reflect on these experiences. The

Matching/sorting games Children tend to put like with like, so a change Children this age are able to play simple match- is challenging, requiring them to inhibit the ing and sorting games, which require children expected action and engage their selective at- to understand the rule that organizes the activ- tention and working memory. ity (sorting by shape, color, size, etc.), hold the n As they get older, toddlers also start to rule in mind, and follow it. enjoy simple puzzles, which require attention n Ask children to play a sorting game in which to shapes and colors. Adults can ask chil- you take turns sorting objects by size, shape, dren to think about what shape or color they or color. need, where they might put a certain piece, or where they might put the piece if it doesn’t fit, n Engage older toddlers in a silly sorting thereby exercising the child’s reflection and game, such as putting small shapes in a big planning skills. bucket and big shapes in a small bucket.

Imaginary play n Ask children questions about what they are Toddlers are beginning to develop the capac- doing. Narrate the things you see happening. ity for simple imaginary play. Often, toddlers n Play along with the child, and let the child imitate adult actions using objects that they direct the play. Give the child a chance to tell have available (such as sweeping with a broom you what role you should play and how you or pretending to cook with a pot). When they should do it. Regulating the behavior of others reach this age, these actions are not simply imi- is an important way that children develop their tative, but can be sustained and show signs of own self-regulation skills. simple imaginary play plots. For example, after “cooking” in the pot, the child will put the pot n Provide a variety of familiar household on the table and pretend to eat. objects, toys, and clothing items to encourage children’s imaginary play.

Resources n www.zerotothree.org/child-development/ Music grandparents/play-24-36-final.pdf n fun.familyeducation.com/toddler/mu- Pretend play suggestions sic/37371.html n www.mindinthemaking.org/wp-content/ Other activities uploads/2014/10/PFL-playing-with-household- n www.zerotothree.org/child-development/ items.pdf grandparents/play-12-24-final.pdf developingchild.harvard.edu 5 Executive Function Activities for 3- to 5-year-olds

Children’s executive function and self- regulation skills grow at a fast pace during this period, so it is important to adapt activities to match the skills of each child. Younger children need a lot of support in learning rules and structures, while older children can be more independent. Ultimately, the goal is to shift children away from relying on adult regulation, so when the child seems ready, try to reduce the support you provide.

Imaginary play older children can re-purpose other things to During intentional imaginary play, children turn them into play props (e.g., paper towel develop rules to guide their actions in playing tube that is used as a cast for a “broken arm”). roles. They also hold complex ideas in mind Reusing familiar objects in a new way also and shape their actions to follow these rules, practices cognitive flexibility. inhibiting impulses or actions that don’t fit the n Allow children to make their own play “role.” Players often take ideas from their own props. Children must determine what is lives, such as going to the doctor’s office. They needed, hold this information in mind, and might act “sick,” be examined by the doctor, then follow through without getting distracted. and receive a shot. The “doctor” talks and acts They also exercise selective attention, work- like a doctor (calm and reassuring), the “sick ing memory, and planning. If the original plans child” talks and acts like a sick child (sad and don’t work out, children need to adjust their scared), and the child in the role of “parent” ideas and try again, challenging their cognitive talks and acts like a concerned parent (wor- flexibility. ried and caring). While younger children tend to play alone or in parallel, children in this n Play plans can be a good way to organize age range are learning to play cooperatively play, as shown by one early education program and often regulate each other’s behavior—an designed to build self-regulation, Tools of the important step in developing self-regulation. Mind. Children decide who they are going to be and what they are going to do before they Ways to support high-level imaginary play: start playing, and then draw their plan on n Read books, go on field trips, and use videos paper. Planning means that children think first to make sure that children know enough about and then act, thus practicing inhibitory control. the scenario and roles to support pretend play. Planning play in a group also encourages children to plan together, hold these plans in n Provide a varied set of props and toys mind, and apply them during the activity. It to encourage this type of play. Younger pre- encourages social problem solving, as well as schoolers may need more realistic props to get oral language. the play started (e.g., toy medical kits), while

Storytelling Ways to support children’s storytelling: Children love to tell stories. Their early stories n Encourage children to tell you stories, tend to be a series of events, each one related to and write them down to read with the child. the one before, but lacking any larger structure. Children can also make pictures and create With practice, children develop more complex their own books. Revisiting the story, either by and organized plots. As the complexity of the reviewing pictures or words, supports more in- storytelling grows, children practice holding and tentional organization and greater elaboration. manipulating information in working memory. continued developingchild.harvard.edu 6 n Tell group stories. One child starts the story, children’s actions and requires them to attend EXECUTIVE FUNCTION and each person in the group adds something to the story and follow it, while inhibiting their ACTIVITIES FOR to it. Children need to pay attention to each impulse to create a new plot. 3- TO 5-YEAR-OLDS other, reflect on possible plot twists, and tailor n Bilingual families can tell stories in their their additions to fit the plot, thereby challenging home language. Research indicates that bilin- their attention, working memory, and self-control. gualism can benefit a variety of executive func- n Have children act out stories they have writ- tion skills in children of all ages, so fostering ten. The story provides a structure that guides fluency in a second language is valuable.

