Fundamental Processes

The fundamental or foundational building blocks are at the base (orange level).
These fundamental building blocks are very sensitive to brain injury and are essential for all learning and behavior.

Jump to a Fundamental Processes section:

Sensory & Motor (Over Stimulation)

Sensory & Motor (Under Stimulation)

Motor - Fine

Motor - Gross

Attention

To learn more about the Fundamental Process of Attention click on the topic area to see a complete list.

Assessment Suggestions

These assessments are used to look at attention impacts secondary to brain injury, not to diagnose ADHD/ADD

A Developmental Neuropsychological Assessment, 2nd (NEPSY-II): Auditory Attention and Auditory Attention Response Set
Cognitive Assessment System, 2nd (CAS2): Attention Scale (Consider Planning Scale)
Wechsler Intelligence Scale for Children, 5th (WISC-V): Cancellation, Symbol Search, Coding, Working Memory Index and Auditory Working Memory Index
Differential Ability Scale, 2nd (DAS-II): Working Memory Composite
Woodcock Johnson, 4th (WJ-IV) Tests of Cognitive Abilities: Verbal Attention, Numbers Reversed, Object-Number Sequencing, Pair Cancellation, Letter-Pattern Matching
Conners Continuous Performance Test, 3rd (CPT3)
Auditory Continuous Performance Test
Tasks of Executive Control (TEC)
Test of Everyday Attention for Children (TEA-CH)
Behavior Assessment System for Children, 3rd (BASC-3)

Behavior Rating Inventory of Executive Function, 2nd (BRIEF-2): Working Memory (examine specific items)
Comprehensive Executive Function Inventory (CEFI)
Delis Rating of Executive Function (D-REF)
Conners, 3rd
Vanderbilt Teacher Behavior Evaluation Scale (VTBES)
Behavioral Observations of Students in Schools (BOSS)
Neurocognitive Evaluation Form (PDF)
Classroom Observations On Task/Off Task Peer Analyses
Behavior observations during testing
Parent, Teacher and Student Interviews

Environmental Supports and Accommodations

Brain Injury in Children and Youth: A Manual for Educators (PDF) (Chapter 3)
Directly teach and practice what paying attention looks like
Teach self-monitoring
Brain Breaks
Vigorous exercise
Mindfulness, meditation, relaxation techniques, yoga
Ensure that you have the child’s focus prior to giving instructions
Frequent check-ins and redirection
Reduce visual and auditory distractions
Clear desk of everything except what is needed for the lesson
Seat child closest to point of instruction and away from distractions
Verbal and visual cues (cue word, nonverbal gesture, sticky note system, stop light system)
Behavior Intervention Plan

Resources and Intervention

Brain Injury in Children and Youth: A Manual for Educators (PDF) (Chapter 3)
BrainSTARS Chapter 3 and Blue tabbed sections: #2 Attention
Executive Function in Children and Adolescents, 2nd (Dawson/Guare)\
Late, Lost and Unprepared (Cooper-Kahn/Dietzel)
Promoting Executive Function in the Classroom (Meltzer)
Smart but Scattered (Dawson/Guare)
Smart but Scattered Teens (Guare/ Dawson/Guare)
Tools for Teaching, 3rd (Jones)
Alert Program: How Does Your Engine Run (Williams/Shellenberger)
Positive Behavior Intervention Supports
Superflex: A Superhero Social Thinking Curriculum (Madrigal/Winner)
Games that build attention skills: Center on the Developing Child
Center on Brain Injury Research & Training
Project LEARNet

Inhibition

To learn more about the Fundamental Process of Inhibition click on the topic area to see a complete list.

