Episode 165: What You Need To Know About Executive Functioning with Tera Sumpter, M. A., CCC-SLP

Hi and welcome to episode 165 of the Untethered Podcast. Today we have Tara Sumpter joining us. Tara is an SLP and executive functioning specialist, founder and owner of our private practice, Seeds of Learning llc, international presenter, author of the internationally selling book the Seeds of Learning, and the developer and instructor of an international and online educational community. Quick disclaimer. All information, content and material of this podcast are the opinions of the speakers and is for the informational purpose only and not intended to serve as a substitute for the consultation, diagnosis and or medical treatment treatment of a qualified healthcare provider. Welcome to the Untethered Podcast. I am your host, Hallie Balkan. I'm a certified orofacial myologist, feeding specialist and mentor. This podcast is all about getting your questions answered and collaborating with colleagues to bring you the most up to date information in the orofacial myofunctional therapy, tethered oral tissue and airway space. I challenge you to keep an open mind and join my mission to get this information out to the masses. Let's get started. Tara, welcome to the podcast. I'm excited to chat today.

Thanks so much for having me. I am so excited to be here. So excited to finally meet you. I mean, it's not live. Live, ish, Right? Yes. Thanks for having me.

It's the way things are done these days. This is how I meet everybody. I love it. It's so convenient, right?

It makes it easy.

We've been chatting on Instagram for like a while now and I feel like I always see your posts and I know that we're in like two different, like, niches, two different specialties, but we're always on the same page, right? I'm always like, yes, she gets it. Yes. Like, you are my people. And so I'm so excited that we're going to chat a bit today because.

So when I was Dani from Speech Goods when I was on her podcast, she said afterwards, she goes, oh my gosh, you and Haley are like two peas in a pod and you guys have to meet. And I was like, okay, I don't know anything about or myofacial. Nothing, right? Nothing. And I was like, great, she sounds fantastic. So, yeah, that's when I reached out to you. I was like, danny, sorry to get to know you. Hi, I'm Tara.

Like, as adults, right? I'm like, I'm like the most awkward person. I'm like, you want to be my friend?

That's exactly the way it comes across. Yeah. I was like, I don't know what.

Else to say my 6 year old had to go make friends, but, like, making friends myself, I'm like, how do I say hi to this person?

Yeah, yeah. Hi, friends. Yeah.

So speaking of which. And you know how to use our brains. So you're an executive functioning specialist, and I know you have your own private practice and you've got your book the Seeds of Learning, and we'll talk about that. And also you're a developer and instructor inside of a educational community as well. So we have a lot. I haven't written a book, but otherwise we have a lot in common, like a business front. We do have, like, a children's series coming out on Tongue Ties and like, the journey of, like, Tongue Tie to Mayo to Tongue Tie Release, because there's nothing out there. And it's like a simple, like, written for, like, young kids kind of series. So we're trying to finalize that. It's been in the work literally for two years, and it shouldn't be taking this long, but hey, no, it does, it does.

It takes absolutely forever. It's a horrific process. I'm actually working on my second book right now, which is the Therapy framework, the executive function therapy framework. And yeah, I mean, it's years. It takes forever. It's torturous.

I thought in my brain, I was like, well, this is a kid's book and it's really, really short, so it should be fast, right? It should be fast to do, but there's all these, like, moving pieces that take forever outside of actually writing it and does that, like. And we've got the images, we've got the text. It's the everything else. It's.

I feel your pain. I feel your pain. I'd be like, it's gonna be out this month. No.

Yeah, right. Like, so I really need that for one of my clients. I'm like, I'll. I'll let you know when it's out. Maybe this month. And I put it on my calendar. I'm like, what is this reminder? And I was like, oh, yeah, they're still not done. I'll have to move. I'll have to let her know. It's maybe next month.

No, it's such a painful process, but it's so worth it. It's so rewarding once it's out there. And, you know, it's a quick resource for people.

I love it. So how did you get into this space? How did you become an executive functioning specialist? Or maybe the better question is, like, why? Like, what. What brought you.

Oh, my God. Ass Backwards, like, walked ass backwards. Right. By the way, put explicit, like an E on my. Okay. And just, like, warn people there may be an F bomb that flies out. Hopefully not, but you never know. So, yeah, really, it was. So it was simply because there was, like, there was a need. And, you know, I was a regular old therapist, just like everybody else coming out of graduate school and doing speech language literacy therapy. And there was something missing. Right. Like, there was something that, you know, my kids were having trouble attending. They just weren't connected to me. And I could tell that that was the level of the breakdown, like, the level at with which they were struggling was their ability to connect to their environment and their ability to connect to me. And so that was when I really started digging. And that was. I mean, that was probably, gosh, 14 years ago or so. And so I've spent the last almost decade and a half doing predominantly all of my continuing education in the fields of psychology, neuropsychology, neuroscience, occupational therapy. That's a big one. Because sensory regulation is really critical to being able to access the executive functioning system. So, you know, that's a lot of years of studying something. Right. And it's interesting because, you know, you get two years in your graduate studies, and my undergrad was not in speech and language pathology, so I did, like a postbac year, and then I did two years. So I had, like, three years. But then when you think about all the years after that that I've been studying, you know, this other area that. That's really where, you know, you hone your skills.

Yeah.

Remember, like, the newbie clinicians, like, you don't know Jack yet. Just hold on. It'll be okay. Like, you'll get. You're learning. So, yeah, so really, it was just. I sort of fell down a rabbit hole. And, you know, when I would. Yeah, you're like, yes, I understand. Yeah. Like, one topic that I would learn about led to another topic, led to another researcher who led to another, you know, therapist who led to more researchers. And so here I am all these years later, and, you know, over time, in terms of, like, lots of continuing education, but also I'm reading constantly. Lots of research analysis, research synthesis, and then applying all of it to my clinical practice. That's. That's how I got here. Slowly, surely, painfully, all that.

