interventions with executive functions. major treatment approaches u i. evaluation (diagnosis) u ii....
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Interventions with Interventions with Executive FunctionsExecutive Functions
Major Treatment ApproachesMajor Treatment Approaches
I. Evaluation (Diagnosis)I. Evaluation (Diagnosis) II. Education (Counseling)II. Education (Counseling) III. MedicationIII. Medication IV. Working Memory TrainingIV. Working Memory Training V. Behavior ManagementV. Behavior Management VI. Educational ManagementVI. Educational Management VII. Environmental ManagementVII. Environmental Management Maturation (accounts for 3-4x more Maturation (accounts for 3-4x more
change)change)
Unproved/Disproved Therapies
Elimination Diet (e.g., removal of sugar, additives, etc.) (Weak evidence)
Megavitamins, Anti-oxidants, Minerals (No compelling proof or disproved)
Sensory Integration Training (disproved) Chiropractic Skull Manipulation (no proof) Play Therapy, Psycho-therapy (disproved) Biofeedback (EMG or EEG) (experimental) Self-Control (Cognitive) Therapies Social Skills Therapies (in clinic)
Implications for TreatmentImplications for Treatment
Teaching skills is inadequateTeaching skills is inadequate Treatments must be at the points of performanceTreatments must be at the points of performance Behavioral treatment is essential but does not generalize or endure Behavioral treatment is essential but does not generalize or endure
after removal after removal Reverse engineer the EFs:Reverse engineer the EFs:
Externalize important information (make lists, post rules, use Externalize important information (make lists, post rules, use signs, etc.)signs, etc.)
Externalize time periods related to tasks (timers)Externalize time periods related to tasks (timers) Break up future tasks into many small ones (do 1 daily)Break up future tasks into many small ones (do 1 daily) Externalize sources of motivation (token systems)Externalize sources of motivation (token systems) Permit more external manipulation of task informationPermit more external manipulation of task information
The compassion and willingness of others to make accommodations The compassion and willingness of others to make accommodations are vital to successare vital to success
A chronic disability perspective is most usefulA chronic disability perspective is most useful
Empirically Proven TreatmentsEmpirically Proven Treatments
Parent Education About ADHDParent Education About ADHD PsychopharmacologyPsychopharmacology
Stimulants (e.g., Concerta, Adderall, etc.)Stimulants (e.g., Concerta, Adderall, etc.)Noradrenergic Medications (e.g., Strattera)Noradrenergic Medications (e.g., Strattera)
Working Memory TrainingWorking Memory Training Parent Training in Child Management Parent Training in Child Management
Children (<11 yrs., 65-75% respond)Children (<11 yrs., 65-75% respond)Adolescents (25-30% show reliable change)Adolescents (25-30% show reliable change)
Family Therapy for Teens: Problem-Solving, Family Therapy for Teens: Problem-Solving, Communication TrainingCommunication Training
Empirically Proven Treatment Empirically Proven Treatment (2)(2)
Teacher Education About ADHDTeacher Education About ADHD Teacher Training in Classroom Behavior Teacher Training in Classroom Behavior
ManagementManagement Special Education Services (IDEA, 504)Special Education Services (IDEA, 504) Residential Treatment (5-8%)Residential Treatment (5-8%) Parent/Family Services (25+%)Parent/Family Services (25+%) Parent/Client Support Groups (CHADD, Parent/Client Support Groups (CHADD,
ADDA, Independents)ADDA, Independents)
What to do about it: What to do about it: EnvironmentalEnvironmental
classroomclassroom seat placement/facilitated attention seat placement/facilitated attention individualized and untimed testingindividualized and untimed testing adjusted workload/frequent checksadjusted workload/frequent checks repetition of instructions/written instructionsrepetition of instructions/written instructions breaking things into manageable bitsbreaking things into manageable bits provide motivation (behavior modification, increased provide motivation (behavior modification, increased
communication bw school and home)communication bw school and home) make it hands on/interactivemake it hands on/interactive allow for physical activity/breaksallow for physical activity/breaks
What to do about it: What to do about it: EnvironmentalEnvironmental
HomeHomeincrease motivation (find the right carrot)increase motivation (find the right carrot)shorten instructions and have them repeated or shorten instructions and have them repeated or
written downwritten downreduce environmental clutter (noise, reduce environmental clutter (noise,
distractions etc.)distractions etc.)assist with organization (reminders, planners)assist with organization (reminders, planners)model appropriate behaviormodel appropriate behaviorChoose battles wisely (timing, necessity)Choose battles wisely (timing, necessity)
Interventions: General PrinciplesInterventions: General Principles
must fit with child, environment, teacher, must fit with child, environment, teacher, parentsparents
make rationale work for the teacher/parentmake rationale work for the teacher/parent involve teacher/parent in planning possible involve teacher/parent in planning possible
solutionssolutions measure success / failuremeasure success / failure
Interventions: General PrinciplesInterventions: General Principles
define relevant EF deficit, associated domain define relevant EF deficit, associated domain specific abilities or deficits, and task/situational specific abilities or deficits, and task/situational demandsdemands
Determine the developmental level of child and Determine the developmental level of child and what are age appropriate expectations for EF. what are age appropriate expectations for EF.