Behavioral Impacts

Acts on first thing that pops into their mind
Blurts thoughts out and can talk excessively
Calling out rather than waiting with hand raised
Fidgety/squirmy
Difficulty staying in line, seat, classroom, etc.
Impulsive; “jumps before looks”
Interrupts; socially intrusive
Jumps into an activity rather than waiting for/reading instructions
Physical touch with others may be too much
Disregard for boundaries
Social Difficulties
Participating in unsafe behaviors or behaviors that get them into trouble

Assessment Suggestions

A Developmental Neuropsychological Assessment, 2nd (NEPSY-II): Inhibition, Statue, Auditory Attention and Response Set
Delis-Kaplan Executive Function System (D-KEFS): Trail Making, Color Word Interference, Design Fluency, Sorting, Tower, 20 Questions
Cognitive Assessment System, 2nd (CAS-2): Attention Scale
Woodcock Johnson, 4th (WJ-IV) Tests of Cognitive Abilities: Pair Cancellation
Wechsler Intelligence Scale for Children, 5th (WISC-V): Matrix Reasoning (quickly responds without considering options or quickly responds and then immediately changes answer)
Differential Ability Scales, 2nd (DAS-II): Matrices (quickly responds without considering options or quickly responds and then immediately changes answer)
Kaufman Assessment Battery for Children, 2nd, (KABC-II): Riddles
Conners Continuous Performance Test, 3rd (CPT3): Response Speed, Commission Errors, Perseverations
Test of Everyday Attention for Children (TEA-Ch)

Stroop Color-Word Interference
Behavior Assessment System for Children, 3rd (BASC-3): Hyperactivity Scale
Conners, 3rd: Hyperactivity/Impulsivity Scale
Behavior Rating Inventory of Executive Function, 2nd (BRIEF2)
Comprehensive Executive Function Inventory (CEFI)
Delis Rating of Executive Function (D-REF)
Observations in the environment
Functional Behavioral Assessment Behavior observations during testing (jump right in or thoughtful about responses/approach)
Parent, Teacher and Student Interviews

Environmental Supports and Accommodations

Brain Injury in Children and Youth: A Manual for Educators (PDF) (Chapter 3)
Provide structure
Teach routines and expectations. Fade external support to internalization of routine and systems
Intentional adult movement through room
Brain Breaks and movement
Fidgets, wiggle seats, exercise balls, etc.
Allow standing while working
Verbal and visual cues (cue word, nonverbal gesture, sticky note system, stop light system)
Teach goal-directed problem solving process; Goal-Plan-Do-Review
Teach stop, relax and think
See Reasoning, Mental Flexibility and Social/ Emotional Competency Building Blocks

Resources and Intervention

Brain Injury in Children and Youth: A Manual for Educators (PDF) (Chapter 3)
Executive Function in Children and Adolescents, 2nd (Dawson/Guare)
Lost at School (Greene)
Promoting Executive Function in the Classroom (Meltzer)
Smart but Scattered (Dawson/Guare)
Smart but Scattered Teens (Guare/ Dawson/Guare)
Alert Program: How Does Your Engine Run (Williams/Shellenberger)
The Incredible 5 Point Scale (Buron/Curtis)
Project Achieve – Stop & Think Program (Knoff)
Project Success (Kastner)
Superflex: A Superhero Social Thinking Curriculum (Madrigal/Winner)
Zones of Regulation (Kuper)

Processing Speed

To learn more about the Fundamental Process of Processing Speed, click on the topic area to see a complete list.

Assessment Suggestions

Wechsler Intelligence Scale for Children, 5th (WISC-V): Processing Speed Index, Cancellation
Differential Ability Scales, 2nd (DAS-II): Processing Speed Composite
Woodcock Johnson, 4th (WJ-IV) Tests of Cognitive Abilities: Letter-Pattern Matching, Pair Cancellation
Cognitive Assessment System, 2nd (CAS2): Planning Index
Task of Executive Control (TEC)
Neurocognitive Evaluation Form (PDF)
Observations in the environment
Behavior observations during testing
Parent, Teacher and Student Interviews

Environmental Supports and Accommodations

Brain Injury in Children and Youth: A Manual for Educators (PDF) (Chapter 3)
Establish daily routines and classroom expectations
Allow for delay in response
Copies of notes and outlines
Extra time
Give clear and concise instructions one at a time
Repeat instructions
Provide written instructions
Combine visual and verbal information
Limit number of tasks required to complete at one time

Memory

To learn more about the Fundamental Process of Memory, click on the topic area to see a complete list.