But I'm here, you know, and you're, like, seeing me not over here, and I'm like, oh, yes, that rabbit hole. It's that thing that I didn't learn in grad school, right. They didn't teach me anything that I felt like I actually, I. They gave me the foundations. I do. You know, it was great, but it's more of a generalist type of approach, like, let's feed you as much information in every area. Because speech pathology is so, it's vast. Like, there's so much that we do as speech pathologists and you know, I'm not to downplay generalists, but if you want to specialize in something like you're going to, in my opinion, the specialist is going to make a lot more headway usually than a generalist. Just because, like you said, we spent thousands and thousands of dollars and thousands of hours like.

Right.

It's not just the dollars, it's the hours, the time commitment, diving into the courses from different people because you learn different things from different instructors and different courses and methodologies, even within a specialty. And then the research and, and you know, I love how you said you had to go into like psychology and you know, even the occupational arena. And it's the same thing with the work that I do. Right. Like I have to look beyond the speech pathology world. There really isn't a lot of research in tongue tie, oral, facial, myology and even feeding, like you have to look into. Like you said, you know, we can't do feeding therapy unless the nervous system is regulated and that requires that, you know, that sensory system. And we can't separate the sensory system from the motor system, but everybody seems to think we can and teaches it that way. Right. So I love how even for you, you were like, yeah, we have to learn about these other arenas because it's also interconnect. It's amazing. So I guess for our listeners who are like, what the heck is executive functioning? Because that's not, you know, obviously the topic of our podcast usually on here, but I do think it's a really important topic for us to talk about for our, even for the patients, the parents who listen normally and the clinicians and other professionals who may be listening. Because if there is an impairment in executive functioning skills, how is that child, what's their response to therapy going to look like? How are they going to access therapy? What do we need to do to modify the therapy to best meet them where they're at? And so I love this whole conversation of executive functioning because people always hear me say that, like to do traditional myo, for example, a child needs to be at a cognitive level of a four year old. Not age wise, but like cognitively. And I don't think people Even understand what that means. Really?

I was going to say they don't know what that means. Yeah, right.

So, but like, what is executive functioning? Will you just kind of simplify that for our listeners?

Okay, so it's not a simple topic. So let's just. It's a really, really complex sort of umbrella terminology and in the term itself references really the prefrontal cortex functioning of the brain. And it's essentially the system of the brain that regulates all other higher level processing. So it's our self regulatory system. We can think of it in a couple of ways. We can think of the executive functioning system. It's like the boss, it's the one that's in charge. It's the one giving the commands to the other workers in the brain. We have all these little workers that do their jobs, but the boss executive functioning system is going to cue the workers to do what they need to do and when and how. It's kind of like that. I also like to think of the executive functioning system like a conductor because it has to make sure that everybody works together. All those workers work together in this really harmonious fashion so that they're integrated. And so just like the conductor, cue the violins and then cue the violas. And then he would say, no, you guys be quiet, okay, you guys be loud. I don't know how to conduct, but I'm making this up, right? Pretend like I do. I play a conductor on zoom. Okay, so you cue. He's cueing, but he's helping all of these different workers and pieces and parts integrate. And that's a really, really important part of this because I feel like when people are addressing executive functioning, that's the one piece that's often missed being talked about is the fact that we might have these workers who know how to do their job. This is really true when it comes to literacy. I know this is like way off from what you do, but when we talk about literacy, because literacy is a really large network of processing with all these different workers that have to do something. And sometimes the workers themselves look fine, but they can't integrate together. They don't talk to each other well, they don't work together well, people test them and they say, well, the workers seem fine, the kids must not have a problem. And then the kids go to the classroom or go home and then it all falls apart. The parents are screaming going, there's a problem. And everyone's like, nope, tested them, they're fine. A lot of times when we see that it's the problem of the conductor. Right. This executive functioning system helping everybody integrate together, do what they're supposed to do and when.

Yeah, so what? You know, I love how you mentioned like kind of where this may fall through the cracks because I feel like that's a common theme, unfortunately, in our industry of these children who, you know, especially when it's school based, you're kind of depending on standardized tests and if they don't fall more than a certain percentage below, then they don't receive services. But if your executive functioning system, right, if you're not able to, whether it's organize yourself or basically be the conductor, you're going to have a hard time in school. And I've always looked at it, I think this is an interesting conversation too, because I always look at it and go, well, what's sleep like? What is their sleep like? What's happening? And I think part of that is airway, but also part of it is what's happening during the day. What's happening? Are they regulated or dysregulated? Because you're not going to sleep great. If you're dysregulated all day, you might hit the bed and crash, but the quality of your sleep is going to be impacted. And I feel like that probably also further impacts your executive functioning if your brain is not getting restorative sleep. So I'm just like, yeah, okay, 100, 100%.

Oh, gosh. There's a really great researcher now. I'm blanking on his name. I want to say it's Walker. I can Google it in a second. But he's a sleep researcher. But he talks about this. He has research that he has referenced that says that if you have less than six hours of sleep at night, the connection between your prefrontal cortex and the other areas of your brain is literally severed.

Are you talking about Matthew Walker? Why we.

Matthew Walker. There it is. Thank you. Yes, thank you. Yeah, his work is fantastic. I love, love his work. But yes, he's talked about if you have less than six hours of sleep a night, this ability for the prefrontal cortex, this executive functioning system to connect and communicate with these other areas of the brain to regulate is severed. It's why if we're not sleeping, sleep is a huge issue when it comes to learning. The other thing about sleep too, that's so important is that when we sleep, we get into deep sleep. Right? So that REM sleep, the brain rehearses the information that was learned that day so it replays it to better store it into long term Memory. And the other thing that happens during this REM sleep is not only does it rehearse it to sort of make it concrete in the brain, get it to stick, but it also helps the brain make associations between information connecting point A to point B. This is something that's really important that we're. And I've seen this with kiddos, kiddos who had nocturnal seizures, kiddos who just simply didn't have good sleep hygiene. They would have all kinds of learning difficulties. They could. So sleep is a big part of the puzzle.