Teach compensatory strategies Teach compensatory strategies Provide external control for those EF's missing in Provide external control for those EF's missing in
the child.the child.
Outcome of Good Executive Function Outcome of Good Executive Function
CognitivelyCognitively- control of conscious and deliberate control of conscious and deliberate
cognitive activity (e.g., rehearsal of cognitive activity (e.g., rehearsal of information in preparation of exam, information in preparation of exam, preparing outline before beginning to preparing outline before beginning to write, considering plan for any complex, write, considering plan for any complex, difficult task)difficult task)
Outcome of Good Executive Outcome of Good Executive Function Function
SociallySocially- inhibiting inappropriate socially impulsive inhibiting inappropriate socially impulsive
behaviorbehavior- guide behavior in social context by learned rules guide behavior in social context by learned rules
of social appropriatenessof social appropriateness- consider other people’s perspectives and consider other people’s perspectives and
interests in making decisionsinterests in making decisions- delay immediate gratification in the interest of delay immediate gratification in the interest of
longer-term gainlonger-term gain
Outcome of Good Executive Outcome of Good Executive Function Function
LanguageLanguage- deliberate, effortful searches of one’s word deliberate, effortful searches of one’s word
knowledgeknowledge
- comprehension of extended language requiring comprehension of extended language requiring active organization of incoming informationactive organization of incoming information
- planned organization of extended discourse, both planned organization of extended discourse, both interactive (conversations) and non-interactive interactive (conversations) and non-interactive (descriptions, explanations)(descriptions, explanations)
- controlled flexible use of abstract, ambiguous, controlled flexible use of abstract, ambiguous, indirect language (irony, metaphor, puns).indirect language (irony, metaphor, puns).
Systems Required to Promote Good Systems Required to Promote Good Executive FunctionExecutive Function
Appropriate Assessment of Needs in the Appropriate Assessment of Needs in the Everyday EnvironmentsEveryday Environments of the Child of the Child
Establish and Support Everyday Establish and Support Everyday RoutinesRoutines to to Support the Executive FunctionSupport the Executive Function
Systems Required to Promote Good Systems Required to Promote Good Executive FunctionExecutive Function
Treatment PrinciplesTreatment Principles Real World Relevance and ApplicationReal World Relevance and Application Within the context of everyday, meaningful Within the context of everyday, meaningful
routinesroutines Collaborative, hypothesis testingCollaborative, hypothesis testing
Interventions: General PrinciplesInterventions: General Principles
External to internal processExternal to internal process External models of multi-step problem-External models of multi-step problem-
solving routinessolving routines External guidance to develop & implement External guidance to develop & implement
everyday routineseveryday routines Practice application/ use of routinesPractice application/ use of routines Fade external support to cueing internal Fade external support to cueing internal
generation & use of routinesgeneration & use of routines
Interventions: General PrinciplesInterventions: General Principles
External to internal processExternal to internal process Internal control to generate & use specific Internal control to generate & use specific
problem-solving routineproblem-solving routine Generalization to new situation, requiring Generalization to new situation, requiring
some external guidancesome external guidance Accumulate experience, examine conditions Accumulate experience, examine conditions
for selective use of various routinesfor selective use of various routines Feedback throughout (i.e., reward)Feedback throughout (i.e., reward)
Reasons for a Reduced Executive Reasons for a Reduced Executive Function FocusFunction Focus
Belief (misguided) that executive functions Belief (misguided) that executive functions are “higher order” and must wait on their are “higher order” and must wait on their treatment until “lower order” cognitive and treatment until “lower order” cognitive and social processes are developed/ treatedsocial processes are developed/ treated
Desire to protect the individual, resulting in Desire to protect the individual, resulting in family or school personnel assuming family or school personnel assuming responsibility for all executive aspects of responsibility for all executive aspects of the individual’s behaviorthe individual’s behavior
Reasons for a Reduced Executive Reasons for a Reduced Executive Function FocusFunction Focus
Paradoxical avoidance of treatment focus Paradoxical avoidance of treatment focus because of severe impairment in this areabecause of severe impairment in this area
Staff tendency to assume that their role as Staff tendency to assume that their role as helping professionals requires assuming helping professionals requires assuming control for executive dimensions of tasks control for executive dimensions of tasks (identifying weaknesses, setting treatment (identifying weaknesses, setting treatment goals, planning and organizing their goals, planning and organizing their activities, etc.)activities, etc.)
