Belle’s OT Corner
Join me in Belle's OT Corner where we explore all things paediatric occupational therapy! This podcast is dedicated to sharing easily accessible information, breaking down occupational therapy concepts, language and jargon. Ultimately helping support parents, carers and teachers build their confidence, up-skill their knowledge and allow for increased understanding of the children in their lives. Each season of Belle's OT corner will tackle various topics related to paediatric OT. So, whether you are a parent, teacher, seasoned occupational therapist, OT student, or just want to expand your knowledge related to children, disability, motor development and more then Belle's OT Corner is for you! Episodes are released fortnightly so come along and join the journey!
Belle’s OT Corner
Executive Functioning Season: Initiation
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Starting an activity or task should be simple, right? Brush teeth. Do the dishes. Begin homework. Record the podcast. Yet for so many kids, teens, and adults, task initiation feels impossible, and the harder we push, the more stuck everyone gets. In this episode we unpack why that happens and what strategies we can use to help.
We break initiation down into what’s really going on: the hidden steps before the task even begins, the cognitive load that stacks up fast, and the way procrastination and avoidance can be a sign of overwhelm and not laziness.
Then we move into strategies you can use straight away. We start with regulation and co-regulation, to practical strategies to support the cognitive load, use of movement to build momentum (including a good dance party) and the all important role of playfulness.
If this helps, subscribe, share it with a friend, and leave a review so more families and educators can find these executive functioning strategies. If you would like to donate and support the podcast - https://buymeacoffee.com/bellesotcorner
DISCLAIMER:
Whilst I will always make evert effort to share correct information as at the date of the podcast, research is constantly happening and as a profession we learn more everyday. One therapist may have a different way of doing things to another, and every child's needs are unique. By listening to this podcast, you agree not to use this podcast as medical advice to treat any medical condition in either yourself or others. Consult your child's paediatrician or therapist for any recommendations for your child.
What task does your household get stuck starting most often?
And welcome back to Bells of the Tea Corner. Today we're going to be jumping into the second episode in our executive functioning season, and we're going to be talking all about initiation. So we started to talk about it a little bit last episode, but we're going to really dig deep into it. In this episode, we'll start off with what initiation is, how it works within our brain, so do a tiny little bit of neuroscience behind initiation, then start to talk through what we can do. And most of the episode is going to be talking through well, what can we do when either ourselves or some of the kids that we work with or your own children have difficulties with initiation. What are the strategies? What are the things we can put in place to help them with this tricky part and help them make it a little bit easier? So let's start off with what initiation is. Initiation is essentially starting an activity. And that could be any activity. It could be brushing my teeth. It could be sitting down and starting the report that I have to write, often one that I find quite hard. It could be doing the dishes. It could be getting dressed. It could be sitting down and doing my homework. It could be starting to play. There's anything within our day that we have to do, at some point we have to start that. And to be able to start that, we also need to finish and stop what we were doing before. So there's a piece in this around like shifting our attention. But actually the initiation is being able to start a task within a time frame that is manageable. So it's that piece of looking at not doing 15,000 other jobs, not getting procrastinated, not avoiding something for many, many turns or many days before actually starting the activity. So when we think about starting a task, it sounds so simple. And this is where it can get really quite tricky with initiation because it's that whole concept, and you start to just think, well, just just just do it. It's just there. Just just do it. And actually, there's a lot of cognitive load and hidden cognitive load, which is a marry up many of our different executive functioning skills that are happening behind the scenes to be able to just start the task. And sometimes that cognitive load in and of itself can be so overwhelming that actually it's just easier to avoid this and I'm not going to start it. Or sometimes it's I don't know where to start it, or I don't know what to do, or there's too many steps to have to get all like if we think about homework, for example, let's say that your child's come home from school and you've said, right, go and do your homework. It sounds like a pretty straightforward ask. If we think about some of the steps that are hidden behind go and do your homework, we've got find your school bag. Well, remember, before we even find our school bag, remember that my homework is in my school bag. Find my school bag. Open my school bag to find my homework or to find my planner that tells me what my homework is without getting distracted by the fact that I've opened that up and gone, oh, there's my lunchbox that I