By Joy Granetz, Ph.D.
In this article on Executive Functioning, Dr. Granetz defines executive functioning and discusses red flags that may help to determine if your child is struggling in this area. Several recommendations are highlighted that have been shown to be useful in supporting children with executive dysfunction.
What is Executive Functioning?
Executive functioning is a term you might have heard in connection with attention and learning related challenges. It is a broad construct that encompasses many different aspects of cognition and behavior. Broadly speaking, the term refers to a collection of higher-level cognitive abilities that allow us to execute a task. There are executive skills that involve thinking, such as holding incoming information in mind, planning, prioritizing, organizing, and time management. There are also executive functions that involve behavior or doing, such as stopping oneself from responding automatically, controlling an emotional response, starting a task, sticking with a task, and flexibly switching from one task or idea to another. Most individuals have a wide range of executive skill strengths and weaknesses and knowing a child's specific strengths and weaknesses can often be helpful in figuring out where support is needed. It is also often helpful to consider your own executive functioning, to see if there is room for improvement on that end, as well. Research suggests that disorders in executive functioning can run in families.
We know that there is a developmental course of these skills that corresponds with growth of the frontal lobes, the part of the brain thought to be critically involved in executive functions. There tend to be changes in children's executive functioning that correspond to brain changes around the ages of 5, 10 or 11, and 17 or 18. Although challenges can emerge at any point of development, problems often emerge as the demands for independent work at school and home increase.
As with most cognitive skills, the development of executive skills is influenced by both biology and environment. This means that while it is true that executive functions may be limited by genetics and other biological factors (e.g., brain injury, exposure to lead), it is also true that the child's experiences and environment impact the development of these skills. Like muscles, the brain tends to operate on a use it or lose it principle. This means that brain connections that are used frequently tend to be strengthened, whereas those that are not used are lost. Importantly, this implies that practice and support of executive functioning skills is important, especially when these abilities appear to be an area of challenge for the child. As with most brain abilities, the earlier the intervention, the better.
How do I know if my child has executive dysfunction?
There are a variety of red flags that could indicate that your child is struggling with executive functioning and could benefit from support. Executive functions are related to what teachers commonly refer to as ‘study skills.' Parents of children with executive dysfunction often express concern that their child does not know how to study. They can learn the material; they just do not know how to learn the material on their own. They can do the assignment, they just cannot remember to bring it to school or hand it to the teacher. Long term projects are often very challenging for children with executive dysfunction because of the planning, prioritizing, and organization required for these projects. Kids with executive dysfunction are often said to have "no sense of time." Written expression is often particularly challenging for these children because writing demands a high level of organization, sequencing, planning, and perseverance. Parents also observe that multi-tasking is nearly impossible, as children with weaknesses in this area often are easily distractible and have difficulty managing several things in mind at one time. They may have difficulty following routines or following multi-step commands. Some children have trouble getting started on tasks independently and seem to get "stuck" during times of transition. It is often helpful for parents to watch their children's emotional and behavioral reactions to certain tasks. The child may be more apt to avoid a task that challenges them. Think about the task demands and consider whether your child has the capacity to do it. Note that even if the child can do the task sometimes, this does not imply that it is laziness or defiance. Inconsistency and variability of performance is often an indicator of executive dysfunction. If they were previously successful, try to pinpoint why. Evaluate your child's self-efficacy, their beliefs about their own likelihood of success and mastery.
Smart But Scattered
In their new book, Smart But Scattered, executive functioning experts, Drs. Guare and Dawson, outline 10 principles for improving a child's executive skills:
- Teach deficient skills rather than expecting the child to acquire them through observation or osmosis (incidental learning). We need to provide children with direct instruction.
- Consider the child's developmental level. A lot of parents hold unrealistic expectations for their child's level of independence. When the child's skills are delayed or deficient based on age, step in and intervene at whatever level the child is functioning at now.
- Move from the external to the internal. When you decide to help a child develop more effective executive skills, you should always begin by changing things outside the child before moving on to strategies that require the child to change.
- Remember that the external includes changes you can make to the environment, the task, or the way you the parent interacts with a child.
- Use, rather than fight, the child's innate drive for mastery and control.
- Create routines and schedules
- Build in choices
- Practice difficult tasks in small steps – don't move on too quickly
- Use negotiation
- Modify tasks to match a child's capacity to exert effort.
- Is the problem that the child is not very good at it, or is the problem that the child does not like to do it?
- If you fought a battle a couple of times and didn't win, it is best to change the nature of the battle.
- Use incentives to augment instruction.
- Provide just enough support for the child to be successful.
- Keep supports and supervision in place until the child achieves mastery or success.
- When you do stop the supports, supervision, and incentives, fade them gradually, never abruptly.
A few practical strategies that are recommended by the National Center for Learning Disabilities are:
- Take step-by-step approaches to work; rely on visual organizational aids.
- Use tools like time organizers, computers or watches with alarms.
- Prepare visual schedules and review them several times a day.
- Ask for written directions with oral instructions whenever possible.
- Plan and structure transition times and shifts in activities.
- Create checklists and "to do" lists, estimating how long tasks will take.
- Break long assignments into chunks and assign time frames for completing each chunk.
- Use visual calendars to keep track of long term assignments, due dates, chores, and activities.
- Use management software such as the Franklin Day Planner, Palm Pilot, or Lotus Organizer.
- Be sure to write the due date on top of each assignment.
- Organize work space.
- Minimize clutter.
- Consider having separate work areas with complete sets of supplies for different activities.
- Schedule a weekly time to clean and organize the work space.
- Make a checklist for getting through assignments. For example, a student's checklist could include such items as: get out pencil and paper; put name on paper; put due date on paper; read directions; etc.
- Meet with a teacher or supervisor on a regular basis to review work; troubleshoot problems.
What should I do if I think my child has executive dysfunction?
As mentioned earlier, most individuals have a wide range of executive skill strengths and weaknesses; knowing a child's and parent's specific strengths and weaknesses can often be helpful in figuring out where support is needed. If you have concerns, a good first step is to discuss your concerns with your child's teacher to see if the teacher has similar concerns. Teachers may be able to provide some insight as to whether a child's executive skills are below expectation for their age and grade level. If there are areas of concern, you can try a few practical strategies, such as those outlined in this article, to see if some environmental changes and supports help your child to succeed. There are also parenting books, such as Smart But Scattered, that provide practical and easy to implement strategies to help support a child's executive skills. If you believe that your child is in need of further support, then a comprehensive evaluation by a psychologist may be helpful to determine your child's specific needs. If your child has an attention or learning related disability, they may be eligible for certain modifications or accommodations at school that are necessary in order for the student to have the opportunity to perform at the same level of their peers and to succeed and thrive.
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