Flexible Thinking Skills

Disclaimer: This information sheet is for education purposes only. Please consult with your doctor or other health professional to make sure this information is right for your child.

What are they?

There are a collection of cognitive, or thinking, skills that are often discussed as a group and often called `executive functions' or `higher level thinking skills'. These skills include flexible thinking skills. These skills help people to adjust to changes in routine and expectations and to shift their thinking from one topic to another. These skills are often affected by acquired brain injury.

What do problems with flexible thinking look like?

The following list outlines some of the common difficulties that may be seen on an everyday basis that could indicate problems in this area.

• Sticking too strictly to a routine and/or getting upset when that routine is changed.
• Not being able to see the point of view of others or accept when somebody wants to do something differently.
• Getting `stuck' on particular activities, ideas or topics of conversation, repeating themselves - this is sometimes called `perseveration'.

What strategies might help?

• Avoid sudden changes in routine as much as possible and provide as much forewarning and explanation as possible.
• Provide forewarning in a number of ways to reinforce the message, for example by telling them verbally but also by posting a sign next to their timetable or noting it in their diary in the days leading up to the change.
• Move the child on by distracting them from the topic or activity they are stuck on.
• Gently move the child onto another topic, or back to the appropriate topic by asking relevant questions or reminding them that they have strayed or are being repetitive.
• Provide clear, calm feedback that they have said or done that before then ignore further repetitions so as not to reinforce it.
• Try not to become angry. The child/young person is not being difficult on purpose.
• Provide opportunities for the child to improve their judgement and understanding of others such as the use of role playing and structured discussion of certain situations.
• Encourage the child to imagine how they would feel in other situations.

Who do I see and how is it diagnosed?

Difficulties with flexible thinking skills, as well as other cognitive difficulties are formally identified by a neuropsychological assessment. A neuropsychologist can help devise compensatory and management strategies that are suitable for each individual child and their cognitive profile.

Rehabilitation Department The Children's Hospital at Westmead Cnr Hawkesbury Rd & Hainsworth St, Westmead Locked Bag 4001, Westmead, 2145 Tel: (02) 9845 2132 - Fax: (02) 9845 0685 http://www.chw.edu.au/rehabilitation/