haven't dealt with yet. Okay. Eventually find the planner or find my homework. Take my homework to the place where I do my homework, be that the kitchen table, my bedroom, the living room, wherever it might be. Find a chair to sit down on and get myself situated. Oh, hang on. I don't have my laptop, or I don't have my pencils, or I don't have my pens, or I don't have the other book that I need to do this, so then I have to locate all of those items. Come back to sit down, check that I've actually got everything that I need, remind myself of what my homework is, and then actually start my homework. I lost track of counting. I was trying to count on my fingers. I lost track of counting. But you get the pitch that there's a lot of steps before actually starting the task. And all of those steps are components of starting the task. But have we actually started homework yet at that point? No. And so it's being mindful of sometimes if there are so many hidden jobs before I can actually start the task that can make it even harder as well. And so where we have difficulties with initiation is where this piece of like feeling like I have to get started or knowing I have to do something feels impossible. And it happens to us as adults as well. You know, I can't tell you how many times there's one or two cups in the sink at the start of the day, and by the end of the day, there's a stack so big, and I'm like, I know I just need to clean the kitchen, and I know I just need to stuck the dishwasher. But I just can't. It's just too much for right now. Or if I'm being really honest and open with you guys, sitting down to record this podcast. So often I have to, you know, plan out the episodes, make sure I've carved out time, that the house is going to be quiet enough that I can record for you guys. And sometimes just the bit of sitting down and starting is really, really tricky. And so I go longer than I want to without putting an episode out, and then I get stressed because I haven't put an episode out, and then it builds and builds, and so it gets to this point where your logical brain goes, It's not that hard, just sit down and do it. But it feels impossible, and so you start to distract yourself or do all the other jobs that you could possibly think of doing. My room is never cleaner than on days when I record sit down to record and podcast. And you do all these other bits instead of the job that we actually need to do. And sometimes that makes it much harder, particularly if there's not any external motivation or there's no a hard deadline that we have to hit. And so you can start to see how it's easy to push these things away and go, Oh, I'm not gonna do that one yet. And it gets more and more tricky. And so, as I think you can kind of tell, initiation and all of the things when we're talking about within executive functioning, these aren't just skills for our children to learn, be that your children, children that you work with, teenagers, young adults, it's for all of us. These can impact everyone in different levels. And the bit that we're gonna talk through today is okay, if we notice that there is some difficulty with this, well, what can we do? What are the strategies that we can put in place? And as I kind of mentioned a little bit before, it gets you almost get a double whammy. It gets um duplicated almost, um, and the task feels like it gets exponentially harder because often the starting of the task can be perceived as this stress and this demand. And then if I haven't started the task, well that stress is just gonna increase because then I've got the stress of the fact that, oh, I also just didn't do it, and I should have done it then, but I didn't. And so actually never getting through the stress of it all can be sometimes just as hard, if not harder, than actually just starting the activity. And all of this to say is when we look at our executive functioning and and our ideation within executive functioning, ideation requires so many other of our executive functioning skills. You know, it requires balances between some of our motivation, it requires us in our working memory to be online. If we think back to the example of homework, well, homework has motivation because there's a deadline of when I have to get it in. But if the deadline's Friday and I'm doing it Monday, well, it's gonna be a little bit harder to set myself down and do it. Working memory is that I need to remember all the things that were on my homework and all the steps the teacher told us to do. My own regulation, how can I manage my regulation to persist through some of these frustrations? Or if I'm, you know, starting my homework and I'm going, I don't know if I actually know the answer to this, navigating those feelings. My attention control, how can I shift my attention to starting this activity, but also how can I then sustain my attention through this activity? So none of these parts of our executive functioning work in isolation, which is why over the season you'll see a couple of the strategies are quite similar, but this season helped aims to give you a deeper understanding of some of the pieces within our executive functioning, and so you can start to have that you know curiosity when you're working with children or your own children, going, ooh, I wonder why that's tricky. Which part of that might be tricky? Well, well, maybe it is the initiation, so maybe we can try to shift and try some of these strategies as a part of it. So if we think about our ideation, not our ideation, sorry, our initiation. If we think about initiation and we think about what this might look