Symposium 122 - Implementing Executive Functioning Interventions and Supports in the Community for Youth and Their Families

Sunday, November 19, 2023

8:30 AM – 10:00 AM PST

Location: Katchess (405), Level 4

CE: 1.5

Keywords: Community-Based, School, Treatment/ Program Design
Level of Familiarity: All
Recommended Readings: Dickson, K.S., Kenworthy, L., Anthony, L.G., & Brookman-Frazee, L. (2022). Mental health therapist perspectives on the role of executive functioning in children’s mental health services. Evidence-Based Practice in Child & Adolescent Mental Health, 8:39-54. DOI: 10.1080/23794925.2021.2013142, Kenworthy, L., Childress, D., Armour, A.C., Verbalis, A., Zhang, A., Troxel, M., Handsman, R., Kocher, K., Myrick, Y., Werner, M., Alexander, K. L. Cannon, L., & Anthony, L.G. (2022). Leveraging Technology to Make Parent Training More Accessible: Randomized Trial of In-person Versus Online Executive Function Training for Parents of Autistic Children, Autism, PMID: 35916246, DOI: 10.1177/13623613221111212, Rothschild, L.B., Ratto, A.B., Kenworthy, L., Hardy, K.K., Verbalis, A., Pugliese, C., Strang, J.F., Safer-Lichtenstein, J., Anthony, B.J., Anthony, L.G., Guter, M.M. and Haaga, D.F. (2022). Parents Matter: Parent Acceptance of School-based Executive Functions Interventions Relates to Improved Child Outcomes. Journal of Clinical Psychology; 78:1388–1406 , DOI: 10.1002/jclp.23309 PMID: 34997971, Swain, D., Troxel, M., Anthony, L.G, Kenworthy, L., Verbalis, A., Hardy, K.K., Ratto, A., Myrick, Y., & Anthony, B. (2021). School-based executive function interventions reduce caregiver strain. International Review of Research in Developmental Disorders, 60:187-211. DOI: 10.1016/bs.irrdd.2021.08.001, Cannon, L., Kenworthy, L., Alexander, K., Werner, M., & Anthony, L.G. (2021). Unstuck and On Target! An Executive Function Curriculum to Improve Flexibility, Planning, and Organization, Second Edition, Revised. Baltimore: Paul H. Brookes Publishing Co., Inc.

Chair(s)

Laura Anthony, Ph.D. (she/her/hers)

Professor
University of Colorado, School of Medicine
Aurora, Colorado

Discussant(s)

Brenna Maddox, Ph.D. (she/her/hers)

Assistant Professor
University of North Carolina at Chapel Hill
Carrboro, North Carolina

Presenter(s)

Laura Anthony, Ph.D. (she/her/hers)

Professor
University of Colorado, School of Medicine
Aurora, Colorado
Cara Pugliese, Ph.D.

Assistant Professor
Children’s National Hospital
Rockville, Maryland
Lauren Kenworthy, Ph.D. (she/her/hers)

Chief, Division of Pediatric Neuropsychology
Center for Autism Spectrum Disorders, Childrens National Hospital
Rockville, Maryland
Kelsey Dickson, Ph.D. (she/her/hers)

Assistant Professor
San Diego State University
San Diego, California

Executive functions (EFs) are a set of self-regulatory abilities that are essential to mental and physical health, well-being, self-determination and succesful functioning. Good EFs enable us to solve problems flexibly, set our own goals and make plans to reach those goals. This potent cognitive function is malleable, and therefore a potential target for intervention. Unstuck and On Target is an evidence-based EF intervention, originally designed to be implemented in elementary schools. A current focus of our projects and those of our partners has been to increase access to the low-cost intervention by expanding our reach and creating free online trainings and supports. To that end, it has recently expanded into middle and high schools, as well as been adapted for community-based clinical contexts. Our panel presents novel findings from diverse, community-based state-of-the-art research and implementation projects targeting:

Implementation of Unstuck and On Target in 230 Colorado and Virginia elementary schools with students with either ADHD or autism spectrum disorder using a variety of implementation supports, like a free online CE training for school implementers, a website with free resources, and coaching sessions

Results from a hybrid effectiveness/implementation trial of Unstuck and On Target in high schools in Virginia and Maryland with students on the autism spectrum

A contextual adaptation of Unstuck and On Target for community mental health centers in California

Results from a community trial with 100 families of short, free videos and tip sheets that cover easy to implement, general EF supports

Our discussant, an implementation scientist, will focus on how: 1) designing for dissemination from the outset of intervention development, combined with 2) ongoing revision of interventions in response to community feedback and 3) identifying facilitators to overcome community-identified barriers to implementation can be applied in attendee’s current work-whether research, dissemination, or clinical practice that seeks to expand beyond the therapy room walls.

Learning Objectives:

At the end of the session, the learner will be able to:

Improved sophistication in adaptations for community-based implementation of interventions.
Improved sophistication in disseminating CBT-based executive functioning skills asynchronously.
List examples of how responding to stakeholder input can enhance feasibility, acceptability, and effectiveness of clinical skills.
Enhance the throughput of EBPs in the broader community through short videos, website resources, school-based lessons, online CE trainings.
Think critically about what EF CBT-based skills can be taught in community settings or outside of the therapy office.