Assessment Suggestions

A Developmental Neuropsychological Assessment, 2nd (NEPSY-II): Memory and Learning Subtests
Woodcock Johnson, 4th (WJ-IV), Test of Cognitive Abilities: Verbal Attention, Numbers Reversed, Object Number Sequencing, Nonword Repetition, Memory for Words, Story Recall, Picture Recognition, Visual-Auditory Learning, Sentence Repetition (Oral Language Battery)
Wechsler Intelligence Scale for Children, 5th (WISC-V): Working Memory and Auditory Working Memory Indexes, Arithmetic, Matrix Reasoning (later items)
Differential Ability Scales, 2nd (DAS-II): Working Memory Composite, Recall of Objects Immediate and Delayed, Recall of Digits Forward, Recognition of Pictures, Recall of Designs, Matrices (later items)
Kaufman Assessment Battery for Children, 2nd, (KABC-II): Sequential Processing Ability Scale
Delis-Kaplan Executive Function System (D-KEFS): Sorting
Child and Adolescent Memory Profile (ChAMP)
Children’s Memory Scale (CMS)

Test of Memory and Learning, 2nd (TOMAL-2)
Wide Range Assessment Memory and Learning, 2nd (WRAML2)
California Verbal Learning Test, 2nd (CVTL-II)
California Verbal Learning Test-Children’s Version (CTVL-C)
Test of Visual Processing Skills, 3rd (TVPS3): Visual Memory & Visual Sequential Memory
Behavior Rating Inventory of Executive Function, 2nd (BRIEF2)
Comprehensive Executive Function Inventory (CEFI)
Delis Rating of Executive Function (D-REF)
Neurocognitive Evaluation Form (PDF)
Behavior observations during testing (can only remember first or last parts of directions or stimulus materials)
Observations in the environment
Parent, Teacher and Student Interviews

Environmental Supports and Accommodations

Brain Injury in Children and Youth: A Manual for Educators (PDF) (Chapter 3)
Encourage to develop visual picture of what have learned or read
Teach concept and have them teach others
Experiential Learning
Have student paraphrase directions or steps
Mnemonic strategies
New concepts – engage background knowledge

Errorless learning
Pictures or visual cues
Provide copies of notes
Practice daily routines
“Priming the pump” – slightly elevate emotions when teaching new concepts
Use memory aids e.g. visual cues, planners, PDAs or other compensatory strategies
Use of competitive games
See New Learning Building Block

Sensory and Motor (Over Stimulation)

To learn more about the Fundamental Process of Sensory and Motor, click on the topic area to see a complete list.

Behavioral Impacts

Always touching people or things
Appears overwhelmed
Behavior may appear oppositional however, it may be adaptive; e.g. wearing hat to cover eyes, laying on the floor
Bumps into others when in line
Clothes are disheveled due to tugging and sucking on clothes
Emotionally melt down
Fidgety
Irritable, short fuse
Overly excited in stimulating environments such as the playground, PE, lunchroom, etc.
Seeks oral stimulation
Seeks physical feedback, e.g. leans on desk
Tunes out due to over stimulation

Cognitive Academic Impacts

Difficulty completing worksheets with too many items on them
Difficulty shifting from workbook/textbook to writing on answer sheet/paper
Difficulty transitioning
Difficulty with group work and group discussion
Difficulty with reading due to visual stimuli
Difficulty with seat work
Excessive erasing, crossing out of words
Gets overwhelmed in crowded environments
Incomplete work
Messy papers, school work is not well-organized
Poor handwriting