like in some of the children that we see or your own children, it might look like come on kids, it's time to get ready, it's time to go. Five minutes later, guys, you've got five minutes, two minutes later, guys, you've got two minutes, get your shoes on, get your things that you need to go, and then all of a sudden, at like 60 seconds, mad rush to get all the things that they need. Like I told you five minutes ago that we were about to leave the house, but it's that needing that absolute last-minute pressure to start, and so then it becomes an absolute mad dash to get out of the house, or it could be difficulties when there's some of those more complex or longer processes, so things like homework where there's more of those hidden steps involved, or it could be for some individuals it could be okay, well, it's time to get dressed, and getting dressed on, you know, if your child has a school uniform, getting dressed on Monday to Friday is easy, but then the weekend she's come on, kind of time to get dressed, and they can get dressed, but then they've got the hidden steps of well, figuring out what I want to wear, choosing what I wear, choosing the clothes from my wardrobe, seeing if I like that outfit or not, and then going, does it work for the weather or not? And so that all of a sudden becomes more hidden steps involved. Because also then, as you're some of our older children, teenagers and young adults, well, then there's the extra pressure of well, what have I got on today? What do I need to dress for? Am I seeing my friends? What do I want to wear if I'm seeing my friends? And you get all of these extra hidden steps involved. It also can look like seeing someone who sat down and use if I use the example of homework again, and I'll use a different example in a minute, but they've sat down, you're like, okay, do your homework, and they're sitting there and they just haven't started. And you're like, Well, what are you doing? Like, I'm thinking about it. Okay. Couple minutes later, you come back home. Still haven't started. What what are you doing? I'm I'm thinking. And that's an extra thinking about the task itself and perseverating in the thinking about the task than actually starting. It can be the same with a shower is quite a common one. Time for a shower, off you go. I'm thinking about it. It's time for a shower. Yep, I'm I'll get there. I'm thinking about it. Leave me alone, I'll get there. And it's that thinking about the tasks that we have to do and getting stuck in that thinking about what we have to do. And then our good old classic distraction and procrastination in the form of doing all of the other tasks. And as I said to you guys, there are days when I do struggle with initiation of certain things, and often you can tell because my house will be the cleanest it ever is, because I will have cleaned everything before actually doing the other job that I know I need to do, or that is a tricky one. The one recently for me were my taxes. I hate doing my taxes, and I just it's not something that my I enjoy doing, it's something that I find quite challenging to do. And so when I have to sit there and do it, and I know it's gonna take a lot of brain power to sit down and do it, I why would I start that? And it's not until I get the the time frame pressure, or use some of the other strategies that we'll talk about, which I often use for myself a lot, to actually do it. And at those times, my house is the cleanest you'll ever see it. So and also sometimes it can start to feel like this bit of like, or it can start to appear as unmotivation or unmotivated, being a bit sluggish or slow, or it can also sometimes look like a difficulty with productivity, and it's none of these things, it's actually looking at well, what's the underlying piece that's making this task so tricky to start. So, what can we do? That's a little bit about the why. Oh, actually, I've got one more little bit about the why. When we think about the when we think about it from a bit more of a neuroscience perspective, and all of our executive functioning skills are all processed in our frontal lobe within our prefrontal cortex. Now, if you think back to the early years regulation season, where we talked a little bit about some of the neuroscience behind our regulation, when we are in a more regulated state and able to access all of our thinking, our frontal cortex is online and our prefrontal cortex is online. The more stress that we're under, and often it can be perceived stress as well, the more it's harder to stay within and access our thinking brain and access that prefrontal cortex. And so then as soon as that goes offline and I don't have access to that part of my brain anymore, and I'm starting to shift into a little bit more of a survival brain, into a bit more of a fight, flight freeze or fawn response, well, then it's going to be even harder because I can't actually access that part of my brain. So before I can even touch starting the task, I need support to be able to regulate myself. And the piece with that is as adults, sometimes we can do that independently and do it as self-regulation. But for most of our kids, it's not. It's through a shared process, it's bits of co-regulation, and they might be able to do elements of that manage elements of their regulation independently, and there's lots of their regulation that we support with as adults. So if we think about what we do, the first bit always is to support the regulation, support that nervous system to be in a state where it can access its thinking brain, it can access that frontal lobe and that prefrontal