What is executive functioning and why do you need to know?
Does your child struggle with impulse control? Do they run out or touch things they know they shouldn’t but seem unable to help themselves despite consequences? Do they struggle to get dressed? Does it take you 30 minutes longer to get out the door in the morning than you think it should? Do they frequently lose things like important papers from teachers? Is their desk, backpack, and folders completely disorganized and in disarray? Do they have difficulties with attention? Do they have emotional outbursts that seem atypical from other children?
If any of these sound familiar to you, your child may be struggling with a deficit in executive functioning skills. Executive functioning skills are regulated by the pre-frontal cortex in the brain. Many kids with developmental delays and disabilities such as: apraxia, dyspraxia, autism, ADHD, sensory processing disorder, and others are at risk for deficits with executive function skills. These skills include the following:
- Impulse Control
- Emotional Control
- Flexible thinking
- Working memory
- Self monitoring
- Planning and prioritizing
- Task initiation
My daughter has apraxia and developmental coordination disorder, but I think difficulties with executive functioning skills have the most impact on us and our life as a family. Any task that involves planning, sequencing, organizing and then execution brings her a massive amount of anxiety and manifests itself as her looking defiant and oppositional. Even a task like “brush your teeth” which she can and has done numerous times independently still stresses her out at times depending on how tired she is, or any other factors. The same is true for getting dressed in the morning or at night, cleaning her room (not gonna happen), or doing her homework from start to finish without direction from us.
How do I know it’s a deficit as opposed to her truly being defiant? I just said she has done most of these things independently at some point. I know though, because when she becomes physically distressed at the thought of performing a task, when I offer to help her she immediately calms down and is willing to do anything that is requested of her; including cleaning her room. An OT at Adam’s Camp this summer gave me this analogy.
Have you ever changed oil on a car? No? Great. It’s exactly like setting your in front of a car and telling you to change the oil. You have no directions and you have no manual (think visuals), and you have no one there to direct you? How would you act?
This was such an “aha” moment for me. Let’s look at our list above. In this scenario, I’m going to struggle with: task initiation, planning and programming and organization at the very least. If I can’t do it and feel I am messing up, it’s probably going to escalate into my emotional control which will potentially affect my flexible thinking and so on.
All of these processes are independent, but they can also be tied together.
So what do we do? Can executive functioning skills be taught?
The good news is YES. There is so much more great research too coming out now, and I’ve seen educational institutions grabbing onto this idea and implementing strategies into their classrooms. If you are a parent, accommodations to help executive functioning skills can be easily placed in the IEP under the accommodations sections; or if you want more targeted instruction, can be written as it’s own goal. Psychologist’s can administer a test to look at executive functioning skills. One such test we use at my school is called the BRIEF (Behavior Rating Inventory of Executive Functioning). Don’t be afraid to ask for testing if you think your child struggles with this.
That’s great for school, but what can frustrated parents like you and me do at home? I will write a Part 2 to this series in which I outline strategies to do at home for various skills.
In the meantime though, Sarah Ward is quickly becoming nationally recognized as a top expert in this area. She gives talks nationwide and if you can see her I have one word of advice: GO. She’s fantastic, fresh and has current ideas that incorporate technology and apps that I have never seen presented before. Most talks on executive functioning that I go to now will almost always include a suggestion they got from Sarah Ward. Her website is Cognitive Connections.
You can also find books on the topic that have good reviews with practical suggestions for parents:
These books are geared more for parents and what you can do at home. I also found some kid books that I think are helpful when we are talking to our kids about their difficulties.