Reasons for a Reduced Executive Reasons for a Reduced Executive Function FocusFunction Focus
Lack of focus of executive function aspects Lack of focus of executive function aspects of treatment within professional training of treatment within professional training programsprograms
Student gives appearance of being in Student gives appearance of being in control under more familiar circumstances control under more familiar circumstances that rely on old knowledge, well-established that rely on old knowledge, well-established routinesroutines
Result of No Focus on Executive Result of No Focus on Executive Function treatment Function treatment
With luck, the child will develop some With luck, the child will develop some sporadic independent problem-solving skillssporadic independent problem-solving skills
More likelyMore likely,, Develop learned helplessnessDevelop learned helplessness Promote dependencyPromote dependency Opposition toward caregiversOpposition toward caregivers
Structuring an executive function Structuring an executive function intervention program intervention program
Use of everyday routines with (e.g., Goal-Use of everyday routines with (e.g., Goal-Plan-Do-Review)Plan-Do-Review)
Support working memory via “hard copy” Support working memory via “hard copy” of routineof routine
Allowing child to become increasingly more Allowing child to become increasingly more active in formulating plans and reviewing active in formulating plans and reviewing their performancetheir performance
Goal-Plan-Do-ReviewGoal-Plan-Do-ReviewGOAL
What do I want to accomplish?
PLANHow am I going to accomplish my goal?
MATERIALS/ EQUIPMENT STEPS/ASSIGNMENTS1. 1.2. 2.
PREDICTION: HOW WELL WILL I DO?
Self rating 1 2 3 4 5 6 7 8 9 10Other Rating 1 2 3 4 5 6 7 8 9 10
How much will I get done?
DOPROBLEMS SOLUTIONS
1. 1.2. 2.3. 3.
REVIEW: HOW DID I DO?Self rating 1 2 3 4 5 6 7 8 9 10Other rating 1 2 3 4 5 6 7 8 9 10
WHAT WORKED? WHAT DIDN'T WORK1. 1.2. 2.
WHAT WILL I TRY NEXT TIME?
ExampleExample with academic tasks with academic tasks
Written statement of student’s goal for the Written statement of student’s goal for the academic taskacademic task
Specific list of all the steps needed to Specific list of all the steps needed to accomplish the taskaccomplish the task
Rate the performance (Self, Other)Rate the performance (Self, Other)Discuss discrepancies in ratingsDiscuss discrepancies in ratingsRecord what worked in one column and what Record what worked in one column and what
didn’t work in another columndidn’t work in another columnRetain the written Sheet in a notebookRetain the written Sheet in a notebook
What EF Intervention is NotWhat EF Intervention is Not Specific set of skills/ information to “teach” Specific set of skills/ information to “teach”
student (e.g., group study skills class)student (e.g., group study skills class) List of steps taped to the top of the student’s List of steps taped to the top of the student’s
deskdesk Simple behavior modification to increase Simple behavior modification to increase
motivationmotivation A “student thing” - listing IEP goals A “student thing” - listing IEP goals
without attention to the “how, who, where, without attention to the “how, who, where, when” of the classroom delivery systemwhen” of the classroom delivery system
Sample “IEP-Speak” for the EF’sSample “IEP-Speak” for the EF’s
Macro (Long-Term) Goal: The student will independently employ a systematic problem-solving method (e.g., Goal-Plan-Do-Review - GPDR) for tasks that involve multiple steps and/or require long-term planning.
Sample “IEP-Speak” for the EF’sSample “IEP-Speak” for the EF’s
Note: For students who are younger or with Note: For students who are younger or with severe executive dysfunction, the objectives severe executive dysfunction, the objectives should be prefaced by the following should be prefaced by the following statement: “With directed assistance, statement: “With directed assistance, Johnny/ Jenny will . . .”Johnny/ Jenny will . . .”