Assessment Suggestions

Sensory Profile-2
Sensory Processing Measure (SPM)
Sensory Processing Measure Preschool (SPM-P)
Sensory Integration Inventory
Degangi-Berk Test of Sensory Integration (TSI)
Dean-Woodcock Sensory Motor Battery
A Developmental Neuropsychological Assessment, 2nd (NEPSY-II): Sensorimotor Subtests

Effective informal vision – ocular motor control
Functional Vision Assessment
Neurocognitive Evaluation Form (PDF)
Vision and hearing screening: conversion/tracking/depth perception
Observations in the environment
Functional Behavioral Assessment Behavior observations during testing
Parent, Teacher and Student Interviews

Environmental Supports and Accommodations

Brain Injury in Children and Youth: A Manual for Educators (PDF) (Chapter 3)
Occupational Therapist and/or Physical Therapist Consult
Allow student to dictate first draft of written assignment rather than write
Allow student to use a computer for written work
Reduce number of problems on a page
Break down written work into chunks
Deep joint pressure
Preferential and thoughtful seating to reduce auditory and visual stimulation
Preferential seating to decrease sensory input

Reduce visual and auditory distractions
Situation modification: earplugs, sunglasses, visors, moving to a new location
Situation selection: tune into preferential sound, mindfulness, goal orientation, diaphragmatic breathing
Use color overlays
Use line ruler to assist with visual tracking
Use study carrel
Weighted vests/ items (blankets, animals)
Wiggle Seat/inflatable chair cushion/ dynamic seating systems
Conduct assistive technology evaluation

Sensory and Motor (Under Stimulation)

To learn more about the Fundamental Process of Sensory and Motor, click on the topic area to see a complete list.

Assessment Suggestions

Sensory Profile-2
Sensory Processing Measure (SPM)
Sensory Processing Measure Preschool (SPM-P)
Sensory Integration Inventory
Degangi-Berk Test of Sensory Integration (TSI)
Dean-Woodcock Sensory Motor Battery
A Developmental Neuropsychological Assessment, 2nd (NEPSY-II): Sensorimotor Subtests

Effective informal vision – ocular motor control
Functional Vision Assessment
Neurocognitive Evaluation Form (PDF)
Vision and hearing screening: conversion/tracking/depth perception
Observations in the environment
Functional Behavioral Assessment Behavior observations during testing
Parent, Teacher and Student Interviews

Environmental Supports and Accommodations

Brain Injury in Children and Youth: A Manual for Educators (PDF) (Chapter 3)
Occupational Therapist and/or Physical Therapist Consult
Allow them to chew gum, hard candy, or crunchy foods
Fidget items
Heavy work or deep pressure activities

Running or jumping
Stretch bands on chairs
Therapy seats/exercise balls for sitting
Therapy swings or swinging
Trampoline
Wall push-ups

Motor - Fine

To learn more about the Fundamental Process of Fine Motor, click on the topic area to see a complete list.

Assessment Suggestions

Beery-Buktenica Developmental Test of Visual Motor Integration, 6th (BEERY VMI)
Bruininks-Oseretsky Test of Motor Proficiency, 2nd (BOT-2)
Bender Visual-Motor Gestalt Test, 2nd
Evaluation of Children’s Handwriting Skills – Grades 1-6 (ETCH)
Test of Handwriting Skills-Revised (THS-R)
Schooldles School Fine Motor Assessment, 4th (SFMA-4)
Peabody Developmental Motor Skills, 2nd (PDMS-2)
Test of Visual Motor Skills, 3rd (TVMS-3)
Preschool Visual Motor Integration Assessment (PVMIA)
Developmental Test of Visual Perception, 3rd (DTVP-3)

Wide Range Assessment of Visual Motor Abilities (WRAVMA)
Slosson Visual-Motor Performance Test (S-VMPT)
A Developmental Neuropsychological Assessment, 2nd (NEPSY-II): Sensorimotor Subtests
Dean-Woodcock Sensory Motor Battery
Differential Ability Scales, 2nd (DAS-II), Recall of Designs
Neurocognitive Evaluation Form (PDF)
Observations in the environment
Observations during testing
Parent, Teacher and Student Interviews

