Executive functioning is an abstract concept, so let’s use an example to start the explanation.  Think about a business you know well.  Maybe it is your own, one you work for, or a company you are familiar with.  All business, big or small, have an owner, director, or CEO.  This is the person who makes business decisions based on all sorts of input from others in the company- people in accounting, marketing, customer service, etc all provide information to the head honcho.  Who often is the gatekeeper for the information, who does the administrative tasks such as filing, relaying messages, scheduling meetings, managing a “to do" list, organizes the office, the waiting areas, coordinates with other departments?  Usually this is an Administrative Assistant, or in the case of a director or CEO, and Executive Assistant.  An executive assistant does all the tasks the CEO needs done so s/he can focus on their job of running the company.  If the CEO had to think about all his phone messages and emails, file all her papers, schedule every meeting, collect all the reports from other people, not much would get done in the CEO’s job.  The executive assistant helps the CEO with executive functions.

Executive functions include organizing, prioritizing, focusing, sustaining and shifting focus to tasks, regulating alertness and processing speed, managing frustration and regulating emotions, working memory, and self-monitoring and regulating action (often called inhibiting).  All of these tasks work together to do a wide variety of daily tasks that require self-regulation by using attention and memory to guide one’s actions.  Alex Michael’s, Executive Director of Milestones, defines executive functioning as, “...skills that enable us to create a goal and a plan for reaching that goal, then initiate, sequence, sustain or inhibit behaviors to work towards and finally attain that goal."

Children with executive functioning deficits often struggle with focus, attention, transitions, organizing, memory, time management, regulating emotions, managing frustration. 

Why is Executive Functioning Important?

As you read the list of executive functions above, it should be clear that these are all skills necessary for children to succeed in school, navigate relationships at home and in the community, and manage day-to-day fluctuations in schedules and routines.  Children with efficient executive functioning take all of these tasks in stride, but those with weak executive skills struggle with school and homework demands, social interactions, and changes in schedule.  These ever changing and fluctuating dynamics feel overwhelming, confusing and downright frustrating. 

It is important for parents and teachers to understand that executive functioning weaknesses are paramount in a child’s ability to demonstrate academic competence.  Children with these weaknesses often have average to above-average IQs, but cannot seem to show what they know.  Why?  Because they cannot either focus, organize their work, get it passed in on time, struggle with getting started, or all of the above.  The end result is they end up frustrated and give up because they cannot get it “right."  Does this sound familiar to your child’s experience? 

A child who feels frustrated and incompetent academically, socially and emotionally because of executive functioning deficits is a child at risk to give up on education, follow a negative peer group, or become depressed and anxious.  Many of my clients who have been referred to me for  anxiety, actually have impaired executive functioning that leads them to feel overwhelmed and confused to the point that they appear to have an anxiety disorder.  Once we address and support the executive functioning weakness, their anxiety lessens considerably. 

Interventions to Support Executive Function Difficulties

There are some easy to implement strategies that can support the child with weak executive skills.  These include:

·        Maintain a predictable structure routine at home and school, as  much as possible

·        Post a daily schedule so the child can refer to it throughout the day

·        Inform children of changes in schedule, such as a doctor’s appointment later in the day, ahead of time.

·        Create concrete rules and be consistent with following through on expectations and consequences for breaking the rules.

·        Use a Countdown to prepare for transitions. Ex:  “John, 10 minutes until we leave the playground.  5 minutes.......3 minutes......2......1.......time to go."

There are many other strategies that can be designed and implemented for each child and family, depending on their needs.  Executive functioning weaknesses can be challenging and frustrating, but can be managed with a plan and consistent support.

Resources

For more information about executive functioning you can read these articles on-line:

Easy to Implement Interventions for Children with Asperger’s Syndrome, Alex Michaels, Executive Director or Milestones.  In The Asperger’s Association of New England Journal, Volume 2:  

Executive Functioning:  A New Lens through which to View Your Child, Kristin Stanberry.  On GreatSchools web site.  

Executive Functioning: Regulating Behavior for School Success, Dr. Sheldon H. HorowitzDirector of Professional Services, NCLD.

Book:   ,  Lynn Meltzer (editor)