Yeah. I once had a. This is making me remember an IEP meeting that I sat in. Gosh. I worked in the schools for, like, three years, so this is dating back like 2010 maybe. And this psych, this neuropsych who ended up. Actually, she ended up leaving the schools and going private. And I've worked with her since. And she's freaking phenomenal. She actually contacts the testing companies to find out how she can modify assessments for different children without invalidating the test. I mean, it is like she'll print things larger and stick it on a wall. For a kid to access that page in the book, it's just, you know, or she'll use it. It's just really cool to see, like, how she functions and then how the kids are able to. Then. Then we can access what they know because it was presented properly to them. It's pretty cool. But I just remember her sitting there basically telling a parents who had a child with the new diagnosis do a new diagnostic diagnosis, can talk of autism. And, you know, the parents are kind of besides themselves. And the dad's going, but he's so smart. And we're going, this isn't a question of intelligence. Like, that's not what we're talking about here. It's. It's a base. And she explained it specifically for him. It impacts how he accesses the information in his brain and how he can share with us what he knows. And so, yes, he's a very intelligent little boy, but. But we have to put in support so that he can learn how to communicate with us in a way that he knows. She said it's kind of like having all these different filing cabinets, and the pathway to this filing cabinet is blocked, or we can't find the key for this cabinet. But this cabinet we've got, however. Oops. The file that's supposed to go here went over there. And so when you just said that comment about, like, I don't remember what you said, it was something about, like, making the connections. And you know, it's almost like for these parents. And she explained it in such a more like a much more beautiful way. She also used like a whole web of different, you know, you know, she was drawing webs and drawing all these lines and showing how his thinking is not linear. It's it. Most of our thinking is not linear. But especially for this child, it was like, definitely, you know, it's not linear. And so she was like, you know, for him, you say sock. And he goes, oh, there's a sock in the book about spiders. So he says, oh yes, spiders. And you're like, no, I said sock. Like how did you get to spiders? Right? But she said it's actually there's probably 10 other things that happened in that web before he got to spiders. It wasn't a direct linear connection. And for us to try and figure out his brain and how he got from point A to point B. You're never going to figure it out unless you really know that child. And you, it's like a favorite book or something. And you go, oh yeah, in that book about spiders, like, you know, they wear purple socks. And it's like his favorite thing to talk about ever, right? So it was just a very eye opening conversation, I think for me, because I was a newer clinician then and to hear her explain that to the parents, for the parents to kind of go like, oh, so my child's not stupid. And I was like, oh, nobody ever said that. But that's the first thing a lot of parents think. And so I think it's like these conversations of explaining to, to others just how the brain thinks differently. And we need to be better about educating the world about how the brain thinks differently. And there's nothing wrong with that. There's right or a wrong, but it's learning about how do we interact and communicate with each other. Knowing that, you know, there aren't just four different types of learning. Like, it's not, you know, like when I was growing up, it's like, oh, we teach dynamically to the four different types of learning. We have auditory and visual and tactile. I'm like, those are senses and they may be ways of what people, you know, learn information as well. And like, you're the expert here. This is like very basic level knowledge in my brain. But I always, you know, being ADHD myself, I'm like, the way I learn is very different than all of my classmates in college. I didn't get the official ADHD diagnosis until I was 19. And even though at age 5, they basically told my mom that I was and medicate me. And she's like, I'm not medicating her. And I figured myself out until about college, and then it all fell apart. So I got tested, and she's like, well, your IQ is really high, so we're not going to give you the label, but here's a Ritalin prescription. And I was like, oh, yeah, that's. That's helpful. So I took it. I hated it. But then I basically was an adult, so I was able to teach myself how to learn because I started researching it, and I was now getting into the psychology and speech world. And so I had access to different ways of learning and, you know, studying for tests. But I would give people my. My notes. And it was very interesting. Number one, my notes off Ritalin versus on Ritalin. It's like a different human wrote them or one number. And I hated this stuff. I only used it for school. I like, did. I refuse to take it otherwise? And then number two, I would give those notes, whether it was on Ritalin or off Ritalin. I would give my notes to friends who didn't go to class, and they would use my notes and they would get an A on the test. And I was in class and I studied those notes and I wrote those notes and I rewrote those notes, and I would get a C. And I was like, what is going on? Like, this is not okay. So I did teach myself how to chunk and how to do all these different types of learning tasks that worked for me. But, yeah, it just. It makes me. I think it made me really appreciate the SLP world. That's like, one of the reasons why I fell into this versus, like, psychology. I started in business, switched to psych, and then ended up in speech. Yeah. And I thought that that's what I was going to do.

Skill set. Coming into the field of slp.

I thought I was going to work with children on the spectrum. I thought I was going to work with autistic people. And I did start there. And then I started to see that a lot of them had all these feeding challenges and constipation issues, and it was interfering with our ability to do our sessions. These kids who were like, I had a kid who was just always holding his bowel movements, and he was so uncomfortable, and he would scream and cry. And there was an ABA therapist there, too, and they were like, just let him be. Just let him do his thing. And I was like, why is nobody talking to a medical professional? To see how we can help this child because it's obviously not the answer and there's other things we probably can be doing and that's. Eventually I fell into the world of feeding and that brought me into tots and my own rest is history. But yeah, no, I was kind of like getting into that ASD space and that was really what I loved working with those kids because I loved how they thought so differently. That same child, I remember like my first session with him, I was taking him over from another therapist and she said he's going to say like yellow and that means he wants you to color the train's wheels yellow. And I'm like, okay. And I sat down with him and I looked at him and I was like, this kid is holding back. Like he can do more. They're just not expecting it out of him too. So that was like another thing too. It was just, it was like a challenge and I loved the challenge. I was like, we are going to figure out how you communicate so you can share your voice with the world, like whatever that looks like. And I don't know, I just, I love those kids, so. But I'm so far from that now.

I know you are so far from that. Well, I mean, yes and no. It all circles back, right? It's all connected. Yeah.

I mean I have a private practice so we still, we still work with, you know, every, every child with every need pretty much based on the different specialties throughout the practice. And I have a large team of therapists but for me personally it's like that's usually we, we co. Treat. I'm like, I am not the specialist in that space anymore. You don't want me for that because I'm done the continuing ed to keep up with that. Like I'm not going to pretend like we can fit it all into one session. Like, no, we're going to focus on what I'm good at and then the other person on my team will focus on what she's good at. So yeah, yeah, yeah.