Movement challenges: lation and focus attention—such as using a songs and games balance beam or yoga poses that include slow breathing. The demands of songs and movement games support executive function because children n Play some music and have children dance re- have to move to a specific rhythm and syn- ally fast, then really slowly. Freeze dance is also chronize words to actions and the music. All of fun, and it can be made more difficult by asking these tasks contribute to inhibitory control and children to freeze in particular positions. (Tools working memory. It is important that these of the Mind uses stick-figure pictures to direct songs and games become increasingly com- children.) When the music stops, children must plex to interest and challenge children as they inhibit action and shift their attention to the develop more self-regulation skills. picture to imitate the shape depicted. n Provide many opportunities for children to n Songs that repeat and add on to earlier test themselves physically through access to sections (either through words or motions) are materials such as climbing structures, balance a great challenge to working memory, such as beams, seesaws, etc. Setting challenges for the motions to She’ll Be Coming ’Round the children—such as obstacle courses and games Mountain, the words to Bought Me a Cat, and that encourage complex motions (skipping, backward-counting songs, such as Five Green balancing, etc.)—can also be fun. When chil- and Speckled Frogs and songs repeating a long dren are trying new and difficult activities, they list (the Alphabet Song). need to focus attention, monitor and adjust n Traditional song games, like Circle ’Round their actions, and persist to achieve a goal. the Zero are also fun. Complex actions, includ- n Encourage attention control through quieter ing finding partners, must be accomplished activities that require children to reduce stimu- without becoming distracted.

Quiet games and other activities by the leader (e.g., for “day,” putting a chip on n Matching and sorting activities are still fun, a nighttime picture). Children have to inhibit but now children can be asked to sort by differ- the tendency to mark the picture that matches, ent rules, promoting cognitive flexibility. Chil- while also remembering the game’s rule. dren can first sort or match by one rule (such as n Increasingly complicated puzzles can engage by color), and then immediately switch to a new children this age, exercising their visual work- rule (such as by shape). For a more challeng- ing memory and planning skills. ing version, play a matching game, but change the rule for each pair. Quirkle and S’Match are n Cooking is also a lot of fun for young chil- commercially available games that challenge dren. They practice inhibition when waiting for cognitive flexibility in this way. Or play a bingo instructions, working memory while holding or lotto game, in which children have to mark complicated directions in mind, and focused a card with the opposite of what is called out attention when measuring and counting.

Resources Pretend play suggestions Montessori activities – Songs n www.mindinthemaking.org/ Walking on the line n kids.niehs.nih.gov/games/ wp-content/uploads/2014/10/ n www.infomontessori.com/ songs/childrens/index.htm PFL-4-year-old-independent- practical-life/control-of-move- play.pdf ment-walking-on-the-line.htm developingchild.harvard.edu 7 Executive Function Activities for 5- to 7-year-olds

Games can exercise children’s executive function and self-regulation skills—and allow them to practice these skills—in different ways. At this age, children start to enjoy games that have rules, but do so with widely varying levels of interest and skill. Since an important aspect of developing these skills is having a constant challenge, it’s important to choose games that are demanding but not too hard for each child. As the child players become familiar with these games, try to decrease the adult role as soon as possible; the challenge is greater for children if they remember and enforce the rules independently. Just be prepared with some techniques for negotiating conflict. Flipping a coin or drawing a straw are some methods used by Tools of the Mind, an early education program designed to build self-regulation.

Card games and board games n Games that require fast responses and n Games that require players to remember monitoring are also great for challenging atten- the location of particular cards are great at tion and inhibition. Snap and Slapjack are card exercising working memory. At the simplest games that fall into this category. Perfection level, there are games such as Concentration, draws on similar skills. in which children uncover cards and have to n Any board game that involves some strategy remember the location of matches. At a more provides important opportunities to make and complicated level are games that require track- hold a plan in mind for several moves ahead, ing types of playing cards as well as remem- consider the varying rules that govern differ- bering their locations, including Go Fish, Old ent pieces, and adjust strategy in response to Maid, Happy Families, and I Doubt It. opponents’ moves. Through strategizing, a n Games in which the child can match playing child’s working memory, inhibitory control, and cards, either by suit or number, are also good flexibility have to work together to support at practicing cognitive flexibility. Examples in- plan-based, effective play. Sorry!, Battleship, clude Crazy Eights, Uno, and Spoons. Blink and Parcheesi, mancala, checkers, and Chinese SET are newer card games in which cards can checkers are some of the many examples of be matched on more than two dimensions. these types of games for children this age.

Physical activities/games who is “It” to mentally track others’ move- n Games that require attention and quick ments, challenging working memory as well; responses help children practice attention and these games include Mother May I? and What inhibition. They include freeze dance (musical Time Is It, Mr. Fox? Others require selective re- statues); musical chairs; Red Light, Green Light; sponses and test inhibition, such as the Magic or Duck, Duck, Goose for younger children. Word Game, in which children wait for a “magic Some of these games also require the person word” to start an action. continued developingchild.harvard.edu 8 n Fast-moving ball games, such as four n Children are now old enough to enjoy struc- EXECUTIVE FUNCTION square, dodgeball, and tetherball, require tured physical activities, such as organized ACTIVITIES FOR constant monitoring, rule following, quick sports. Games that require coordination and 5- TO 7-YEAR-OLDS decision-making, and self-control. provide aerobic exercise, such as soccer, have been shown to support better attention skills. n Simon Says is another great game for at- Physical activities that combine mindfulness tention, inhibition, and cognitive flexibility, as and movement, such as yoga and Tae Kwon the child has to track which rule to apply and Do, also help children develop their ability to switch actions, as appropriate. Other versions focus attention and control actions. are the Australian Do This, Do That or the varia- tion, Do As I Say (Not As I Do).