Goal Setting: (1) The Student will participate with teachers in setting
instructional goals (e.g., "I want to be able to read this book, write this paragraph, etc.”)
(2) The student will accurately predict how effectively he will (2) The student will accurately predict how effectively he will accomplish a task. For example, he will accurately predict accomplish a task. For example, he will accurately predict whether or not he will be able to complete a task; predict whether or not he will be able to complete a task; predict how many (of something) he can finish; predict his grade how many (of something) he can finish; predict his grade on tests; predict how many problems he will be able to on tests; predict how many problems he will be able to complete in a specific time period; etc. complete in a specific time period; etc.
Planning:
(1) Given a routine (e.g., complete sheet of math problems, clean his room), the student will indicate what steps or items are needed and the order of the events.
(2) Given a selection of 3 actions necessary for an instructional session, the student will indicate their order, create a plan on paper, and stick to the plan.
(3) Given a task that he correctly identifies as difficult for him, the student will create a plan for accomplishing the task.
(4) Having failed to achieve a predicted grade on a test, The Student will create a plan for improving performance for the next test.
Organizing: (1) The student will follow/ create a system for organizing
personal items in his locker.
(2) The student will select and use a system to organize his assignments and other school work.
(3) Given a complex task, the student will organize the task on paper, including the materials needed, the steps to accomplish the task, and a time frame.
(4) The student will prepare an organized outline before proceeding with writing projects.
Self-Monitoring, Self-Evaluating: (1) The student will keep a journal in which he records his
plans and predictions for success and also records his actual level of performance and its relation to his predictions.
(2) The student will identify errors in his work without teacher assistance.
(3) The student's rating of his performance on a 10-point scale will be within one point of the teacher's rating.
Self-Awareness: (1) The student will accurately identify tasks that are
easy/difficult for him. (2) The student will accurately identify his/her strengths and
weaknesses.
(3) The student will explain why some tasks are easy/difficult for him.
Self-Initiating: (1) When the student does not know what to do, he will ask
the teacher. (2) With regular/ minimal prompting from the teacher,
assistant or parent, The student will begin his assigned tasks, initiate work on his plan, etc.
College AccommodationsCollege Accommodations
- student should - student should be allowed to take tests and be allowed to take tests and complete work on an untimed or extended complete work on an untimed or extended time basistime basis
- Student- Student should have access to notes and should have access to notes and class outlines class outlines
All assignments should be included on All assignments should be included on syllabi and student should work with syllabi and student should work with someone to develop and appropriate plan someone to develop and appropriate plan for completing the assignments in a timely for completing the assignments in a timely mannermanner
College AccommodationsCollege Accommodations
StudentStudent might be allowed to take a might be allowed to take a reduced courseload, but still reduced courseload, but still considered a full time student considered a full time student
Seat placement in coursesSeat placement in courses Electronic OrganizerElectronic Organizer Use of tape recorderUse of tape recorder Training in test-taking strategiesTraining in test-taking strategies Relaxation trainingRelaxation training
18 General Ideas for Management18 General Ideas for Management(Barkley)(Barkley)
Parents are Shepherds; not EngineersParents are Shepherds; not Engineers
Reduce delays & externalize timeReduce delays & externalize time
Externalize important informationExternalize important information
Externalize motivation (think win/win)Externalize motivation (think win/win)
Externalize problem solvingExternalize problem solving
Use immediate feedbackUse immediate feedback
Increase frequency of consequencesIncrease frequency of consequences
Increase accountability to othersIncrease accountability to others
Use more salient & artificial rewardsUse more salient & artificial rewards
More of the ideas…More of the ideas…
Change rewards periodicallyChange rewards periodically
Touch more, talk lessTouch more, talk less
Act, don’t yak…Act, don’t yak…
Keep your sense of humorKeep your sense of humor
Use rewards before punishment (reward early & often!)Use rewards before punishment (reward early & often!)
Anticipate problem settings; & make a plan for them!Anticipate problem settings; & make a plan for them!