It's interesting, listening, you know, to talk all that because it all circles back to executive functioning and how important having that as a foundation for all of our learning, all of our development is because if we think about when you ask like what is executive functioning? And I gave you the easy answer of, you know, it's the self regulatory system. But the really complex answer is that there's a whole host of, of skills involved in that processing. And really the most foundational ones are perception. Are we aware of our Environment? Are we perceiving our environment? Are we perceiving the objects and people in our environment? Are we perceiving ourself? Right. Can we shine the attention flashlight inwards? Right. Can we shine it outwards? So perception is a huge one. Focus and attention. Can we direct our attention where it needs to go? And can I hold it there long enough to be able to absorb information from the environment? These are where so many of our children with speech and language disorders have breakdowns within their development. And so what ends up happening is when they're not really focused and perceiving their environment for long periods of time, then they look like their development's really choppy and really gappy and kind of all over the place. People will say, well, they can develop this, but why didn't they develop this? Well, maybe because that wasn't what they were focused to and tuned into during development. It's not necessarily a language issue. The symptom becomes language. Right. Language disorder becomes the symptom. But the root cause of that symptom is the fact that their executive functioning system wasn't helping them perceive and focus for sustained periods so that they got a sustained sort of exposure to speech and language. And that's something that really bothers me. And I feel like we shame parents way too much and it makes me bonkers. You hear so much of like, read to your kids, which is great, right? Obviously we need to read to our kids. We need to talk to our kids. But I feel like there's a lot of therapy coming out. You know, you need to expose them to all the language. And it's like, you know, the parents are over here going, I'm not like locking them in a closet and not talking to them like they are here in part of our world. I think we need to be careful that we are missing the fact that this child or these children could be in a really language rich environment and still missing lots of information simply because they're not connected to their environment because their executive functioning system is not regulating themselves to external information. Right. And as a result, they're going to look like they may have some breakdowns in development.

Yeah, yeah. I mean, it makes me just think of so many children that I worked with back when I was doing like more of the early intervention stuff. And you know, and it's. Some of these kids looked, you know, they would get a diagnosis of being on the spectrum and they would have that ASD diagnosis. And a year later with, after working with them, it was like, well, they don't look like that anymore and. Well, how about we don't just like throw around diagnoses at age 2? How about we get to know the child first and not just something on standardized or lack of standardized tests because two, you know, that's super easy to diagnose with standardized tests anyways. It's a whole other conversation for another day.

All other conversation. Yes.

Um, but you know, it's, it's fascinating and you could, you could just see that these children were not connected with their, their world. And so maybe that's why they're lining up these toys in a straight line across the classroom. Because that's how they know how to play and that's what makes sense to their, to their system right now. That's what feels good. That's what they know and that's just, that's how they're playing at the moment.

Yeah, it's.

Yeah. And then to see these kids be like to get the right intervention and to work with them in a way that teaches them, you know, maybe they need that one on one. Maybe learning in the classroom setting is not enough for them. Or maybe being in a, you know, and that like you said, being in a language rich environment is great, but not every kid is still going to respond the same way or be able to access it if something else is, you know, there's a disconnect and especially in executive functioning. So I think this is a really important conversation because we talk a lot about these kids who we know are not sleeping well and who sometimes look a little spacey. They might be turned around at circle time. They might not be responding to their name. Like they're, you know, they have splinter skills. Like you're talking about, why do they get this skill but not that skill? And we're like, their skills are all over the map. There's like no linear like development here that we would expect. Like, and if you're following milestones and whatnot and, and I have seen it turn around when a child sleeps changes like, let's say that child had enlarged adenoids or tonsils and they had obstructive sleep apnea because we're seeing that in three year olds. And then they have either the procedure and, or whatever is done to address sleep hygiene and proper breathing through your nose and you know, closed mouth posture and whatnot. We're seeing a complete 180. And these kids, like, they are going, we're like, who is this child? Like this child was, this child went from kind of like staring off into space like Turned around it like just like you said, disconnected from their environment. And this is a more extreme case, I think. You know, we got other kids who look like they're playing and they look like they're kind of fitting in. And I feel like these are our kids who always fall through the cracks because I'm going, yeah, but something is off here because they are not connecting with their peers and they're not, you know, they're the kids who are having a hard time following directions, but they can follow directions. So why are they not doing it in the classroom? Or they work really well with an adult or one on one. But then you put them in a group setting and it's like they really struggle. Right. It's just.

Yeah. So then when I see kiddos like that, then I'm starting to wonder if we have difficulties with an executive functioning skill of inhibition. And that is one of also the foundational skills, really our attention, our inhibition and our working memory. These three are like the triad, the foundational triad for our whole executive functioning system by which all the other skills, higher executive functioning skills develop. Out of these three inhibition, we really have to be able to say, that's not important right now, this is important. And that's where my focus and attention has to go. And so you have to inhibit something. Now for littles, this is really, really hard, right? This is really hard. And they're not supposed to be able to be great at inhibiting because if you think about, you know, Dr. Amishi Ja, she talks about attention. She's a neuroscientist who only studies attention or primarily studies attention. She talks about attention in terms of being a flashlight versus pointed focus, directed focus as opposed to. We have a system of attention that's like a floodlight, open and alert to everything. Children, they have a broader, more floodlight like young children, especially our birth to 3 population. But even this can carry on until 4 or 5. And this is why some of those kindergartners have very little detail focused attention because they have that floodlight attention. And the reason that is so important is because for this little brain to be learning everything that it has to learn in such a short period of time in this early development, if they were only focused in on one thing all day long, it would take a long time for them to learn all of the skills that they needed to. So their executive functioning system, their attention system has to be much broader, more like that floodlight taking everything in. And so that's normal, that's normal development. And then these kids get into kindergarten and everyone's like, they can't pay attention to me. They can't do the work worksheet. And everyone's like so upset they shouldn't.

Be at that age. But that's also another conversation, right?

Well, you know, and again, there's a range of development. We know that every kiddo is going to develop differently and that is normal. Like, and this is a whole other conversation. But I don't like milestones. I don't use milestones. I don't follow milestones. So that's just another conversation. But, but because again, they're based off of a 50th percentile child. I've never worked with this 50th percentile child. So none of this data means jack squat to me. So I don't use it. I meet the child where they are.

Yes.

