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Strategy A: Environmental changes combined with executive function coaching

Brief, direct instruction in working memory techniques (visual checklists, timers), classroom structure (clear expectations, less distractions), and organization should be used.

How it improves cognition: By teaching techniques and lowering conflicting inputs, it improves working memory, goal planning, and inhibitory control.

Three-step implementation: 1) Establish a low-distraction workspace; 2) Provide one or two concrete methods (e.g., "first/then" boards); 3) Employ brief practice windows with frequent breaks and instant feedback.

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POSITIVE REINFORCEMENT AT HOME: (Token Charts reinforcement for home)

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Strategy B: Token economies and positive behavior support

Description: Teach replacement skills in conjunction with explicit, instantaneous feedback for on-task conduct and short, attainable goals.

How it improves cognition: By encouraging cognitive engagement and offering frequent success, it increases sustained attention and task persistence.

Three-step implementation: 1) Establish clear rewards and one or two goal actions; 2) Give regular, instantaneous reinforcement (tokens); 3) progressively raise expectations and switch to naturalistic rewards.

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American Academy of Pediatrics. (2019). ADHD: Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics, 144(4), e20192528.

Barkley, R. A. (2014). Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment (4th ed.). Guilford Press.

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ABA Prompting Hierarchy: Examples and Strategies

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Strategy A: Using task analysis to scaffold instruction

Dissect difficult activities into manageable chunks and offer progressive assistance that diminishes as proficiency rises.

How it aids cognition: By lowering task demands and developing progressively more complex skills, it supports problem-solving, working memory, and skill mastery.

Three-step implementation: 1) Break down the desired task into discrete steps; 2) Model and guide the initial step; 3) As accuracy increases, fade supports and combine steps.

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Strategy B: Multimodal instruction and assistive technologies

Use multimodal instruction (visual, aural, and tactile) in addition to basic assistive technology (AT) such as picture-based apps and speech-generating gadgets.

It facilitates encoding and retention through a variety of modalities and offers alternative communication channels.

Three-step implementation: 1) Determine functional objectives (such as matching and requesting); 2) Select a suitable low-tech or high-tech instrument; and 3) Provide repeated practice to teach methodical use in various contexts.

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American Association on Intellectual and Developmental Disabilities. (2010). Intellectual disability: Definition, classification, and systems of supports (11th ed.). AAIDD.

Schalock, R. L., et al. (2010). The renorming of the American Association on Intellectual and Developmental Disabilities’ adaptive behavior scales. Intellectual and Developmental Disabilities, 48(2), 105–117.

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Coffee Convo - "Pivotal Response Treatment (PRT) and Early Language and Communication" - July 2023

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Naturalistic Developmental Behavioral Interventions (NDBI) are the first strategy.

This approach integrates behavioral (like systematic prompting) and developmental (like following the child's lead) techniques into routines and play.

How it improves cognition: By combining abilities with stimulating tasks in natural environments, it fosters language, cooperative attention, and adaptable problem solving.

Three-step implementation: 1) Determine the child's favorite activities; 2) Model language and use brief, contingent prompts; 3) Encourage impromptu attempts and progressively reduce the frequency of suggestions.

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Visual Schedule for Preschool (free printable)

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Strategy B: Structured procedures combined with visual aids

Make use of decision boards, visual schedules, and detailed picture sequences.

It promotes working memory and sequencing, lessens cognitive burden, and facilitates transitions and task initiation.

Three-step implementation: 1) Make a basic image timetable for your everyday activities; 2) Show the youngster how to check and progress the schedule; and 3) When teaching multi-step tasks, use visual hints.

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National Research Council. (2001). Educating children with autism. National Academies Press.

Landa, R. (2018). Early intervention and the development of children with autism. Pediatrics, 141(Supplement 3), S234–S241.