cortex so that it can start to do some of the problem solving, so that it can start to make some of the decisions, so that we can actually initiate the task. And if we think about how we're gonna do this, we're gonna use all of our co-regulation strategies. We're going to, and again, jump back into the earlier season because there's heaps on this, and I'll kind of talk through links to the regulation throughout some of the other strategies, but it's looking at the understanding of this strategy is gonna be successful if the brain's ready for it, and if the brain's not ready for it, I need to do something slightly different, and sometimes that can be as simple as sitting down with your child and going, Whew, this one's a bit tricky today. That's alright. We're gonna take a minute together. I know it's been a bit frustrating, but we'll figure it out together, and that co-regulation, I'm sharing my calm with them and showing them that they're not alone within this, and that there will be a solution to this, and we'll be able to figure it out together. It could also be doing something different first, and we'll talk about in a minute about movement and movement initiation, but it could be going, we're gonna do something different to help our body and help our brain feel better, and then we're gonna come back to this. And so putting in those strategies with them about what are the adaptive strategies that we can use, what can we shift away to go and do to help our brain and body feel better before we come back and do this trickier task? And it's always coming back to that idea of regulation for the purpose of what? So in this case, we're helping ourselves get regulated, we're helping our body and our brain feel ready to come back and do the tricky task that we were having difficulty with. So always thinking about it in terms of are we regulated enough for this activity? And if you're not sure, my advice is to always go in with a bit of extra regulation support because it can only help before then shifting into some of the strategies. So then if we think about movement, movement is fantastic, and often when we put in some movement, and this could be anything from a dance party to jumping jacks to a running race to going for a walk, moving our body has so many benefits, and it has many benefits from a regulation perspective because I'm moving my body in and I'm getting that more proprioceptive input and a little bit of vestibular input often, and so I'm helping my body go, no, I'm okay, I'm grounded, I feel okay. But equally, what it does is it shifts our attention to something else, and it helps us start a bit of momentum, and momentum is so helpful in then going, okay, I can move through this, I can move through this, and all of a sudden, oh, I can start that next task, and it wasn't as hard anymore. And it helps us start to have those smaller wins. And I'll be honest with you guys, as anytime before I sit down and record a podcast episode, I have a dance party because I know that I movement's really helpful, and I know that I love to dance, and particularly dance to songs that have some strong rhythm to them, and I have a dance party in my room, help my body feel better, help my brain feel ready, and then I'm good to sit down and record this episode. And so sometimes it's looking at the things that we know are gonna be tricky to start and putting in activities before them. So we're not even gonna try starting that task until we know that our brain's ready. So it could be before we're getting dressed in the morning, we're doing some animal walks, or we're doing a bit of an obstacle course, or we're doing some jumping jacks, or we're having a dance party in the kitchen, whatever it might be. You could do the same around homework time, or actually, before we even touch homework, we're gonna go for a walk outside, or we're gonna go ride a bike, or we're gonna go to the playground, get all of that energy out, and then we're gonna come back and we're feeling a little bit better, and our brain is ready to tackle it. Movement also helps get that balance within our arousal and our alertness level. So, particularly if we've had a bit of a sluggish day, we're moving a bit slow and we're just feeling a bit, oh, my brain's tired, everything's just I'm exhausted. Actually, shifting into a bit of a movement helps increase that arousal, gets that brain back online, and then we're ready for it. So you could do anything from heavy work activities, a dance party, as I said, a bit of a stretch is also really nice. So just thinking about the times where you could use a little bit of movement if there are activities that we know are trickier to start, or if you notice that your child's gotten stuck and actually is perseverating through this going to be helpful, or do we actually just need to shift, give the brain something else to focus on, use movement to help that shift and then come back to the activity that we were doing. Another really key strategy, if we're thinking about this, is reducing the cognitive load. And part of this just comes from being mindful of the hidden cognitive load that's associated with a lot of these tasks. And so it's things like breaking it down into smaller steps. I know it sounds so simple, but actually going, okay, it's almost time for homework. What do we need to do first? Can you help me remember? Hang on. There's something before we start homework. Oh, we need to find your homework. Great, let's go find our homework. And so again, we're doing that shared problem solving piece of can you help me remember? I've forgotten. You can do the