Movement/song games games of Packing for a Picnic or Packing a n Copy games, in which the person imitat- Suitcase for Grandma’s fall in this category, too. ing has to hold in mind the model’s actions, Older children can enjoy the added challenge draw on working memory. Punchinella is one of alphabetizing the list. example, with the model watching during the n Singing in rounds is a challenge for older second verse (“I can do it, too”). Call-and- children that requires use of working memory response songs provide a similar auditory and inhibition. Row, Row, Row Your Boat is a challenge, like Boom Chicka Boom and I Met a simple round to start with, but there are many Bear. with greater complexity. n Songs that repeat and add on to earlier sec- n Complicated clapping rhythms also practice tions (either through words or motions) also working memory, inhibition, and cognitive flex- challenge working memory, like the motions to ibility, and have been popular with generations She’ll Be Coming ’Round the Mountain, or the of children in many cultures. Miss Mary Mack words to Bought Me a Cat. The classic memory and Down Down Baby are familiar examples.

Quiet activities requiring old favorite that now has a simpler version for strategy and reflection younger children. Educational online game sites provide many similar activities as well. n Children become increasingly independent at this age, and puzzle and brain teaser books n Guessing games are also popular and that include mazes, simple word finds, match- require players to use working memory and ing games, etc., exercise attention and prob- flexible thinking to hold in mind previous lem-solving skills (requiring working memory responses while they develop and discard and cognitive flexibility). potential theories. Some examples are 20 Questions or Guess My Rule (often played with n Logic and reasoning games, in which rules blocks of different colors, sizes, and shapes, about what is possible need to be applied to so that children try to guess which attribute, or solve puzzles, start to become interesting and set of attributes, defines the rule for the set). provide great working memory and cognitive flexibility challenges. ThinkFun, a game and n I Spy and the books derived from this game puzzle company, provides some appealing and require children to think about categorization age-appropriate versions with Traffic Jam and and use selective attention in searching for the Chocolate Fix, while Mastermind is another correct type of object.

Resources Fun songs Online games n www.scoutsongs.com n www.coolmath.com ThinkFun n pbskids.org/lab/games n www.thinkfun.com Game rules Tools of the Mind n www.pagat.com n www.toolsofthemind.org n en.wikipedia.org/wiki/List_of_traditional_ Helping your child manage social play children%27s_games n mindinthemaking.org/wp-content/up- loads/2015/03/PFL-stubborn-play-schoolage.pdf developingchild.harvard.edu 9 Executive Function Activities for 7- to 12-year-olds

These games provide challenges and practice for executive function and self-regulation skills among school-age children. For children in this age range, it is important to steadily increase the complexity of games and activities.

Card games and board games n Card games in which children have to track playing cards exercise working memory and promote mental flexibility in the service of planning and strategy. Hearts, spades, and bridge are popular examples. n Games that require monitoring and fast re- sponses are great for challenging attention and quick decision-making in children at this age. Spit, for example, requires attending to your own play as well as your opponents’ progress. n For younger children, card games requiring matching by either suit or number continue to test cognitive flexibility. Rummy games, including gin rummy, are popular examples. Games with more complicated sets of options, such as poker and mahjong, may challenge a yearly competition testing new games, and older children. provides an interesting list of favorites. n Any game involving strategy provides impor- n Children this age also enjoy more complex tant practice with holding complicated moves games involving fantasy play, which require in mind, planning many moves ahead, and then holding in working memory complicated adjusting plans—both in response to imagined information about places visited in imaginary outcomes and the moves of opponents. With worlds, rules about how characters and ma- practice, children can develop real skill at clas- terials can be used, and strategy in attaining sic games of strategy like Go or chess, while self-determined goals. Minecraft is a popular challenging working memory and cognitive computer game of this sort, while Dungeons & flexibility. Many more modern strategy games Dragons is a longtime card-based favorite. exist as well. Mensa, the high IQ society, holds

Physical activities/games n Various jump rope games also become n Organized sports become very popular for popular among children of this age. Children many children during this period. Developing can become very skilled at jump rope, double skill at these games practices children’s ability Dutch, Chinese jump rope, and other such chal- to hold complicated rules and strategies in lenges. Developing skill in these games requires mind, monitor their own and others’ actions, focused practice, as well as the attention control make quick decisions and respond flexibly to and working memory to recall the words of the play. There is also evidence that high levels chant while attending to the motions. of physical activity, particularly activity that n Games that require constant monitoring of requires coordination, like soccer, can improve the environment and fast reaction times also all aspects of executive function. challenge selective attention, monitoring, and continued developingchild.harvard.edu 10 inhibition. For younger children, hiding/tag violent content, so care should be taken in EXECUTIVE FUNCTION games, particularly those played in the dark, selecting appropriate options and setting rea- ACTIVITIES FOR like flashlight tagand Ghost in the Graveyard, sonable time limits. Common Sense Media, a 7- TO 12-YEAR-OLDS are fun. Older children may enjoy games like non-partisan media information organization, laser tag and paintball. Many video games also provides useful reviews of popular games. provide practice of these skills, but can include