Environmental Supports and Accommodations

Wide Range Assessment of Visual Motor Abilities (WRAVMA)
Slosson Visual-Motor Performance Test (S-VMPT)
A Developmental Neuropsychological Assessment, 2nd (NEPSY-II): Sensorimotor Subtests
Dean-Woodcock Sensory Motor Battery
Differential Ability Scales, 2nd (DAS-II), Recall of Designs
Neurocognitive Evaluation Form (PDF)
Observations in the environment
Observations during testing
Parent, Teacher and Student Interviews

Motor - Gross

To learn more about the Fundamental Process of Gross Motor, click on the topic area to see a complete list.

Assessment Suggestions

School Functional Assessment (SFA)
Test of Gross Motor Development, 2nd (TGMD-2)
Peabody Developmental Motor Scales, 2nd (PDMS-2)
Bruininks-Oseretsky Test of Motor Proficiency, 2nd (BOT-2)
Peabody Developmental Motor Skills, 2nd (PDMS-2), for birth to 2 yr
Dean-Woodcock Sensory Motor Battery
Neurocognitive Evaluation Form (PDF)
Observations in the environment
Parent, Teacher and Student Interviews

Environmental Supports and Accommodations

Building Blocks of Brain Development & Glossary Developers/Authors (2018): Nicole Crawford, Patricia Colella, Judy Dettmer, Heather Hotchkiss, Karen McAvoy, Peter Thompson, Janet Tyler. Special Thanks to Tami Cassel, Donna Detmar-Hannah, Laura Dosch, Jayne Dougherty, Mary Linz, and Jennifer Mathis.

(*indicates free resource)

