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What Does it Mean to Have a Skill Deficit in Flexible Thinking?

Dr. J. Stuart Ablon

Transcription:

The basis of pretty much all of our work here at Think:Kids is recognizing that kids who struggle to manage their behavior, they don't lack the will to behave well. What they lack are the skills to behave well. And we've done a lot of research, but many other people around the world have done a lot of research over decades now, basically a half a century, to help identify the types of skills that kids who struggle with their behavior have a hard time with. And in essence, it comes down to five core domains of skill. And today, I want to talk a little bit more about one of those. And I have to say that it might be one of my favorite areas, and that is cognitive flexibility. And there are a whole bunch of kids out there who struggle with cognitive flexibility. That is with being flexible in their thinking.

They are what we often refer to as the black and white thinkers of the world, stuck in what is, unfortunately for them, a pretty gray world. You know, as you navigate your way throughout the course of the day, things rarely go exactly according to plan. We are asked to be flexible a lot during the day. Kids who struggle with flexibility, well, if everything goes magically according to plan, according to the routine, the template they had in their head, well, life is good. But if there's any change in the routine, if things don't go quite according to plan, if something crops up that requires a change, a shift, they really struggle. These kids also struggle with any new or ambiguous situation where they aren't able to create a template in their head ahead of time.

Now, the flip side of this is that these are kids who, you know, create templates in their heads, so if they do something one way, one time, it's often burned into their brain that way. They have incredible memories like that. The problem is just flexing with that information if it needs to be shifted at any time in the future.

Now, to make this come to life a little bit, I thought I would share a story of a girl who came into the office with her mom for a consultation. And the reason I like this story is it demonstrates that when you're looking through the lens of skill, not will, and paying attention; it's pretty easy to spot the skills that a given kid struggles with. You know, for instance, a full neuropsychological evaluation is very, very helpful if you can get it. But if you can't get it, looking in the right places will tell you a lot. And as I mentioned at the outset here, one of the five areas you want to pay attention to is flexibility in thinking. Now, what are the others that will cover some other times? They are things like language and communication skills, attention and working memory skills, emotion and self-regulation skills, and social thinking skills.

So back to the story. I go out to meet this young girl and her mother for consultation. And the first thing I, of course, like to do is to make some connection with the child who is probably wondering what they're doing here and why their parent dragged them here. And I go out into the waiting room. I see this girl who's in this amazing getup. She's got this big straw hat, is one thing, with dozens and dozens of beaded necklaces that are wrapped all around the hat and draping down from the hat, that she's clearly made. And she's also carrying, clutching close to her chest, what looks to me like a diary. And I was pretty sure it was a diary because my daughter used to have one just like it. So, in any case, I walk up, and I get down to my knee to meet her, eye to eye.

And I say, "I love your hat." And I said, "it's really cool. Did you make those necklaces yourself?" And she says, "yep." And I said, "and is that a diary?" And she looks at me, and she says, "no." I said," oh, it is not a diary. Okay. Well, what is it?" And she says, "it's a book." So, of course, I said, "oh, what kind of a book?" And she said, "a book, you write stuff in." And I was like, "oh, cool, okay." Following along, "what kind of stuff do you write in the book?" And she looks at me, and she says, "private stuff." And I'm thinking to myself, sounds like a diary. And so I say to her, "oh, it sort of sounds like a diary." And she says, "it's not a diary. It doesn't have a lock." I was thinking to myself, ah, okay.

To be a diary, it must have a lock or else. It is not a diary. So I'm taking a mental note. And I say to her, um, so do you mind me asking the kinds of private stuff you like to write in there? And she says, well, I can't tell you much, or it wouldn't be private. I said, good point. And she says, but I'll tell you that I do like to write songs. Oh, okay. She says, I just wrote a new one. Want to know what it's called? I said, of course. And she says, "Mad."

So I said, "oh, okay." And she says, "do you want to hear it? I said, "of course." And she says, "okay, it's eight minutes long. And don't interrupt me!" At this point, I decide, you know what? I should probably take this from the waiting room back into my office here, especially if it was going to be eight minutes long. And she willingly goes back into the office with me and then proceeds to recite, by heart, an eight-minute song with the theme being "mad." Now I share this little anecdote with you just to say again; you don't have to be a neuropsychologist to figure out in the first minute of an interaction with a girl like this the types of skills that she likely struggles with that lead to her behavioral challenges. In other words, the reason that her mother was bringing her in to see me and into our clinic in the first place. And which area should be screaming loud and clear at you, cognitive flexibility skills.

Now, of course, if you're paying close attention, you're wondering yourself, okay, her song she's writing all about is "Mad." Maybe there are some emotion-regulation challenges there, and yes, you might have guessed from our little interaction that social thinking skills may not be her strong suit. Which is a good reminder, folks, that it is extraordinarily rare that a kid will struggle in just one of those five areas that I mentioned because they're interrelated. They are not mutually exclusive. And for instance, I've never met a kid who has been very rigid, concrete, literal in their thinking like her, who struggled with flexibility, who doesn't also struggle to regulate their emotions, and have some difficulties in social interactions. Because the reality is when you're a very black and white thinker, you're sort of always operating in this state of hyper-vigilance—wondering when the world is going to throw the next gray thing at your black and white thinking brain, which has you in sort of a state of heightened anxiety.

And, of course, social interactions are all about taking another person's perspective or point of view into account, even if it doesn't align perfectly with yours, which makes for a lot of social subtleties, being hard for a child who struggles with cognitive flexibility skills. I hope this little anecdote is helpful to bring it to life. Again, the big take-home point here is that if a kid is struggling with their behavior, it's about skill, not will. And we know the types of skills that you need to be on the lookout for. And if you're looking for those skills, even in the slightest of little interactions, you'll get confirmation about whether your hypotheses are right or not. And once you figure out which skills the kid struggles with, well now, you know what you need to on, because if it's about skill, not will rewards and punishments and things like that. They're going to be barking up the wrong therapeutic tree. Instead, after identifying the skills that a child like this struggles with, our job, as adults, as helpers in this child's life, is to help them build those skills.

 

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