Music, singing, and dance n Learning to play a musical instrument can test selective attention and self-monitoring. In addition to the physical skill required, this ac- tivity challenges working memory to hold the music in mind. There is also some evidence that the practice of two-handed coordination supports better executive function. n Whether or not children learn an instru- ment, participating in music classes or com- munity events can still require them to follow rhythmic patterns, particularly when improvi- sation is involved (e.g., clapping or drumming). This can challenge their coordination of work- ing memory, attention, cognitive flexibility, and adults can present them with steadily increas- inhibition. ing challenges. n Singing in parts and rounds, as is done in n Dancing, too, provides many opportuni- children’s singing groups, is also a fun chal- ties to develop attention, self-monitoring, lenge, requiring a similar coordination of and working memory, as dancers must hold working memory, monitoring, and selective choreography in mind while coordinating their attention. As children’s musical skills grow, movements with the music.

Brain teasers works with numbers and equations rather than Puzzles that require information to be held and letters and words. manipulated in working memory can be terrific n Classic spatial puzzles like Rubik’s Cube challenges. require children to be mentally flexible and n Crossword puzzles are available for all skill consider spatial information in devising poten- levels and draw on manipulation of letters and tial solutions. words in working memory as well as cognitive n Cogmed and Lumosity provide computer flexibility. game puzzles and challenges that are designed n Sudoku provides a similar challenge but to exercise working memory and attention.

Resources Other programs Common Sense Media n www.cogmed.com n www.commonsensemedia.org n www.lumosity.com n www.commonsensemedia.org/game-reviews Tips for using video games List of winning games from American Mensa’s n www.mindinthemaking.org/wp-content/up- Mind Games competitions loads/2014/10/PFL-learning-and-videogames. n mindgames.us.mensa.org/about/winning- pdf games/

developingchild.harvard.edu 11 Executive Function Activities for Adolescents

During adolescence, executive function skills are not yet at adult levels, but the demands placed on these skills often are. Teenagers need to communicate effec- tively in multiple contexts, manage their own school and extracurricular assign- ments, and successfully complete more abstract and complicated projects. Here are some suggestions for helping teens practice better self-regulation throughout the daily challenges they face.

Goal setting, planning and monitoring Self-regulation is necessary in any goal- directed activity. Identifying goals, planning, monitoring progress, and adjusting behavior are important skills to practice. n To focus the planning process, encourage teens to identify something specific that they want to accomplish. Most important is that the goals are meaningful to the teen and not established by others. For some teens, planning the college application process may be self-mo- tivating, but for others, planning a social event may be more important. Start with something n Taking on large social issues, such as fairly simple and achievable, such as getting a homelessness, domestic violence, or bully- driver’s license or saving money to buy a com- ing can be both appealing and overwhelming puter, before moving on to longer-term goals to teens. DoSomething.org and Volunteer- like buying a car or applying to colleges. Match.org can help identify concrete actions. n Help teens develop plans for steps to reach n Remind adolescents to periodically monitor these goals. They should identify short- and their behavior and consider whether they are long-term goals and think about what has to doing the things they planned and whether be done to achieve them. For example: If teens these plans are achieving the goals they iden- want their team to win the sports champion- tified. “Is this part of the plan? If not, why am ship, what skills do they need to learn? How I doing it? Has something changed?” Monitor- might they practice them? Identify some prob- ing in this way can identify counter-productive lems that might arise, and encourage the teen habitual and impulsive actions and maintain to plan ahead for them. focused attention and conscious control.

Tools for self-monitoring arise that provoke strong negative emotions n Self-talk is a powerful way to bring thoughts or feelings of failure, self-talk can help adoles- and actions into consciousness. Examples cents identify potentially problematic thinking include having teenagers talk themselves and behavior patterns. through the steps of a difficult activity or peri- n Encourage self-talk that focuses on growth. odically pausing for a mental play-by-play nar- Help teens recognize that an experience—par- rative of what is happening. When occasions ticularly a failure—can offer lessons, and need continued developingchild.harvard.edu 12 not be interpreted as a final judgment on one’s n Understanding the motivations of others EXECUTIVE FUNCTION abilities. For example, when a sports team can be challenging, particularly when people ACTIVITIES FOR loses a game, help a discouraged team mem- are driven by different perspectives. Encourage ADOLESCENTS ber to consider what went wrong and what he teens to identify their hypotheses about oth- or she might do to improve next time—rather ers’ motivations and then consider alternatives. than simply deciding the team lacks any skills. “Why do you think she bumped into you? Can The same thinking can be helpful for school as- you think of another explanation?” Teens who signments. Carol S. Dweck, a professor at Stan- are not used to this kind of thinking may need ford University who researches mindsets, has you to model the process: “Could it be that she developed a website with more suggestions. didn’t see you?” n Help adolescents be mindful of interruptions n Writing a personal journal can foster self- (particularly from electronic communication reflection by providing teens a means with such as email and cell phones). Multitasking which to explore thoughts, feelings, actions, may feel good, but there is strong evidence that beliefs, and decisions. There are many ways it saps attention and impedes performance. If to approach journaling, but all encourage two (or more) tasks are competing for atten- self-awareness, reflection, and planning (see tion, discuss ways to prioritize and sequence. websites at end of this section).