same with dressing. It's time to get dressed. What do we need to get dressed today? Do we need your shoes? No, we need something before your shoes. What do we need? Oh your socks. Oh, hang on, what are we gonna wear today? Let's think about it together, let's figure this out together. And it's the same with is it a sports day? Some schools, you know, if it's they've got PE that day, they're going into school in sports uniform all day. Okay, is it a sports day? Which uniform do we need? Making these hidden cognitive load a bit more explicit and working through that piece together. So breaking down the processes together. And sometimes this can be making a list. I had one um child that I worked with who, for him, it was posted. And he loved to post-it. And so we made post-it lists around the house and then he could take them off. And he had his um you know, they only stick so many times, but typically they'd last about a week. And so he'd pull out his ones for getting dressed, he'd put the post-its up on the mirror, and then as he went through, he took them off and put them back away. And then next time he had to get dressed, they came out again. And then at the end of the week, he'd rewrite the steps. And sometimes he'd be actually I don't need that step anymore. Because I don't I'm my brain was remembering that one now. And so over time the post-its he didn't need them at all because the more repeated successes you have of something, the more you're proving to your brain that it's easy to do, and you can do this independently, you're building your confidence and you're building your skills in it, and the less of the supports you need, or you may need the supports forever, and that's also okay too, because it's finding the supports that work for you. Other times it's a whiteboard, like can we write down the smaller steps in a whiteboard, and then you get the success of ticking them off or crossing a line through them or rubbing them off, whatever it might be that works. And by using the smaller steps, and you could use like pictures as well. Sometimes pictures works better than written. Um, but by using the smaller steps, all of a sudden the goal isn't this big or huge goal that I don't know how to start. It's naturally broken down into smaller steps, and then you can make it fun by going, okay, let's say it's getting dressed that's the tricky one to initiate, and you say, Well, let's let's see who can do it first. Should we have a race now that we've got our plan? And then for the next room, you might be calling up and be like, Oh, I've done the first one, I've got my socks on, how are you going? Oh, you're on the second one already. What was the second one again? Oh, that's right. I was putting my top on, and I realized I just said socks and top, and that's definitely not the order. Well, you could do it in that order, there's no reason you can't, but um just thinking about and how you can do that shared and helping them remember just by asking some questions. Oh, I need help. You know, asking for help and modeling the thinking that you're doing to help them start to practice that thinking as well. And it also makes it fun, and it's something you can do in class as well, you know. All right, we're gonna split up. You guys have, you know, let's say you've got six tables and you've got so three groups of two, and right that group over there, you guys are gonna be responsible for getting the paper. This group over there, you guys are gonna be responsible for getting the colored pencils, and this group over here, you guys are gonna be responsible for getting the glue sticks. So your job is you have to get the thing that you're responsible for, make sure each table has some and come back to your chair so you're ready to start, and then go. And all of a sudden, each group knows their piece within the bigger process instead of all right, everyone, we're gonna do this arts and craft activity and off you go, get all the resources, much harder to do. So it's just a bit of a rethink around how we can give those little strategies within how we frame and structure a task. So that's the piece when we think about reducing the cognitive load, um, breaking down it into smaller steps, and also sometimes, and this is more for some of our older kids, last thing on cognitive load, is just sitting down and doing a bit of a brain dump together. Because sometimes we have difficulties with initiation because there's too many things to do, and it can be really helpful to just sit there and write them all down, do a bit of a mind map, and then go, right, I'm not gonna worry about all of those ones right now. These are the two that I'm gonna prioritize, but I don't need to keep thinking about all these other ones. I don't need to hold them in my brain because I've written them down and I know that I'll be able to come back to them. The other strategies that you can do is look at the quick wins that you can get and build on the success. So this kind of comes hand in hand with the task breakdown that we do and looking at the smaller steps, but it's looking at that piece of which are the bits that we can achieve quickly and have that real success with before we start to tackle the bigger c the bigger task. And is it that we again do a bit of a shift and do something slightly different to do an easier quick win, get a bit of that momentum and that success fee happening, successful feeling happening to then shift into the harder activity. You know, it's the things of coming home at the end of the day, and let's say, well, let's say it's the weekend and you've got some time and