Last updated on September 29, 2016 By MPGteam Executive functioning refers to those skills that allow us to anticipate, plan, organize, set goals, carry out goals, and monitor one’s behavior according to changing demands. Executive functioning impairment does not necessarily reflect intellectual or verbal processing difficulties. Instead, it affects the regulation and use of all areas of cognitive functions, such as memory, attention, problem-solving, impulse control, motor skills, and planning/monitoring multi-step tasks. Children with executive dysfunction can have difficulty with: Initiating – starting chores, homework, and other tasks; generating ideas or problem solving Inhibiting – controlling verbal or physical impulses at specific times Shifting – thinking/acting flexibly; transitioning and getting stuck on topics, activities, etc.. Planning/Organizing – managing/problem-solving current and future-oriented tasks Organizing Materials – imposing order on work, play, or storage spaces Self-Monitoring – checking one’s work and the impact of his/her behavior on others Emotional control – modulate emotional responses with rational thought; easily upset or explosive Working Memory – holding information to complete tasks A recent study from the Society for Research in Child Development found that “children of moms who answered their children’s requests for help quickly and accurately; talked about their children’s preferences, thoughts, and memories during play; and encouraged successful strategies to help solve difficult problems performed better at a year and a half and 2 years on tasks that call for executive skills than children of moms who didn’t use these techniques in interacting with their youngsters.” I work with children and adolescents with Attention Deficit Hyperactivity Disorder (ADHD), Learning Disabilities (LD), and Pervasive Developmental Delays (PDD). Though these conditions are very different, they each can include some difficulties with executive functioning (e.g., getting ready for school, doing homework, and going to bed). I teach the following skills to parents and children to help them peform better at home and school: Self talk & goal verbalizations – give your child simple and clear directions of what they should do during transitions. “You are to walk quietly and slowly to the dinner table, sit in your chair, keep your arms/hands at your sides, and ask to be served.” Then ask your child to repeat what they heard to verify that they were listening and rehearse in their mind what they should be doing. This type of mental practice is essential. It also helps them learn how to talk themselves through solving problems. Structure & schedules – regular, predictable routines provide a sense of stability and focus, which is difficult to cultivate for children with executive functioning problems. They often lack internal mechanisms for planning ahead and adjusting to changes, which is evident during transitions (e.g., switching classes at school, going from school to home, or changing from playtime to homework). Further, it is best have written/visual schedules that children can keep with them and review multiple times per day. Problem-solving skills – it’s easy to overlook the level of effort required to solve problems at home, work, and in relationships. The steps: 1) Defining the problem, 2) considering all possible solutions, 3) evaluating pros/cons of each solution, and 4) executing your decision. In addition, one has to have the verbal and emotional skills to communicate their needs/wants during stressful situations. Giving feedback – it is extremely helpful to give children feedback on what’s effective and areas for improvement. This can be done on the spot when teaching a new task or helping them transition. For example, “I like how you walked slowly and kept your hands in your pockets. Next time, let’s try to also use our indoor talking voice.” I also recommend checking-in during breakfast and at bedtime to map-out and review the day. Finally, get feedback from your child how you can be more helpful when they are struggling. Rewards & consequences – one of the best ways to help children learn how to control their behavior is to reinforce those behaviors you want to continue or increase and punish those behaviors you want to eliminate. The most important aspects about implementing these are that you follow-through on your word, be consistent, and that the punishment/reward match the crime/good behavior. Following through on your promise to pick-up your child after school is equally as important as following through on a time-out when they misbehave because both actions model trust and responsible behavior. Written by Joshua Rosenthal, PsyD