Activities There are many activities that teens may enjoy that draw on a range of self-regulation skills. The key is a focus on continual improvement and increasing challenge. Some examples fol- low, below: n Sports — The focused attention and skill de- velopment inherent in competitive sports draw on the ability to monitor one’s own and others’ actions, make quick decisions, and respond flexibly to play. Ongoing, challenging aerobic activity can also improve executive function. n Yoga and meditation — Activities that sup- port a state of mindfulness, or a nonjudgmental awareness of moment-to-moment experiences, may help teens develop sustained attention, reduce stress, and promote less reactive, more reflective decision-making and behavior. n Music — Working memory, selective atten- tion, cognitive flexibility, and inhibition are challenged while developing skills in playing a musical instrument, singing, or dancing—par- and attention. Mensa, the high IQ society, ticularly when dealing with complicated pieces holds a yearly competition testing new games that involve multiple parts, sophisticated and has an interesting list of strategy games. rhythms, and improvisation. n Computer games can also be valuable, as n Theater — A performance is carefully choreo- long as time limits are established and ob- graphed and requires all participants, on stage served. Games that require constant monitor- and backstage, to remember their jobs, attend ing of the environment and fast reaction times to their timing, and manage their behavior. For challenge selective attention, monitoring, actors, learning the lines and actions of a role and inhibition. Moving through complicated draw heavily on attention and working memory. imaginary worlds, such as those found in many n Strategy games and logic puzzles — Classic computer games, also challenges working games like chess, as well as computer-based memory. Common Sense Media, a non-parti- training programs like Cogmed and Lumosity, san media information source, provides some exercise aspects of working memory, planning, good reviews of popular games. developingchild.harvard.edu 13 Study skills times to self-monitor (e.g., before handing in an EXECUTIVE FUNCTION In school, adolescents are expected to be in- assignment, when leaving the house, etc.). ACTIVITIES FOR ADOLESCENTS creasingly independent and organized in their n Be aware of critical times for focused atten- work. These expectations can place a large tion. Multitasking impedes learning. Identify load on all aspects of executive function. Basic ways to reduce distractions (e.g., turn off elec- organization skills can be very helpful in this tronics, find a quiet room). regard. The list below can serve as a guide for teens to use. n Use memory supports for organizing tasks. Mnemonic devices can be powerful tools for re- n Break a project down into manageable membering information. Developing the habit pieces. of writing things down also helps. n Identify reasonable plans (with timelines) for n Keep a calendar of project deadlines and completing each piece. Be sure that all steps steps along the way. have been explicitly identified and ensure that the completion of each step is recognized and n After completing an assignment, reflect on celebrated. what did and did not work well. Develop a list of things that have supported focused and sus- n Self-monitor while working. Set a timer to tained attention as well as good organization, go off periodically as a reminder to check on memory and project completion. Think about whether one is paying attention and under- ways to ensure that these supports are in place standing. When you don’t understand, what for other projects. might be the problem? Are there words you don’t know? Do you know what the directions n Think about what was learned from assign- are? Is there someone you can ask for help? ments that were not completed well. Was this Would looking back at your notes help? If you due to a lack of information, a need to improve have stopped paying attention, what distracted certain skills, bad time management, etc.? you? What might you do to refocus? Identify key What would you do differently next time?

Resources List of winning games from American Mensa’s Journaling with teens – some supports Mind Games competitions n extension.missouri.edu/p/GH6150 n mindgames.us.mensa.org/about/winning- n www.cedu.niu.edu/~shumow/iit/doc/journal- games/ writing.pdf Other programs Carol S. Dweck’s work on mindsets n www.cogmed.com n mindsetonline.com/changeyourmindset/ n www.lumosity.com firststeps/index.html Stress management suggestions Common Sense Media n www.mindinthemaking.org/wp-content/ n www.commonsensemedia.org uploads/2014/10/PFL-school-age-stress-man- n www.commonsensemedia.org/game-reviews agement.pdf