Presentations:

(SYM 122) Developing Implementation Facilitators to Expand the Reach and Impact of Unstuck and on Target in Elementary Schools
Speaker: Laura Anthony, Ph.D. (she/her/hers) – University of Colorado, School of Medicine
Co-author: Lauren Kenworthy, Ph.D. (she/her/hers) – Center for Autism Spectrum Disorders, Childrens National Hospital
Co-author: Jessica V. Smith, B.S. (she/her/hers) – Children's National Hospital
Co-author: Alyssa Verbalis, PhD (she/her/hers) – Children's National Hospital
Co-author: Tennyson Dahlman, B.S. – University of Colorado Anschutz Medical Campus
Co-author: Anna C. Armour, MA (she/her/hers) – Children's National Hospital
Co-author: Jessica Holmes, M.S., Ph.D. – University of Colorado Anschutz Medical Campus
Co-author: Lynn Cannon, M.Ed. – The Maddux School
Co-author: Monica A. Werner, LCPC, MA (she/her/hers) – Monica Werner Counseling
Co-author: Katie C. Alexander, OTD, MS, OTR/L (she/her/hers) – The Occupational Therapy Institute
Co-author: Allison Ratto, PhD (she/her/hers) – Children's National Hospital
Co-author: Kristina Hardy, PhD (she/her/hers) – Children's National Hospital
Co-author: Bruno Anthony, PhD (he/him/his) – Children's Hospital of Colorado
Co-author: Meredith W. Gunn, PhD, MSW (she/her/hers) – Innovations Institute, University of Connecticut School of Social Work
Co-author: Kaitlyn Decker, MS (she/her/hers) – Innovations Institute, University of Connecticut School of Social Work
Co-author: Dennard Brown, Jr., B.S. (he/him/his) – The Institute for Innovation and Implementation, University of Maryland School of Social Work
Co-author: Jacob Whiteford, MS (he/him/his) – Innovations Institute, University of Connecticut School of Social Work
Co-Author: Laura Campos, B.A. – Children’s National Health System
Co-Author: Eddy Panklang, N/A, B.S. – University of Colorado Anschutz Medical Campus
(SYM 122) Implementation Outcomes of Unstuck & on Target: High School at the Interventionist & Group Level
Speaker: Cara Pugliese, Ph.D. – Children’s National Hospital
Co-author: Laura Anthony, Ph.D. (she/her/hers) – University of Colorado, School of Medicine
Co-author: Lauren Kenworthy, Ph.D. (she/her/hers) – Center for Autism Spectrum Disorders, Childrens National Hospital
(SYM 122) Caregiver Videos for Supporting Executive Functions in Elementary School-age Children
Speaker: Lauren Kenworthy, Ph.D. (she/her/hers) – Center for Autism Spectrum Disorders, Childrens National Hospital
Co-author: Katie C. Alexander, OTD, MS, OTR/L (she/her/hers) – The Occupational Therapy Institute
Co-author: Allison Ratto, PhD (she/her/hers) – Children's National Hospital
Co-author: Kristina Hardy, PhD (she/her/hers) – Children's National Hospital
Co-author: Bruno Anthony, PhD (he/him/his) – Children's Hospital of Colorado
Co-author: Meredith W. Gunn, PhD, MSW (she/her/hers) – Innovations Institute, University of Connecticut School of Social Work
Co-author: Kaitlyn Decker, MS (she/her/hers) – Innovations Institute, University of Connecticut School of Social Work
Co-author: Dennard Brown, Jr., B.S. (he/him/his) – The Institute for Innovation and Implementation, University of Maryland School of Social Work
Co-author: Jacob Whiteford, MS (he/him/his) – Innovations Institute, University of Connecticut School of Social Work
Co-author: Laura G. Anthony, PhD (she/her/hers) – Children's Hospital of Colorado
Co-author: Monica A. Werner, LCPC, MA (she/her/hers) – Monica Werner Counseling
Co-author: Jessica V. Smith, B.S. (she/her/hers) – Children's National Hospital
Co-author: Alyssa Verbalis, PhD (she/her/hers) – Children's National Hospital
Co-author: Tennyson Dahlman, B.S. – University of Colorado Anschutz Medical Campus
Co-author: Anna C. Armour, MA (she/her/hers) – Children's National Hospital
Co-author: Jessica Holmes, M.S., Ph.D. – University of Colorado Anschutz Medical Campus
Co-author: Lynn Cannon, M.Ed. – The Maddux School
(SYM 122) Adaptations and Implementation of Unstuck and on Target in Community Mental Health Clinics
Speaker: Kelsey S. Dickson, Ph.D. (she/her/hers) – San Diego State University
Co-author: Megan Galligan, Ph.D. (she/her/hers) – San Diego State University
Co-author: Tana Holt, PhD – San Diego State University
Co-author: Laura Anthony, Ph.D. (she/her/hers) – University of Colorado, School of Medicine
Co-author: Lauren Kenworthy, Ph.D. (she/her/hers) – Center for Autism Spectrum Disorders, Childrens National Hospital