Does your child have good ideas but struggle to get them down on paper? Do you frequently return to your child’s school to retrieve forgotten homework assignments? Have you ever been alarmed to discover your child has an untouched long-term assignment due tomorrow? Problems such as these are common among children with executive function deficits. Executive functions organize and control our cognitive abilities. They enable us to plan, organize, prioritize, self-regulate, initiate activities, think flexibly, and inhibit inappropriate behaviors. In school, executive functioning problems may result in lateness, difficulty transitioning, impulsiveness, poor test-taking abilities, and difficulty remembering and completing assignments. At home, they may result in difficulty with morning or nightly routines and with following general directions, such as being told to clean your room. Weekends can also be challenging due to decreased structure.
Executive dysfunction is common among children with autistic disorders, ADHD, and learning disabilities. However, some children have deficits without a co-occurring diagnosis. These children are typically harder to identify and are often described as lazy, unmotivated, or even oppositional by parents and teachers. They may be told they are “just not paying attention.” But it’s not that simple. They have neurological deficits that can persist or can change with appropriate intervention.
The development of self-awareness is an overarching goal in treating executive dysfunction. We want children to learn how they learn – to understand which strategies are successful for them individually. Parents and teachers should collaborate to identify a child’s areas of weakness and to develop plans. Routines can be established for everything from getting ready in the morning to completing assignments. For instance, if a child has difficulty selecting and organizing materials, teachers can check with a student at the end of each day to make sure he has the necessary tools to work from home. Checklists taped inside a child’s locker can also be a useful memory aide. To work on time management, you can ask your child to estimate how long she believes an activity will take and then record the actual time. Children (and adults) are often surprised by how much they miscalculate time. Exercises like this foster self-awareness. In addition, all directions should be specific rather than general. Instead of asking a child to clean her room, parents can list tasks, for example: make your bed, pick up clothes, and put them in the hamper.
Writing assignments are particularly taxing on executive functions and are therefore quite challenging for individuals. Writing requires organizing thoughts, holding information in your mind while typing, flexible thinking, and constant revising. In order to complete a research project, a person must scour books and the internet, sift through large amounts of information, choose appropriate material, and then read, take notes, outline, and compose. Executive functioning deficits can make these kinds of projects a nightmare. Therefore, having strategies to tackle them is crucial for success. Papers and projects should be broken down into pieces, and expected completion dates should be clearly documented on a calendar.
Executive functioning deficits can range from minor to more significant. Regardless of the severity, there are many strategies – some of which are noted above – that parents and teachers can try to implement and monitor. Include your child in the development and monitoring of progress so she learns to be more self-aware and to revise strategies along the way. If problems persist, a neuropsychological evaluation might be warranted in order to understand your child’s unique profile of functioning and to devise effective interventions.
Jaime earned her Doctorate in Clinical Psychology from Yeshiva University. She works in a private practice doing psychotherapy and evaluations. Jaime’s specialty is in working with individuals of all ages on the autism spectrum. www.spectrumservicesnyc.com. JaimeBlackPsyD@gmail.com. (914) 712-8208.