So, so anyways, but, but so we have, you know, this kiddo who has this, you know, from the time they're an infant, they have this floodlight type of attention. And then the older they get, they start to develop the flashlight. They start to develop the flashlight type of attention. Some kids are going to develop the flashlight faster than others. And it's just, it's just the way it is. Are there things we can do to support it? Absolutely right. We don't want them to be totally derailed, you know, through their development. There are things that we can do to support it. But for sure, it's, it's so variable.

Yeah. You know, going into so many preschool classrooms just through my own private practice or through like infants and toddlers when I worked for them. But then also I've only ever worked with the birth to 5 population in terms of like language. I've never worked beyond five or so. Maybe I did follow one case with a child. Just, I loved this family. The child had a seizure disorder and I did work with her a little bit beyond the typical age range that I work. But like, so all of my experience in the language world was always with like our earliest population. And it just, it drove me a little bonkers to see like what they're doing in the schools, which I know we could talk about all day long. But you know, it's like what they used to expect in second grade is now first. First is kindergarten. Kindergarten is pre K. And I'm just like, some kids might be ready, but like, most kids are not. And you know, I'm finding that it's just, it's too much for their little brains. I mean, do you have any thought on that, do you feel like.

Yeah, I have a lot of thought on that. Let's see, where's my soapbox and my microphone? Yes, I have a lot of thought of that. I mean, executive functioning for one. Right. They're at different peaks. So I'll talk about executive functioning. There's one thing I want to talk about, literacy, don't let me forget, but executive functioning, Right. We have their first, the kids have their first big peak of development between 4, 5, 4 or 5 ish. Sometimes it goes a little later into 6. Okay. So they really have awful self regulatory skills until that point. So we're in elementary school at that point. Okay, so we're already expecting them to sit for too long and do a task for too long. Right. So there's that. The other aspect is there's a second peak of development that takes place in the executive functioning system and that's in middle adolescence and that's usually high school years. Okay, so when do we see kids fall off the cliff in school? I tend to see, because I work with all age ranges, I tend. There's a continuous pattern that I've seen for my entire career that when the kids fall off the cliff is when they go into middle school.

I was going to say, is it that elementary to middle school transition, usually.

Fifth grade, sixth grade, depending on when the school transfers? Yeah, because as soon as they go to middle school they're expected to be little adults. They're expected to be able to organize their work and you know, plan out really long tasks and execute now for something that might happen a week later.

They're trying to get to your classroom in five minutes from like one building to the next with a whole like crowd of people. I mean it's overwhelming. And then just there's so much more responsibility expected as well that I'm like, they're not ready for all of this.

They're not. And it's not that the executive functioning system stops developing between that four or five peak and the middle adolescence peak. But it's, but it's a slow, it's sort of a slow climb. And so, you know, we, we're expecting a whole lot from these kids way too early. So there's that there's the executive functioning component. And then when we talk about literacy, there is one part of the brain, the visual word for Maria, that it's an area that literally has to be created. So we're not born with it. We're born with every other aspect of processing that we need for literacy, except for this One area. So the brain literally has to create a whole new processing area. And this usually happens anywhere between six and seven years old.

Okay. That's where my daughter is right now.

Yeah. And some kids. Again, some kids will develop it sooner and some later, but the average is six to seven years old. So we're asking preschoolers to be doing sight words and to be doing with this. They haven't even developed this part of the brain yet. And so what happens when we put these unrealistic expectations on a little brain? Right. Stress. Oh, now we have anxiety. And let's medicate them for anxiety. Like, I just can't. Right?

Like, what? You're saying this, and I'm sitting here going, you know, I feel so much better hearing this from you, even though my daughter's teachers have said to me, these kids come into first grade. And mind you, we. She was homeschooled last year because our schools were mostly shut down with COVID So here we are, new school. This past August, I was like, let's move down early before, you know, we're ready to move, because I want them to start where they're going to end the school year, and I want them to make friends, and I want them just to feel. I don't want the added stress on them. And everyone's like, oh, they'll be fine. Just go do what's more convenient for you. And I'm like, I'd rather inconvenience myself as the mother and the adult, like, because I have that ability to do it this way and. And allow them to, like, get comfortable versus, like, popping into a new school two months before the school year ends, which was. Would have been the original plan if we waited till our, like, house was done. So I. So here we are, new school, and I'm, like, stressed out because I'm like, girlfriend keeps forgetting to bring her math homework home. And, like, that's just not an area we focused on a lot last week. Year in home school. My husband's supposed to do it. He didn't really do it. So we ended up getting her, like, a math tutor because I'm like, someone else can help, like, beef up this practice. Like, I don't understand how they're teaching math these days, and I don't really have time to learn. So I'm going to, you know, a teacher from the school who wants to earn some extra cash. Like, she can come tutor Lily. It'll be great for all of us.

I have a lily, too.

Okay.

Sorry.

Sorry.

I have a lily. All right.

So anyways, she, I mean she's been fabulous and just that one on one attention really helped, but she also just had a lot of gaps to close. But it was interesting because I was talking to the teachers and they basically were like, don't worry about like forgotten homework in terms like we're just, we don't check it for accuracy. We're just checking to see they turned it in. And even if they don't turn it in, we're not going to count it against them. Like it's very common during the first, you know, six, you know, first 50% of first grade that things are going to get forgotten. They really need a lot of reminders from us. And I was like, I'm so glad that you guys would expect them to be little adults yet. And you know, and they said usually come like January, February, you'll notice that they'll start to remember to do a lot of these things themselves. And we kind of back off on the reminders. And I'm over here going, it's May and Lily's still forgetting her stuff. So I just feel so much better now that you're still in that transition period.

Yeah, yeah. Well, and by the way, this is kind of off topic, but you bring up the concept of homework. All the research shows that there are no benefits to homework in the early years. We start to see benefits to homework when the kids are in late middle school and high school. That's when we start to see from a neuroscience researchers doing the research of showing that education system will catch up. I don't know.

