Wednesday, October 10, 2012

Executive Functioning

Our children’s, or even our own, actions and behaviors often get attributed to a variety of things. Some of which may be accurate explanations, but often times we misdiagnose the cause. And as a result, the chance of success in changing these behaviors is significantly decreased.

While we may not be able to pinpoint the origin of all behaviors, there are some behaviors that we are increasingly becoming more aware of. Some of which are behaviors related to executive functioning.

Now ask yourself:

Does your child put his/her homework in their backpack, but somehow it never gets turned in? Do they often act on impulse before thinking? Is their backpack full of loose papers? Are they missing assignments? Do they have an abnormally hard time picking-up messes or cleaning? Is it difficult for them to make choices?


Do you tend to start tasks but not finish them? Is your personal space typically disorganized? Does it take you significantly longer/shorter to complete tasks than you had anticipated? Do large projects overwhelm you? Do you have a hard time adjusting to change?

If you’ve answered yes to any of the above, then it’s probably a good idea to become more familiar with executive functioning, and how it may be impacting your life.

So, what is executive functioning?

The formal definition:
“A set of processes that all have to do with managing oneself and one’s resources in order to achieve a goal. It is an umbrella term for the neurologically-based skills involving mental control and self-regulation.” (Cooper-Kahn, 2008)

In other words, executive functioning is what helps a person “function” in day-to-day life.

What’s involved?

Generally speaking, there are many skills involved in executive functioning, each of which plays a crucial role in contributing to a person’s life, career, and academic success. These skills include:

·      Planning
·      Organization
·      Prioritization
·      Inhibition
·      Emotional regulation
·      Time management
·      Flexibility
·      Persistence/follow-through
·      Working memory
·      Attention shifting
·      Self monitoring (metacognition)

A person with good executive functioning tends to perform these skills well. They are likely goal oriented, persist at tasks, monitor and adjust his/her behavior to be more efficient, are on top of work and schoolwork, and organized.

A person with poor executive functioning, or executive dysfunction, does not seem to have much success or ability to perform well with these skills, regardless of motivation or effort. These individuals might appear disorganized, emotional, forgetful, lost, or sometimes even lazy. They tend to set goals, but can’t seem to reach them. They often are missing assignments and behind at work. In general, they just seem to lack the ability to follow-through.

Anyone can have executive functioning deficits, or executive dysfunction, however it is a very common occurrence in individuals with Autism Spectrum Disorders, ADD/ADHD, and as well mental disorders and syndromes.

If someone performs some but not all of these skills well, do they have executive dysfunction?

Not necessarily. Most of us tend to be better at some executive functioning skills than others. Few of us are likely good at them all. A key difference between those with executive dysfunction and the rest of us is that those with real deficits in these areas really just can’t seem to get it right no matter how hard they try.  In fact, they may not even have the ability to come up with any solutions.

Is there a way to tell the difference?

Yes, there are a few ways that may help differentiate whether or not these problems are a result of real executive functioning deficits or something else. A couple of initial identifiers may include 1) attempts to improve the problems aren’t proving successful, 2) reinforcement and motivation don’t seem to work, and 3) there seems to be little if no improvement over time.

From a clinical and more diagnostic perspective, evaluations from a mental health provider can be performed to assess executive functioning.  These evaluations are able to identify and break down the specific areas of deficit.

Why it matters:

Real executive functioning deficits, or executive dysfunction, can greatly impact a person’s day-to-day and long-term quality of life. If an individual is not able to effectively perform tasks and work through routine obstacles, the chances of being successful in academics, career, and life in general can be greatly decreased. It is for this reason that specific deficits be identified and addressed appropriately in order to provide the individual the opportunity to reach their greatest potential.

What to do if you suspect a problem:

If you suspect a problem there are things you may want to do: 1) try some of the strategies listed below. 2) Communicate with teachers, supervisors, service providers, etc., to gather as much in formation as you can about the individual and what is going on in various environments. 3) If the problem is significant contact your mental health provider to discuss a possible evaluation to further assess the problem as well as information on additional support strategies.

Strategies for intervention:

Depending on age and developmental level there are various interventions and strategies that can be used as supports as well as for skill building. Some of these interventions and strategies include:

·      Step-by-step instructions for completing tasks
·      Visual organization aides, such as graphic organizers
·      Lists and checklists
·      Break up work into smaller pieces
·      Written as well as oral instruction
·      Minimization of clutter
·      Specification of expectations
·      Use of watches, timers, and alarms
·      Calendars and schedules
·      Identification of short and long term goals
·      Regular self reflection and evaluation
·      Specific vs. open-ended questions, expectations or requests
·      Reduction of distractions
·      Use of 1 and 2 vs. multi-step directions
·      Slowly increasing expectations and demands over time
·      Plan ahead when possible
·      Positive reinforcement
·      Behavior tracking of various interventions
·      Constant and open communication

To wrap it up:

Executive functioning skills are keys to success in almost all areas of our life. Before dismissing someone as being lazy or disorganized, understand that there may be something more going on. It is important to find strategies that work specifically for the individual, as we all are different and what works for one, may not work for another.

For more information on executive functioning, check out these resources:

Late, Lost, and Unprepared: A parents guide to Helping Children with Executive Functioning. By: Joyce Cooper-Hahn, Ph. D. and Laurie Dietzel, Ph.D.

Executive Skills in Children and Adolescents: Practical Guide to Children Assessment and Intervention. By: Peg Dawson and Richard Guare

Smart but Scattered. By: Peg Dawson and Richard Guare

Cognitive-Behavioral Therapy for Adult ADHD: Targeting Executive Dysfunction. By: Mary V. Solanto

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