developingchild.harvard.edu 14 References ENHANCINGENHANCING ANDAND PRACTICINGPRACTICING EXECUTIVEEXECUTIVE FUNCTION FUNCTIONSKILLS IN CHILDRENSKILLS Barenberg, J., Berse, T., & Dutke, S. (2011). Executive Crone, E.A. (2009). Executive functions in adolescence: functions in learning processes: Do they benefit from Inferences from brain and behavior. Developmental WITHFROM CHILDREN INFANCY TO physical activity? Educational Research Review, 6(3), Science, 12(6), 825–830. FROMADOLESCENCE INFANCY TO ADOLESCENCE 208–222. Davis, C.L., Tomporowski, P.D., McDowell, J.E., Austin, Bavelier, D., & Davidson, R.J. (2013). Brain training: B.P., Miller, P.H., Yanasak, N.E., Allison, J.D., & Naglieri, Games to do you good. Nature, 494(7438), 425–426. J.A. (2011). Exercise improves executive function and Best, J.R., & Miller, P.H. (2010). A developmental achievement and alters brain activation in overweight perspective on executive function. Child Development, children: A randomized, controlled trial. 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Experimen- cognitive control in development during childhood: tal Brain Research, 225(2), 187–196. Potentials and limits of cognitive interventions. Child Cohen-Gilbert, J.E., & Thomas, K.M. (2013). Inhibitory Development Perspectives, 7(2), 121–125. control during emotional distraction across adoles- Mackey, A.P., Hill, S.S., Stone, S.I., & Bunge, S.A. (2011). cence and early adulthood. Child Development, 84(6), Differential effects of reasoning and speed training in 1954–1966. children. Developmental Science, 14(3), 582–590. developingchild.harvard.edu 15 Marcovitch, S., Jacques, S., Boseovski, J.J., & Zelazo, Steinberg, L. (2005). Cognitive and affective develop- P.D. (2008). Self-reflection and the cognitive control of ment in adolescence. Trends in Cognitive Sciences, ENHANCING behavior: Implications for learning. Mind, Brain, and 9(2), 69–74. AND PRACTICING Education, 2(3), 136–141. Steinberg, L. (2007). Risk taking in adolescence: New EXECUTIVE Meltzer, L. (Ed.). (2007). Executive Function in Educa- perspectives from brain and behavioral science. Cur- FUNCTION SKILLS tion: From Theory to Practice. New York: The Guilford rent Directions in Psychological Science, 16(2), 55–59. WITH CHILDREN Press. Steinberg, L. (2008). A social neuroscience perspec- FROM INFANCY TO National Scientific Council on the Developing Child. tive on adolescent risk-taking. Developmental Review, ADOLESCENCE (2004). Young Children Develop in an Environment of 28(1), 78–106. Relationships: Working Paper No. 1. Retrieved from Steinberg, L. (2010). A behavioral scientist looks at the http://developingchild.harvard.edu. science of adolescent brain development. Brain and Ophir, E., Nass, C., & Wagner, A.D. (2009). Cognitive Cognition, 72(1), 160–164. control in media multitaskers. Proceedings of the Tang, Y.-Y., Yang, L., Leve, L.D., & Harold, G.T. (2012). National Academy of Sciences of the United States of Improving executive function and its neurobiological America, 106(37), 15583–15587. mechanisms through a mindfulness-based interven- Prencipe, A., & Zelazo, P. D. (2005). Development of af- tion: Advances within the field of developmental fective decision making for self and other: Evidence for neuroscience. Child Development Perspectives, 6(4), the integration of first- and third-person perspectives. 361–366. Psychological Science, 16(7), 501–506. Taylor, S.J., Barker, L.A., Heavey, L., & McHale, S. (2013). Richtel, M. (2010, June 7). Attached to technology The typical developmental trajectory of social and and paying a price. The New York Times. Retrieved executive functions in late adolescence and early adult- from http://www.nytimes.com/2010/06/07/ hood. Developmental Psychology, 49(7), 1253–1265. technology/07brain.html?pagewanted=1. Ursache, A., Blair, C., & Raver, C.C. (2012). The promo- Rosen, C. (2008). The Myth of Multitasking. The New tion of self-regulation as a means of enhancing school Atlantis, Spring, 105–110. readiness and early achievement in children at risk for Schunk, D.H., & Zimmerman, B.J. (Eds.). (2008). Moti- school failure. Child Development Perspectives, 6(2), vation and Self-Regulated Learning: Theory, Research, 122–128. and Applications. New York: Lawrence Erlbaum Associ- Winsler, A., Ducenne, L., & Koury, A. (2011). Singing ates. one’s way to self-regulation: The role of early music Staiano, A.E., Abraham, A.A., & Calvert, S.L. (2012). and movement curricula and private speech. Early Competitive versus cooperative exergame play for Education and Development, 22(2), 274–304. African American adolescents’ executive function skills: Yurgelun-Todd, D. (2007). Emotional and cognitive Short-term effects in a long-term training intervention. changes during adolescence. Current Opinion in Neuro- Developmental Psychology, 48(2), 337–342. biology, 17(2), 251–257.

developingchild.harvard.edu 16 THE BRAIN ARCHITECTURE GAME Life experiences matter!

GAME RULE BOOK

The goal of the game is to build a brain that is tall, which represents functional brain ability, but is also as strong as possible so that it won’t collapse in later years under the burdens of stress. For background on how life experiences affect brain development and to get an overview of how to play the game, start by watching the video The Science of Early Childhood & The Brain Architecture Game, available free on our website: http://www.thebrainarchitecturegame.com

Before you start, here is a quick overview of the game materials:

LIFE EXPERIENCE CARDS and THE LIFE JOURNAL

Before playing the game, organize Life Experience Cards by year (years 1-8).

*DO NOT MIX UP THE CARDS - THEY ARE ALREADY ORGANIZED BY YEAR.

Life experiences can be positive, tolerable, or toxic to developing brains.

Record your life experiences and stress type in the Life Journal.

Tolerable stresses are marked “tolerable” and then you figure out building materials, BUT do not move the mark on the Life Journal!

Designate a person in the team to perform this task before you begin.

DIE PIPE CLEANERS Roll the die in the beginning Connect pipe cleaners at the of the game to determine ends to make closed spaces, your genetic lottery and for example: triangles and social support lottery. squares.

WEIGHTS You will have to hang weights in years 6-8 STRAWS from the tallest point These are your support of your brain. materials. You will slip straws over pipe cleaners to make the structure stronger. 2 Build a foundation for your brain BUILD YOUR using pipe cleaners and straws. FOUNDATION Before you start building, you need to determine what your base will be -- this is your genetic lottery.