Yeah, I mean I think up north the homework was heavier. I think down here it's more so just like read for 15 minutes and she went from. And so it's encouraging her to read on her own, which I'm like, she, you know, that's great. Like I, it's not like sit down and do five hours of homework and then the math for us, you know, I think there's plenty of people who don't do it and I don't think it gets counted against the kids. So I think it's kind of just like do what you can. But for us it was like we need to figure out where the gaps are in her skills. So it helped us a little bit. I am totally with you on like the no homework camp because I'm like when they come home and after sitting all day, I, you know, and I can see it in her. She doesn't want to do it. She wants to play, she wants to relax, she Wants to like decompress. Like, some days we go to dance, some days, you know, it's like they, they don't need to be continuing to work their brains. They need to be, you know, using their skills in a different way and being more.

And the other thing that's so important here is that again, the information that was learned during the day, we know that what gets that information solidified, right, is it is sleep, but it is also the downtime. So, you know, some of the researchers talk about going for a walk, doing, you know, playing something, and then the brain will sort of run through very subconsciously. Right? But the brain rehearses and stores the information and makes associations. And so if we're constantly plugging away, giving them new stimulus after new stimulus after, like they're just having to work and keep their working memory going constantly. It never gives the brain this downtime to just rehearse. And plus, these little ones, they have to play. I mean, we know that, we know that that's how their brain learns best. And that is so important. And then, you know, meeting their sensory needs, you know, they've got to get home and do all those things, jumping around, running outside, rolling whatever it is to meet all the sensory needs that they couldn't get met during the day.

Yeah, I made a couple of purchases during COVID when we were home. It was like one of those Jumperoo. It's like that, that inflated tire looking thing at the bottom. It has like the poles that come up and loop over in like three different ways. It has a little swingy thing in the middle. And we put it in our basement and they loved it. We put like little balls from a ball pit down in the middle of it on the bottom. So it was like very versatile. And then more recently, even though like things are not closed down down here in Florida, I saw a friend up north, had bought this like air track for her daughter, I guess, because.

Oh yeah, those are cool.

So of course I was like, well, both my kids are going to fight over this. So I bought one that was like double long. So it takes up like two freaking rooms. It insane. They love it. And they're not even gymnasts, like, but they, they need to bounce. And I'm like. Keeps them from bouncing on the furniture. It gets them moving. Like we can go for a walk and tire them out outside. But it's just like having these different things because it deflates and you can just put it away. I'm like, it's so important and I don't think That a lot of children, one, get the opportunity to do these things, unfortunately. And two, like you said, it's, you know, they need to play. When I was in kindergarten, there were no desks. We maybe had a half moon table that you might have gone and sat at for like snack time or something. And other than that, it was all open with foreplay and toys and like we've gotten so far away from that. I know we could go on the tangent forever, but I'm just like it, it breaks my heart that five year olds and six year olds are sitting at a desk for six and a half hours a day. And that's why I homeschooled Lily last year, because I was like, all right, it's enough that you're sitting at a desk in person and you can have human interaction. I was like, but to sit on Zoom for 23 hours, yeah, that was hard. I was like, I know too much. This not. I mean she wouldn't have done it anyways because she's just like, after 30 minutes she's like, this is boring. And I'm like, oh, this is going to be so much fun. So I mean, I hope, I feel.

Like, I feel like at large in our education system, we've, we've lost sight of the big picture, right? That like their grades, the grades that they get in elementary school, they don't matter. The grades like in elementary school are not going to predict what college they go. They have no boundary, you know. Yeah, they, yeah, it just, they're not related. Yeah. The way that I. And even in middle school, unless you're trying to do a really elite high school, right, That's a little bit different than the grid. Grades do matter, but the grades don't matter. The way that I always, you know, when I work with our families at our private practice, you know, I say when they're little elementary school, we're learning how to learn and then when we get to middle school we're learning how to get good grades. So that means we're learning our study skills. We're starting to learn how to self regulate a little bit better keep ourselves organized and self monitoring and self correct and planning all of those really good executive functioning skills, right. So you know, we're learning time management, pacing ourselves, all of that. So we're learning that in middle school so that when we get to high school we're ready to get good grades instead of like pushing this down to these little. Because I feel like we miss this big picture.

A four year old to act like they're in 10th grade. I mean, it's normal, right?

No. And it's not working. Like, it's not.

Yeah.

The United States. What the max. Yeah, we have for. For a developed country, we have the highest college dropout rate.

Oh, really?

Yes.

Interesting. Yes.

There's a really fascinating book called Age of Opportunity by Lawrence Steinberg. I think every parent and educator, anybody who touches children and, you know, not touch it, don't touch them. You know what I mean? Like, it's creepy what just happened there.

Oh, my God.

Okay. You can totally keep that in. But I just somehow creeped out this whole conversation. But anyways, you know, that reaches children. Okay. This book is so phenomenal. Lauren Steinberg, Age of Opportunity. And it's about the neuroscience behind adolescence. But really it's very much about all aspects of development. And I think it'd be really handy even for young people, you know, parents of young children to. To read it. But he talks about that. He talks about why is it that we have the most resources in this country. Pretty much in the world. There might be other countries that have a little bit more, but, you know, we're in the top there for sure in terms of resources, yet we have one of the highest college dropout rates. And a lot of these factors that we're talking about right now contribute to that.

Yeah, no, I believe it. I mean, aside from financial, you know, reasons, I would definitely believe that it has a lot. I mean, I experienced it my first year in college too. I was. I literally went from being like an A student with a GPA over 4.0 to having taken some like, college level courses as a senior in high school from like this new program that they were beta testing with the local, you know, community college and went to a great college. I went to University of Maryland and it's a great program. And here I'm in my business classes and I'm getting seasoned tests and I'm like, what just happened? Like, I'm studying the same way I always have, which clearly was not going to cut it for what was required in college. But I think, you know, and so some people are like, well, you probably just have test anxiety. And I'm like, well, okay, maybe I do, but that doesn't help me. Like, how do I fix it? Like, what do I do to change this? I'm like, I don't feel anxious before a test. Like when I. And so the fun part too is I remember taking my GREs because at that point I was on Ritalin and, you know, they Give you all these supports. Well, one of them is like headphones, right? And you're taking the test on the computer. And so they give me the headphones. So, like, because I'm very highly distractible and talk about being highly distractible. Talk about being highly distractible. I can hear my own heart beating. And I could not think because through the headphones I'm hearing is like.

Bone conduction now, right? As soon as you put the headphones on, now you've got the sound rattling around. Yeah.