you've got some playtime and everyone's having a great time, and you go, right, kids, we're gonna have to go to the shops today, and then we're gonna go to the park, and then but before we do all of that, we need to shower and get ready. And so you might sit down with them and go, Okay, so before we can leave today to go out to the park and go and see everybody and go to the shops, we need to pack away what we're playing with, we need to have a shower, we need to get dressed, we need to find our shoes, and we need to pack our bags today. And you might look at all those and go, ooh, which one should we do first? Which one feels easy? And they might go, oh, let's go have a shower first. That feels fine, great, let's do do that. And then we've got the success of that, and we can tick that one off, and we can tick the next one off, and then the trickier bit of having to pack away my toys that I was really enjoying playing with, well, we can do that last because then all of a sudden we're just about to leave. So the motivation's there, and I can go, fantastic, let's go and get out the door. And I've also been in that momentum of ticking things off and having those successes to make that harder one of packing away all my toys feel a little bit easier. And also within this, you can model this to your kids. It could be cooking dinner. Oh guys, I don't really feel like cooking dinner today. I wonder if you guys could help me, because it feels a bit tricky today. And I just there's so much to do for dinner today. But you know what? Maybe we just start with chopping the veg that we need. Can you help me? And then we do the next little bit and the next little bit. Or it could be the same with getting dressed. Like it literally could be anything, but you can model your thinking out loud for them to go, oh yeah, we can do that little bit. That bit feels easy, not a problem. And then again you start to get into this little bit of a momentum state to be able to then tackle the next things. And you can also and the biggest bit actually, I say also, but no, it's the biggest bit. Within all of these, the big biggest piece of advice I can give is make it playful and fun. And even if sometimes that means doing something in a silly way, then do it in a silly way and have those shared moments of joy together because most of a child's day is play. And the more that we can hide some of this learning within play, the easier it's gonna be. So you could use, you know, timers and races to make it a bit silly. You could be do getting dressed and putting the wrong things in the wrong part of your body and having them go, Oh, that's not right. Hang on, remind me again. Where does it go? You could, you know, make many challenges up together, and you could set them up so they're gonna win and they have the success. But you can also give them autonomy within this as well, and go, I think this one's a little bit too hard right now, so we're gonna do something different, and then we'll I'll come back and we'll do this together later. But first, let's do something that's gonna help ourselves feel ready and let's make it fun, you know, and so it's not just all right, we're gonna do these jumping jacks, these jumping jacks are gonna help. It's like, right, let's do a dance party, let's do an obstacle course, let's go for a bike ride, let's play a bit of a silly game. Twister's a great one, pull that out for a bit of a change. You know, use the post-it notes, be playful with it, or whatever the strategy might be, the more you can be playful and silly with it, the easier that's gonna be for them to start to access the learning and feel more confident in what they're doing. You know, I've done a whiteboard list in a session many, many times, but you know, we'll write our list of what we're doing so that we all know and it's gonna be easy to get through the jobs that we have to do in our session. And then we get through them and I go, hang on, we forgot we need to rub it off the whiteboard. Should I rub it off with my nose or my finger? Or and you know, we just have a bit of a laugh about it, do it in a little bit of silly way, and then once we've wrapped off, I was like, man, what's the next thing? Oh, that's right, now we're doing handwriting. Off we go. Well, not that I like handwriting all that much, but whatever the activity is, even if it is moving into the next um game that we're doing, the bit is actually that we're initiating the next and initiating the next, and what we're working on is the initiating the different activities, but we're doing it in a fun, playful, silly way. So, as always, I think you guys are probably sick of hearing me say it by now, but the more that we can add play into what we're doing, the easier it's gonna be, and also the more fun that you're gonna have too. And if we can have those moments of shared joy, everything gets a little bit easier. Well, that is it for this week's episode, guys. I hope you've enjoyed. As always, if you think the podcast can be helpful to anyone, please share it around to your friends. It's there for you guys. If you have any questions or anything that you would like me to cover in upcoming seasons, drop me an email to belzotcorner at gmail.com or send me a message on Instagram, whichever works best for you. And if you would like to support the show and help me keep it going, there's a link in the um my bio on Instagram and also should come up in the episodes for buy me a coffee, which is just a place where you can donate if you'd like to support the show to keep going. And have a lovely week, guys, and I will see you soon. Bye.