Roll the die to Circle the 1 determine your 2 corresponding base. This is your base drawing on genetic lottery. your Life Journal.

Construct the STRAW 3 shape that corresponds to the number you rolled. STRAW

HINT: Put a pipe cleaner through a straw as you see it pictured.

3 Pipe cleaners are a weak building material when used SOCIAL on their own. Straws are used SUPPORT to make them stronger.

Straws you receive now represent the social supports available to your brain at the time of birth.

These straws can be used any time during the game.

Roll the die to determine Take as many straws as 1 the number of straws you 2 the number on your die. receive from the social support lottery.

Record the number 3 of social supports you received in the Life Journal.

4 The deck of Life Experience Cards contains seven (7) cards for each YOUR year of life. FIRST LIFE EXPERIENCE Each card determines what type of building materials you will take to attach to your brain.

1 1 WHAT DOES THIS ALL MEAN?

this experience was positive 1 for development

To begin, draw one WHAT DO I BUILD WITH? card at random from 1 take one pipe cleaner and YEAR 1 and read thread it through one straw the card. 1

Responsive, Supportive Caregivers this experience has Su er from resulted in toxic stress Childhood Illness

Responsive, Responsive, Supportive Caregivers Supportive Caregivers 1 take one pipe cleaner Su er from Record theSu er Life from Childhood Illness Childhood IllnessExperience Card and 2 the stress type on 1 your Life Journal.

this experience has resulted VERY IMPORTANT! in tolerable stress Responsive, SupportiveRolling Caregivers the die for tolerable Su erstress from applies ONLY if: Childhood Illness If this is your first card in a) this is your first card the first year, roll the die. OR

b) if you have receivedResponsive, an What did you get? equal number Supportiveof positive Caregivers and 2,4,6 = pipe cleaner + straw Su er from 1,3,5 = pipe cleaner only toxic stress cardsChildhood in later Illness years.

Pay close attention to this rule!

Responsive, Supportive Caregivers Su er from 5 Childhood Illness Continue building years 1-5 and record progress in the Life Journal.

BUILDING Draw 2 more cards from Year 1, one at a time. Attach all YEARS 1-5 the building materials from Year 1 before going to Year 2. For each year that follows, draw a total of 3 cards at random within the year, one card at a time.

At no point should you detach pipe cleaners and remodel1 your brain...

1 Building rules for life experiences:

POSITIVE TOLERABLE Take one pipe cleaner and take Count the number of positive and 1 one straw; insert pipe cleaner in toxic stress events in your Life straw. Attach to your brain. Journal. Take building materials for the type of experience your brain has experienced the most so far. Attach to your brain.

Responsive, Supportive Caregivers Su er from Childhood Illness Responsive, Supportive Caregivers TOXIC Take only a pipe cleaner Su er from Childhood Illness and attach to your brain. If you received straws at the beginning of the game, you may use them to reinforce a pipe All pipe Responsive, cleaner at any time. HINT: Supportive Caregivers cleaners must be Su er from Childhood Illness attached at both ends at the end of each year before drawing cards from the next year. They must form closed spaces. 6 RULES CHANGE! BUILDING No more straws can be earned in YEARS 6-8 this phase of the game and you may get weights that could collapse your structure.

Record progress in the Life Journal.

6 6 6 Building rules for life experiences: Clean and safe Encouragement Ostracized by playground nearby while learning a skill peers at school

6 6 66 6 66 6 6 Frequently exposed Clean and safeViolentClean incident and safeEncouragementEncouragementOstracized by Ostracized by Death in family to drug and playground nearbyplaygroundat school nearbywhile learning a whileskill learning a skillpeers at school peers at school alcohol abuse

6 6 76 6 76 6 6

Community policing Safe home providedFrequently exposedFrequently exposed Witness Violent incident Violent incident Death in familyreducesPOSITIVEDeath neighborhood in family while rebuildingTOXIC from to drug and to drug andTOLERABLE domestic violence at school at school Takeviolence one pipe cleaner and natural disasterHangalcohol a weight abuse from alcohol abuseCount the number of positive and attach it anywhere, still the tallest part of toxic stress events in your Life making closed spaces. your structure. Journal. Take building materials for the type of experience your brain has experienced the most 7 6 76 7 77 7 7 so far. Attach to your brain. Community policingCommunity policingSafe home providedSafe home provided Suspended from WitnessExcludedWitness by a group Injury/illness/ reduces neighborhoodreduces neighborhoodwhile rebuilding whilefrom rebuilding from school for bad behaviordomestic violenceof youthdomestic at school violence hospitalization violence violence natural disaster natural disaster The game is finished at the end of year 8, 7 7 77 7or when87 your7 structure7 collapses, Frequently exposed whichever comes first... Suspended fromSuspended fromExcluded by aTeacher groupExcluded helps by build a groupInjury/illness/ Injury/illness/ Sexual abuse to drug and school for bad behaviorschool for bad behaviorof youth atanger-management schoolof youth at school skillshospitalization hospitalization alcohol abuse 7 8 7 87 7 87 8 8 Frequently exposed School lunch program UnsafeFrequently drug-related exposedTeacher helps build Sexual abuseBullied by a gang to drug and Teacher helps build o€ers healthy Sexual abuse paraphernaliato drug found anger-managementand skills at school alcohol abuse anger-management skills snacks at playgroundalcohol abuse