Taking the medicine. Wearing the headphones, I'm like, I can't do this. Like, I took the headphones off and like, it was less distracting for me to hear other people's, like, keys clicking than it was for me to hear my own heartbeat. And people are like, you know, oh, it's so quiet. You can't hear a pin drop. I'm like, I can hear a pin drop.

You're like, yes, yes.

We're all the pin drops.

Yeah. My, my teenagers will never be able to sneak out of the house because one step and sisters, I am on you like a fly on shit. I hear. I'm like, you hear everything.

My daughter's always like, you heard that? I'm like, oh, I. I hear and see everything. I have. I'm like, I do what my mom used to say. My mom used to be like, I've got eyes behind my head. Like, I will see everything you do. So now I tell Lily that, and she's like, how did you know? I was like, I told you. I warned you. I know everything. And she was like, yeah, watch out, kid. Watch out.

Years in all directions.

Oh, my gosh. Yeah.

But it's really interesting because going back to Steinberg's book, you know, he talks about the reason why. What he talks about is. And what the research is showing is that the lack of self determination and resiliency are the two biggest reasons for why we have these young adults who are struggling. And he says, we can set them up with all the education, but if we don't help them work on being able to self direct for future goals, then they're going to be struggling. And that is executive functioning. Executive functioning. Executive functioning is self directing for something that hasn't happened yet. There's more to it. There's also self reflection so we can reflect on what's happened in the past. So all of that is part of the executive functioning system. But yeah, we're not really working on these skills. And when I work with teachers and school districts, that's Something I try to show them is you can take your curriculum that you have right now, but let's structure it in a little bit of a different way so that now we're showing them, okay, here's a goal that we see further ahead. How can we plan for that now to set ourselves up for success later?

Right.

So much that we can do.

Yeah, yeah, yeah. No, I mean, I think about a few people that I know where it's like, they couldn't even get to class. Like, they couldn't get themselves to class. And you talk about, like, you know, determination. Well, you know, and I've been in other business arenas and everything where we talk a lot about determination and resiliency and all these things. And it's, you know, we don't have. Some people are very internally determined and like, it doesn't matter what you do, like, it doesn't matter what they struggle with. They are going to get there. They're going to do it, you know. But that's not the majority of people. That's. I think it's a much smaller. Like, that's me. I don't care if I'm failing. I don't care, like, if. Unless I am sick and stuck in bed, like, if I committed to being somewhere, like, I am going to be there. At least that's how it used to be. Now I try to get out of everything as an adult, but, you know, in college I was like, I have to go to class. What do you mean I can't go to class. I'll be in trouble if I don't go to class. Like, in trouble with who? Like, I mean. Right. But that was basically what I told myself and what I. That was my belief system that I think also kept me kind of plugging along even though it was hard and I was struggling. And I don't think anybody really knew that I was struggling other than myself and my mother, you know, my family. But I think it's a very interesting conversation because it's. It's just. It takes everything just from getting up in the morning to going to the class, doing, you know, assignments or readings or whatever, to participating in the class, to paying attention while you're sitting in class. I mean, it's hard. There's a lot. Just get access to that information.

Yeah, yeah. And I think too, it's important to remember that our executive functioning, so all of those skills, all those things that you just mentioned, all fall under, you know, become issues that the self that the executive functioning system has to regulate. So it's all part of that system. And when we wake up in the morning, we have a finite capacity to do that. Right. And so some people are going to have a really big glass, and some people may start with half a glass of executive functioning control capacity, and some may start with a tiny little bit at the bottom of the glass. Right. So not everybody's starting off with the same amount of executive functioning capacity. So that's one really important point. Another really important point is that some people are going to deplete their cup, their capacity faster.

Yeah. Right.

And so some children, you know, they're going to deplete their executive functioning control by the time they get to school. The whole morning routine of just getting up, getting ready, and getting out the door and making sure everything's organized and getting to school, by the time they get to school, they've got nothing left. Right.

Yeah.

So, you know, it's. I always say it's. It's why I like it that by the end of the week in particular, you know, like on a Friday.

Yeah.

Nobody wants. Who wants to cook on a Friday? Nobody. Like nobody wants to cook dinner on a Friday. So it's always like the night, you know, we'll go out to dinner. Because it's Friday, nobody wants to cook. And so my husband will say, where do you want to go for dinner? And I look at him and I'm like, how dare you ask me a question.

Me too.

Yeah, I know, I know.

I'm like all the other decisions this week. Why are you asking me this? Can't you make a decision for once?

Audacity. The audacity to ask me a question on a Friday night. How dare you? That's grounds for. But the reason why is because we have literally depleted our capacity. And guess what? Decision making is the highest level executive functioning skill. It has to do. In order to just make a decision, we have to hold all kinds of information in our mind and associate it and compare it and then decide, prioritize which one makes the most efficient. That takes a lot of working memory. That takes a lot of executive function control. And on Friday night, you better damn believe it. I got an unlocked. So maybe, like, maybe the. Maybe we set a plan where, like Monday morning we decide where we're going to dinner on Fridays. That might be the better answer to this. We just solved the world problems. Good night, everybody. Yeah.

Oh, you know, like she'll. She's with us right now and she'll say things like, well, what do you guys want for dinner? And she'll start asking us at like 3pm because she knows that nobody's going to give her an answer. And at six o' clock we're like, so where are we ordering from? Because at this point like died. And like, it's just. Yeah, but it's kind of the running joke in this house. And I, I will say to like, they'll ask me, hallie, what do you want to eat? Because I'm like, I'm gluten free and I don't eat fried food and I'm, I'm, you know, a little bit pickier in what I eat. And so, you know, I'm like, I don't care tonight. I don't have the capacity, this is always like, I do not have the capacity to decide what I'm going to eat. I just need to nourish my body. So you all decide because I'll find something wherever you pick. Like, I just, I can't. I mean this is like literally like it happens several times a week that we have.

And now you, and now, you know, now you can say I don't have the executive functioning capacity. Now you really smart and everybody will listen to that and be done.

It's my ADHD and I was just told I don't have the executive functioning capacity. And then they'll be like, oh, okay. And then they'll get it, they'll get it. Because I just play things on my.

