Executive functioning program changed one family's lives

Leo Krause was diagnosed with ADHD and anxiety in the fourth grade. Although Leo was prescribed medication for these conditions, not all of his problems were solved, said his mother Jodi Krause. The situation required a different approach.

Jodi Krause is a brain injury specialist and special education teacher who is considered an executive functioning expert. Despite her profession and training, she struggled to understand how to help her son without experiencing high levels of stress and anxiety.

“It was like he used all his energy to keep it together at school and would just fall apart at home,” Jodi Krause said. 

Leo didn’t want to do homework and struggled with transitioning from one task to another, especially if one was not preferred. 

“He was struggling with flexibility. He was completely inflexible,” Jodi Krause said. “Our whole world was upside down and the mood in our house was awful.”

It was then that Jodi Krause decided that something else needed to be done. As an executive functioning teacher, Krause knew about the Unstuck and On Target program, or UOT, but had not used it for her family. It wasn’t until she felt as though her family was in crisis mode that she decided to look deeper into the program.

The UOT program was developed by a collaboration between Children’s Hospital Colorado, Children’s National Hospital and the Institute for Innovation and Implementation at the University of Maryland in Baltimore and focuses on teaching executive functioning skills to students who have autism, ADHD and other executive functioning deficit diagnoses. 

While Jodi Krause and Leo attended a program at Children’s Hospital Colorado, the program has recently become free and online to all parents and educators.

The program was adapted to a virtual setting after it received a $2 million contract from the Patient-Centered Outcomes Research Institute in 2020. 

“Through our initial research, we saw that the classroom behaviors of children with autism spectrum disorder or attention deficit hyperactivity disorder improved markedly with a teacher’s implementation of Unstuck and On Target groups,” said Laura Anthony, PhD, Children’s Colorado psychologist, professor of psychology at the University of Colorado School of Medicine and lead researcher. “Making a video-version of this training accessible and free to educators everywhere is a dream realized. This is a huge accomplishment for this research team, and we want to applaud the school districts and educators already taking advantage of these invaluable resources. There are many kids who need Unstuck in every school, and we hope this training will make it more possible for them to receive it.”

The program began in schools — where the team believed executive functioning skills were most in demand — with students helping to build it, Anthony said. This setting allowed for the interventions to have the best access to all students with low executive functioning skills.

After the project was deemed successful, Anthony and her team began working on how to automate it so that it was available to the most amount of people possible.

The program was developed so that individuals using it are not required to be certified in order to reach success, Anthony said. 

“It is really easy to use and we haven’t found any educators who don’t do it well. Even if someone is a para, somebody is a school psychologist … somebody is a teacher or a special educator — we’ve even had substitutes doing Unstuck and On Target — it doesn’t matter. If somebody wants to train to see what it looks like — which is what schools have asked us for, so that is what we created,” Anthony said.

While the program was designed to work with students with executive functioning deficits, Anthony has found that students of all ages and abilities have achieved success with the program. According to Anthony, executive functioning skills continue to develop up to the age of 30.   

“It was just spot on. It was as if they were describing him (Leo) to a T and was super validating …,” Jodi Krause said. 

For the Krause family, the program provided them common language that helped address the behaviors Leo was exhibiting and gave Leo a way to voice his views. It also helped Leo’s parents understand his abilities to function in certain situations and to provide support when it was needed instead of seeing it as a “won’t” moment, Jodi Krause said. The program also gave Leo’s school the tools needed to keep consistency in Leo’s life.

“Although he isn’t in an Unstuck group anymore, we still use it in our home,” Jodi Krause said. “Honestly, it sounds super cliche and exaggerated but the entire experience is a game changer for us and we are forever indebted to the program forever for coming into our home and changing the dynamics.”