Aggression Replacement Training. Goldstein, A, Glick, B. & Gibbs, J. Research Press
American Speech Language Hearing Association http://www.asha.org
Assessment and treatment of TBI with school age children & adults. 1992. Ylvisaker, M. Buffalo NY: Educom Associates
*Brain Injury in Children and Youth: A Manual for Educators. 2018. Colorado Department of Education. www.cde.state.co.us/cdesped/sd-tbi
Brain Injury Survival Kit, 365 Tips, Tools, & Tricks to Deal with Cognitive Function Loss. 2008. Sullivan, C.
*BrainLine – Children with TBI – www.Brainline.org
BrainSTARS: Brain Injury—Strategies for Teams and Re-education for Students. 2002. Dise-Lewis, J., Calvery, M. & Lewis, H.
BrainWise: 10 wise ways to stop and Think 1996. Barry, P.G. Denver, CO: Innisfree Press.
Bully Proofing Your School. 2004. Garrity. C. Longmont, CO: Sopris West.
*The Center on Brain Injury Research & Training. Evidence-based strategies for students with Brain Injury. https://cbirt.org/back-school
*Center on the Developing Child: Harvard University. http://developingchild.harvard.edu/resources/activities-guide-enhancing-and-practicing-executive-function-skills-with-children-from-infancy-to-adolescence/
Circle of Friends. https://www.circleofriends.org/
Essentials of School Neuropsychological Assessment, Second Edition. 2013. Miller, D.C. Hoboken, NJ: John Wiley and Sons, Inc.
Executive Function in Education: From Theory to Practice. 2007. Meltzer, L. NY: Guilford Press.
Executive Skills in Children and Adolescents, 2nd Edition. 2010. Dawson, P. & Guare, R. NY: Guilford Press.
Explosive Child: A New Approach for Understanding and Parenting Easily Frustrated, Chronically Inflexible Children. 2014. Greene, R.W. Harper Paperbacks
Helping the Child who Doesn’t Fit In. 1992. Nowicki, S. and Duke, MP. Peachtree Publishers
How does your engine run? Alert Program for Self-Regulation. 1996. Williams, MS. & Shellenberger, S. TherapyWorks, Inc.
In Focus: Improving Social and Emotional Intelligence One Day at a Time. 2013. McSheehy, T. Burlington, WI: Thoughtful Learning.
Incredible 5 Point Scale. 2012 Burone, K. D. & Curis, M. Lenexa, KS: AAPC
Incredible Years, Incredible Years Program, Seattle, Washington http://www.incredibleyears.com/
*Interventioncentral.org – Interventions, suggestions, tools for social/emotional strategies. www.interventioncentral.org
Kidspiration (Grades K-5) & Inspiration (Grades 6-Adult) Software programs – http://www.inspiration.com/
Late, Lost, and Unprepared: A Parent’s Guide to Helping Children with Executive Funtioning. 2008. Cooper-Kahn, J. & Dietzel, L. Bethesda, MD: Woodbine House, Inc.
*LEARNet, Ylvisaker, M, HibbardM & Feeney, T. www.projectlearnet.org
Lifeskills Training http://www.lifeskillstraining.com
Lost at School: Why Our Kids with Behavioral Challenges are Falling Through the Cracks and How We Can Help Them. 2014. Greene, R.W. New York, NY: Scribner.
Make social learning stick!: How to guide and nurture social competence through everyday routines and activities. 2012. Sautter, E. Shawnee Mission, KS: AAPC Publishing.
The MindUp Curriculum: Brain Focused Strategies for Learning and Living. 2010. Hawn Foundation. New York, NY: Scholastic Teaching Resources.
*Positive Behavior Intervention Support. https://www.pbis.org
Project Achieve: Stop & think social skills program. 2001. Knoff, H. Longmont, CO: Sopris West.
Promoting Executive Function in the Classroom. 2010. Meltzer. L. New York, NY: Guilford Press.
Providing Alternative Thinking Strategies (PATHS), Kusche, C. and Greenberg, M., Channing Bete Company.
Sarah Ward: Cognitive Connections: 360 Thinking. http://efpractice.com/
SecondStep: Skills for Social and Academic Success. 2011. Goldstein, A & McGinnis, E. Research Press Publishers http://www.cfchildren.org/second-step SkillStreaming.
Smart but Scattered. 2009. Dawson P & Guare R. NY: Guilford Press.
Smart but Scattered Teens. 2013. Guare, R., Dawson, P. & Guare. New York, NY: Guilford Press.
Social Thinking Worksheets for Tweens and Teens. 2014. Garcia Winner, M. San Jose, CA: Think Social Publishing, Inc.
Superflex: A Superhero Social Thinking Curriculum. 2008. Madrigal, S. & Garcia Winner, M. Think Social Publishing.
Teachers Encyclopedia of Behavior Management 100 Problems/500 Plans. 2012. Sprick, R and Howard, L. Pacific Northwest Publishing
*Think:Kids – Rethinking Challenging Kids. Massachusetts General Hospital. http://www.thinkkids.org/
Tools for Teaching, 3rd Edition. 2013. Jones F. CA: Frederic H Jones & Associates, Inc.
Treating Explosive Kids: The Collaborative Problem Solving Approach. 2005. Greene, R.W. & Ablon, J.S. New York, NY: Guilford Press.
Visual Spatial Portals to Thinking, Feeling and Movement 2012. Wieder, S., & Wachs, H. Mendham, New Jersey: Profectum Foundation
*What Works Clearinghouse. 2002. U.S. Department of Education, Institute for Education Sciences. www.whatworks.ed.gov
Why Try – Building Resilience in the Workplace, at School and at Home. Moore, C. https://www.whytry.org/
You are a Social Detective. 2008. Garcia Winner, M. & Crooke, P. San Jose, CA: Think Social Publishing, Inc.
The Zones of Regulation: A Framework to Foster Self-Regulation & Emotional Control. 2011. Kuypers, L. San Jose, CA: Think Social Publishing.

Fundamental Processes

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