8 8 8 8 8 8

School lunch programSchool lunch program Unsafe drug-relatedUnsafe drug-related Bullied by a gangBullied by a gang o€ers healthy o€ers healthy paraphernalia foundparaphernalia found at school at school snacks snacks at playground at playground For more science and to get your own copy of the game, visit our website: www.thebrainarchitecturegame.com

Version 4M _ Color, 10/23/2017 STRESS & EARLY BRAIN DEVELOPMENT Understanding Adverse Childhood Experiences (ACEs)

What are ACEs? ACEs are significant childhood traumas as identified below which can result in actual changes in brain development. These changes may affect a child’s learning ability, social skills, and can result in long-tem health problems. The Centers for Disease Control and Prevention (CDC) views ACEs as one of the major health issues in the 21st century.

Adverse Childhood How do ACEs affect health? Experiences can include: Through stress. Frequent or prolonged exposure to ACEs can create toxic stress which 1. Emotional abuse can damage the developing brain of a child and affect overall health. 2. Physical abuse 3. Sexual abuse 4. Emotional neglect Reduces ability to respond, learn, or Lower tolerance for stress can result in process effectively which can behaviors such as aggression, 5. Physical neglect result in problems in school checking out, and defiance 6. Mother treated violently

7. Household substance abuse 8. Household mental illness c May have difficulty Problems with 9. Parental separation or divorce o making friends and learning and 10. Incarcerated household member b maintaining memory can l relationships be permanent e m Exposure to childhood ACEs s can increase the risk of: w

 Adolescent pregnancy May cause i Increases stress hormones  Alcoholism and alcohol abuse lasting health t which affects the body's  Chronic obstructive problems h pulmonary disease (COPD) ability to fight infection  Depression l  Early initiation of sexual activity e  Early initiation of smoking a  Fetal death r  Health-related quality of life n  Illicit drug use i  Ischemic heart disease (IHD) n  Liver disease g  Multiple sexual partners  Risk for intimate a partner violence n  Sexually transmitted diseases d (STDs)

 Smoking m  Suicide attempts A Survival Mode Response is one that increases heart rate, blood e  Unintended pregnancy pressure, breathing and muscle tension. When a child is in m survival mode, self-protection is their priority. In other words: o “I can’t hear you, I can’t respond to you, I am just trying to be safe.” r y

c a n

The good news is resilience brings hope!

What is Resilience? Resilience is the ability to adjust (or bounce back) when bad things happen. Research shows resilience helps reduce the effects of ACEs. Protective factors are internal and external resources that help us to build our resilience.

Resilience trumps ACEs!

Parents, teachers and caregivers can help children by:

 Gaining an understanding of ACEs  Creating environments where children feel safe emotionally and physically  Helping children identify feelings and manage emotions  Creating protective factors at home, schools and in communities

What are protective factors?

1. Parental resilience Increasing parents’ ability to problem-solve and build relationships with their child and others

2. Nurturing and attachment Listening and responding to a child in a supportive way and discovering and paying attention to the child’s physical and emotional needs

3. Social connections Having family, friends or neighbors who are supportive and willing to help or listen when needed Resources: 4. Concrete supports

Having their child’s basic needs met, Parent Help 123 such as housing, food, clothing and www.parenthelp123.org health care 1-800-322-2588

5. Knowledge of parenting and child Resilience Trumps ACEs development www.resiliencetrumpsaces.org Increasing parents’ knowledge of their child’s development and appropriate Washington Information Network expectations for their child’s behavior www.win211.org 1-877-211-WASH (9274) 6. Social and emotional competence of children CDC Adverse Childhood Helping their child to interact positively Experiences (ACE) Study with others, manage emotions and www.cdc.gov/ace/about.htm communicate feelings

Cowlitz County Health and Human Services Departments 900 Ocean Beach Highway, Longview, WA 98632 TEL 360.414.5599 | FAX 360.425-7531 www.co.cowlitz.wa.us/health

Adapted from Spokane Regional Health District

Pre- and Post-Assessment Module 3E: Brain Power: How Language Interaction Nurtures and Trauma Impairs Date: ______

Trainer’s Name: ______Participant’s Name: ______

Job Title: Teacher Assistant Teacher Director Other: ______(circle one)

Ages you work with: infants toddler: ones toddler: twos preschool pre-k (circle all that apply) 6 weeks to 12 months 13 to 23 months 24 to 35 months 3 to 4 years 4 to 5 years

Instructions: Think about the following statements in relation to what you understand BEFORE and AFTER the training. Please check the box that best describes how you would rate your level of knowledge and skills based on the training topic: 1 (lowest) to 5 (highest).

BEFORE THE TRAINING AFTER THE TRAINING STATEMENTS 1 2 3 4 5 N/A 1 2 3 4 5 N/A

The rapid development of a young child’s brain

The elements needed for optimal brain development – including a language-rich environment, caring and responsive relationships, developmentally appropriate limits to learn self-regulation and buffering from toxic stress How to discuss adverse childhood experiences and toxic stress

How toxic stress impedes healthy brain development and leads to maladaptive behavior

Strategies to promote language development within the context of caring

Strategies to buffer young children from toxic stress