You do have it. You do have it. You've just depleted it, right? You've just tapped out.

Like you talked about the glass full, glass half full. Because I use this in feeding therapy a lot where I tell people, like, if we have 10 buckets, right, and we walk into, you know, the therapy room or into a meal time with, let's say we don't even have our 10 buckets starting because of these three other things that happened prior to that meal, right? We're starting with seven. And now you put a food on the table that is going to be noxious to that child. It is going to make them like want to gag or they're going to have some kind of a sensory response. Even though it's not in front of them, it's on somebody else's plate. We've just lost a bucket. And then you ask this child, what do you want to eat? And even if it's our family style and they get to pick it, you know, themselves now they have to. There goes another bucket. Now they have to make a choice about what they're going to put on their Plate how much, you know, and then it's, I'm like, you see how we quickly go from like 10 buckets that we have for our entire day and how a meal time might, like one single meal time might take up a whole bunch of those buckets. You know, that's where I love these kind of analogies because I feel like spoon theory. Yeah.

Have you seen that? Like, how many spoons do we have? Yeah, yeah.

And that's where I think when we start to explain this to people, it's like, oh, okay, I get it. Like, the battery has run out. We have to recharge the battery. But how do you recharge a battery in the middle of the day or in the middle of mealtime when you're, you know, I'm like, well, you just, you just do. Or you make changes so that those buckets of energy, those spoons, those, you know, that glass of water lasts longer throughout the day because we've been very intentional with what we're putting in place to allow for that. Right. And so that's, you know, it's.

We can do that in the same way. So when I look, when I hear that we can do that in the same way. With the child's executive functioning within the school day, there are ways that we can set them up for success and not drain their executive functioning glass just immediately at the end of the day. We can help them chunk and plan information. We can be really mindful of what looks like a really simple worksheet that you're going to put in front of a kiddo. Let's say the child has to flip back and forth. The answers are on the back. So like the word key, the word bank is on the back, yet the questions are on the front. And so the child has to look for the.

That drives me crazy.

Right. And that's a working. That's an issue with working memory. So that takes a lot of working memory capacity to be able to remember the question. When you flip over and compare it and look for the answer and then remember the answer and flip it back over and remember where to find. So.

Right.

That's something that will drain a child's executive functioning really quickly. That's simple to fix side by side papers, right. So that they have them both there and it's going to support their working memory. There's so many little things, you know, like that, that we can, that we can do to support them, but we have to be mindful of it and we have to know. Right. A lot of people A lot of teachers, a lot of therapists just don't care of. Yeah. Aware of that. And then how to support it.

Yeah, yeah. So what are. So I know you have your book and where can everybody find you? Because I know like from a resource standpoint, if someone says, okay, I want to learn more about executive functioning, or I think I have my child, or even I have something going on, like where can they, where can they find you? How do they get your book? Share that with us.

Okay. Four really great places. I know that sounds a lot. Oh my gosh. Okay. The first one, my private practice, which, you know, we're. Yeah, so we're pretty full. But. But that's okay. And obviously certification always becomes an issue there too. But if you want to look out for that. So Seeds of learning dot com. Seeds of Learning llc dot com.

Sorry.

Second one, my book is on Amazon. So it's called the Seeds of Learning. It's a cognitive processing model for speech, language and literacy. And really what I did there was I was trying to put a holistic approach together so that everybody can see how these different pieces and parts work together. How does executive functioning impact language? How does language impact literacy? How you know all of this? So that's the Seeds of Learning on Amazon and then Instagram. I'm constantly posting free education on Instagram, so that's an easy one. And done source. And I post almost every day. And then the last.

What's your handle? Tell us your handle.

Arasunter. Underscore. Slp. Thank you. You mean you can read my mind? Okay, yeah. And the last one is. So I have an educational community. It's an online educational community specifically for executive functioning. So we work on, you know, there's self study material, there's weekly live zooms. We have 50 plus hours of saved recordings in the, in the community. And then we have resource libraries packed with information, lots and lots of resources. Assessment, treatment information and, and I don't know the website off the top of my head.

That's okay, you can send me. I'll put it in the. For you.

Yeah.

Is that geared towards like SLPs? Is that geared towards parents? Who is that for?

Okay, so that is geared towards SLPs. However, we have a lot of parents in there who ask to be in there and are saying that they're finding so much value in it. We also have school psychologists, occupational therapists, but it's all geared towards executive functioning, assessment and then intervention. And so people are always like, just tell me how to do the intervention. That's where you go for the therapy. If you want the therapy. It's. It's there. And that's what my second book is going to be on. But I can't get the book quickly, so I created the Community. So that's a really, a really fantastic resource with people from all over the world. And there's, you know, so we're these SLPs and parents are constantly communicating. You know, we've got an SLP from Portugal and China and Australia. I mean, Ireland from all over, and they're all communicating and it is so freaking cool. Like, when SLP does their job in Portugal, I'm like, this is so cool.

You know, I've learned a lot from like, feeding therapy and mayo and stuff in like, other. Because of my online programs and having all these different people who I never would have reached, like, in Australia. And, you know, it's just, it's. It's very cool to be able to interact with other people in our industry. So I totally get that. Yeah, this has been amazing. Is there any last. Any last things you want to share with us before we start to wrap up?

I don't think so. I just, I mean, I had one nugget that I had to leave everybody with. It would be that executive functioning is the foundation for all later learning. And so when we're seeing children who are struggling to acquire, you know, certain aspects of speech language literacy development in particular, you know, really, maybe there's something going on right within that executive functioning system.

I love that. I love that. Thank you. This has been so impactful.

Thanks for joining me. I know. Thanks for having me. I'm so glad that we finally got this to work.

Yes. Thanks for listening to this podcast. If you want to hear more of these Myo Tots, Airway and Feeding related episodes, be sure to leave a review on Apple podcasts or pledge a small amount on patreon.com the Untethered podcast. If you found value, others, you know in this space will too. So be sure to share this episode on your social media platforms and join us over on Facebook on my Facebook page at Halle Balkanbiz, on Instagram at Hallebulcken. And you can head over to theuntetheredpodcast.com to grab a copy of the show Notes where you can also subscribe, be kept up to date on the latest podcast episodes.