Tag Archives: integration

More on Executive Function:



Executive functioning (EF) is a real “lumper”, as in “lumper or splitter”, term. That is, it refers to a very broad class of skills that we use to get through the day at home, at school, and at work. Not only that, but for executive functioning to work well, all these skills have to be coordinated with one another. It is conceptually confusing to try to collapse all this complexity into one “thing”, but since it is frequently used to describe children, we will use it here too. EFD has a big overlap with ADHD, as you might imagine.

EF is used to help plan, organize, make decisions, and shift between situations or thoughts (make transitions), control emotions and impulsivity, and learn from past experience. It includes cognitive processes referred to as “working memory”, in which facts that are needed to solve problems – in academic tasks, social situations, or tasks of living, such as what is involved in getting ready in the morning – are kept accessible for use when necessary. A figurative image that is often used for working memory is facts on a shelf in the front of the brain, so that if a child is trying to solve a math problem, she may need to be able to find the multiplication tables right away and not stumble as she tries to retrieve them. Or if he is in a tricky social situation, he may need to recall a fact about another boy he wants to play with – such as that this boy does not like to be called a certain nickname – if he wants to make a good connection.

A child with EF difficulty, “executive function disorder” (a term I dislike because of the word “disorder” since there is no discrete “disorder”), has difficulty with organizing his life. He often has difficulty with handwriting (visual motor integration), trouble managing the multiple transitions of his daily life (getting ready in the morning, going from one activity in school to another, managing the bedtime routine), making sense of the complex social communications of the playground, inhibiting impulses (“using your words instead of your body”). Children with this type of difficulty also often have trouble with team sports in which you have to coordinate with multiple other players as well as manage your own body.

What can you to help your child who struggles with executive function problems? Well, to begin with, consider not that you are helping him “compensate” for deficits (which may be true in the immediate situation, of course) but rather that you are “growing his brain”. You are helping him to develop more robust capacities than he has, and you are doing that by making it possible for him to use his less developed capacities in a less demanding situation (so that he can be successful) and practice them over and over so that they can become stronger and more versatile. You are helping him build good habits. You are helping him expand his repertoire of competencies. You are helping him grow his brain.

You would like to ensure success through these considerations:

1. Context – The first thing to do is to identify the contexts in which your child can most easily succeed. Some kids can regulate themselves well in a highly structured setting such as many school classrooms. Others require the reduced stimulation of a small group of children. Some may be able to sustain attention on a simple, structured task such as simple Lego kits or simple academic worksheets, but get frustrated and fall apart with less structured writing assignments or more complex Lego kits. It is common for some kids to do well on tasks requiring information that the child has learned well by practice but be unable to grasp novel concepts easily. Often children with these challenges are more vulnerable to physical or emotional distress interfering with their concentration – a cold or a conflict with a friend. Recognizing the context means you are empathizing with your child, which is at the core of successful parenting of a challenging child.
2. Take Your Time – No matter how much hurry you are in, slow down. Rushing will make everybody anxious and make matters much worse.
3. Break it Down– Then break down the information you want the child to learn into small enough pieces that he can take it in. Directions should be simple (“First, hang your coat on the hook.”); beware of multi-step directions (“Hang your coat on the hook and put your boots, and then come into the kitchen to have your snack.”). Or, teach morning routine in pieces, such as (1) use the toilet; (2) brush your teeth; (3) wash your hands and face; (4) put on your clothes; (5) come down to breakfast.
4. Make Checklists – Help your child by making checklists. Often these children get so preoccupied by making the first decision, that they cannot even start working on the task they have decided on. Setting out the requisite tasks in order ahead of time can make all the difference in a smooth transition. Checking off all the steps can create an experience of mastery. It is also helpful to do as many of the tasks involved in transitions ahead of time, such as laying out the clothes for the next morning the night before, putting everything in the backpack, making the lunch.
5. Write it Down (or Make Pictures) – For younger children, it is helpful to make a schedule strip of Velcro with words, or pictures (depending on the maturity of the child) to document the child’s daily routine. For older children, weekly planners are very useful.
6. Routines are Your Best Friend – Routines establish a comforting predictability that ease tension by making transitions easier. When children know what is coming, the momentum of the schedule can carry them into activities that they would otherwise refuse. Routines help you practice, and practice is essential to building a bigger repertoire.
7. Rewards – I think of rewards – stickers, treats, or special time with parents – not as bribes but as acknowledgement for an accomplishment hard won. Especially for kids with attention problems, rewards given quickly after a good effort can promote motivation.

Photo by Ginger Gregory