Keep a sense of prioritiesKeep a sense of priorities
Maintain a disability perspectiveMaintain a disability perspective
Practice forgiveness (child, self, others)Practice forgiveness (child, self, others)
Making commands effectiveMaking commands effective
Heavily praise high compliance commands initiallyHeavily praise high compliance commands initially
Use imperatives, not questionsUse imperatives, not questions
Go to child, touch, & use eye contactGo to child, touch, & use eye contact
Child recites requestChild recites request
Make complex tasks simpler onesMake complex tasks simpler ones
Make chore cards for multi-step tasksMake chore cards for multi-step tasks
List all steps involved in task on 3X5 file cardList all steps involved in task on 3X5 file card
Stipulate a time period on the cardStipulate a time period on the card
More on effective commandsMore on effective commands
Reduce time delays for consequencesReduce time delays for consequences
Use timers at points of performanceUse timers at points of performance
Don’t assign multiple tasks at onceDon’t assign multiple tasks at once
Praise the initiation of compliancePraise the initiation of compliance
Reward throughout the taskReward throughout the task
Child evaluates performance at endChild evaluates performance at end
Create a “grab bag” of surprises (average out to every Create a “grab bag” of surprises (average out to every third incident of compliance)third incident of compliance)
Classroom Management I: Tips for Classroom Management I: Tips for TeachersTeachers
Educate yourself about ADHD (nature, course, outcome, & Educate yourself about ADHD (nature, course, outcome, & causes)causes)
Keep in mind the 30% rule; anticipate the difficulties!Keep in mind the 30% rule; anticipate the difficulties!
Keep in mind that interventions within the school setting are Keep in mind that interventions within the school setting are most effective for improving school performancemost effective for improving school performance
Get in-depth training and consultation on behavioral Get in-depth training and consultation on behavioral principles & modificationprinciples & modification
Pick good administrators Pick good administrators ; those that support & recognize ; those that support & recognize your efforts!your efforts!
Know your limits and practice good self-care…Know your limits and practice good self-care…
Classroom Management II: More Tips for Classroom Management II: More Tips for TeachersTeachers
Establish behavioral control – Primary objective in the first Establish behavioral control – Primary objective in the first two weeks of schooltwo weeks of school
Decrease workload, or give smaller quotas of workDecrease workload, or give smaller quotas of work
Traditional desk arrangement & seat close to teaching areaTraditional desk arrangement & seat close to teaching area
Target productivity first; accuracy comes laterTarget productivity first; accuracy comes later
Don’t send home unfinished Don’t send home unfinished classclass work work
Give weekly homework assignment sheets; ahead of time!Give weekly homework assignment sheets; ahead of time!
Consider reducing/eliminating homework!?!?Consider reducing/eliminating homework!?!?
Allow restlessness…Allow restlessness…
Review homework at start of class; this helps all students!Review homework at start of class; this helps all students!
Help the student “think aloud & think ahead”Help the student “think aloud & think ahead”
Domain-Specific InterventionsDomain-Specific Interventions
Initiating: Initiating:
Increase structure of tasksIncrease structure of tasks Establish and rely on routinesEstablish and rely on routines Determine minimal level of cue to help start and Determine minimal level of cue to help start and
reduce cue over timereduce cue over time Break tasks into small, manageable stepsBreak tasks into small, manageable steps Place child with partner or group for modeling and Place child with partner or group for modeling and
cuing from peerscuing from peers Reframe "lack of motivation" as initiation deficit for Reframe "lack of motivation" as initiation deficit for
child, parent, teacherschild, parent, teachers
Sustaining:Sustaining:
Increase salience in task- rely on high interest tasksIncrease salience in task- rely on high interest tasks Hands-on activities support sustained attention problemsHands-on activities support sustained attention problems Ask child to choose among topics of interest to increase Ask child to choose among topics of interest to increase
investmentinvestment Use verbal mediation (self talk-aloud or to self) to help Use verbal mediation (self talk-aloud or to self) to help
remain focusedremain focused Write down list of what to attend to for a specific taskWrite down list of what to attend to for a specific task
Sustained Working Memory:Sustained Working Memory:
Repeat instructions as needed, perhaps quietly Repeat instructions as needed, perhaps quietly to the childto the child
Keep instructions clear and conciseKeep instructions clear and concise Concrete referenceConcrete reference Use of scriptUse of script Reduce rate of presentation/initial load (sense Reduce rate of presentation/initial load (sense
of overwhelm)of overwhelm) Frequent breaksFrequent breaks Task switching (not for everyone)Task switching (not for everyone)
Inhibiting: Inhibiting:
Increase structure in environment to set limits for Increase structure in environment to set limits for inhibition problemsinhibition problems
Make behavior and work expectations clear and Make behavior and work expectations clear and explicit; review with studentexplicit; review with student
Post milieu rules in view; point to them when child Post milieu rules in view; point to them when child breaks rulebreaks rule
Teach response delay techniques (counting to ten Teach response delay techniques (counting to ten before acting)before acting)
Environmental modifications (reduce distractions)Environmental modifications (reduce distractions)
Shifting:Shifting:
Increase routine to the day Increase routine to the day Make schedule clear and publicMake schedule clear and public Forewarn of any changes in scheduleForewarn of any changes in schedule Give 2 minute warnings of time to changeGive 2 minute warnings of time to change Make changes from one task to the next, or one Make changes from one task to the next, or one
topic to the next, clear and explicittopic to the next, clear and explicit Shifting may be a problem of inhibiting, so apply Shifting may be a problem of inhibiting, so apply
strategies for inhibition problemsstrategies for inhibition problems
Organizing:Organizing: Increase organization in milieuIncrease organization in milieu Increase organization of therapy to serve as model Increase organization of therapy to serve as model
and help child grasp structure of novel materialand help child grasp structure of novel material Present the framework of new information to be Present the framework of new information to be
learned at the outset, and review again at the end learned at the outset, and review again at the end of a lessonof a lesson
Begin with tasks with only few steps and increase Begin with tasks with only few steps and increase graduallygradually
Implement memory book/organizational systemImplement memory book/organizational system Teach child to look for organization inherent in Teach child to look for organization inherent in
novel informationnovel information
Planning: Planning:
Practice with tasks with only a few steps firstPractice with tasks with only a few steps first Teach simple flow charting as planning toolTeach simple flow charting as planning tool Practice with planning tasks (e.g., mazes, cooking)Practice with planning tasks (e.g., mazes, cooking) Ask child to verbalize plan before beginning workAsk child to verbalize plan before beginning work Ask child to verbalize second plan if first doesn't workAsk child to verbalize second plan if first doesn't work Ask child to verbalize possible consequences of actions Ask child to verbalize possible consequences of actions
before beginning and contingencies for possible blockagesbefore beginning and contingencies for possible blockages Review incidents of poor planning/anticipation with childReview incidents of poor planning/anticipation with child
Self-monitoring: Self-monitoring:
Anticipate performance- ask child to state how Anticipate performance- ask child to state how he/she will do on a task, then compare gently with he/she will do on a task, then compare gently with actual performanceactual performance
Videotape child's behavior and review with child Videotape child's behavior and review with child in supportive mannerin supportive manner
Increase attention to behavior- ask child to Increase attention to behavior- ask child to verbalize steps as he/she is doing themverbalize steps as he/she is doing them
Find motivation for accuracy/neatness (reward Find motivation for accuracy/neatness (reward etc.)etc.)
ReferencesReferences
The Study Skills Handbook The Study Skills Handbook by Judith Dodgeby Judith Dodge
Overcoming Underachieving Overcoming Underachieving by Nancy by Nancy Mather and Sam GoldsteinMather and Sam Goldstein
Why Bright Kids Get Poor Grades and What Why Bright Kids Get Poor Grades and What You can Do About It You can Do About It by Sylvia Rimmby Sylvia Rimm
www.tourettesyndrome.org/htm.efwww.tourettesyndrome.org/htm.ef
ReferencesReferences Survival Guide for College Students with Survival Guide for College Students with
ADD or LD ADD or LD by Kathleen G. Nadeau (1994)by Kathleen G. Nadeau (1994) Learning How to Learn: A Guide for Getting Learning How to Learn: A Guide for Getting
into College With a Learning Disability, into College With a Learning Disability, Staying In, and Staying Sane Staying In, and Staying Sane by Joyanne by Joyanne Cobb (2000)Cobb (2000)
Help Yourself: Handbook for College-Bound Help Yourself: Handbook for College-Bound Students with Learning Disabilities Students with Learning Disabilities (Princeton Review) (Princeton Review) by Erica-Lee Lewis & Eric by Erica-Lee Lewis & Eric Lewis (1996)Lewis (1996)
Succeeding in College With Attention Deficit Succeeding in College With Attention Deficit Disorders: Issues and Strategies for Disorders: Issues and Strategies for Students, Counselors and Educators Students, Counselors and Educators by by Jennifer S. Bramer (1996)Jennifer S. Bramer (1996)
Steven C. Guy, Ph.D.Steven C. Guy, Ph.D.Licensed PsychologistLicensed Psychologist
Pediatric NeuropsychologistPediatric Neuropsychologist170 North Woods Blvd.170 North Woods Blvd.
Suite 220Suite 220Columbus, OH 43235Columbus, OH 43235
(614) 848-9708(614) 848-9708Fax: 888-1014Fax: 888-1014
[email protected]@columbus.rr.com