“It’s not that kids with executive problems don’t know what to do, it’s that they don’t do what they know.” – Dr. Russell Barkley

What are executive functions?

Executive functions describe a cluster of skills that include organization, self-discipline, self-regulation, remembering what to do, time management, attention, and impulse control. Although these skills develop slowly over time, sometimes they do not develop normally and intervention is required to further the development of these critical skills. Children with learning or attentional problems are at greater risk for having under-developed executive functions. Deficits become more pronounced as demands increase in middle school and high school.

Executive functions are important for the initiation and completion of tasks, and perseverance in the face of challenges. They help us pre-plan, anticipate and recognize when unexpected situations arise, and enable us to make alternative plans. In this way, executive function contributes to success in work and school.Executive functions also inhibit inappropriate behaviors. People with poor executive functions often have problems interacting with other people since they may say or do things that are odd or offensive to others.

Some signs of executive function disorder:

• Inefficient use of time
• Does not produce work that is reflective of abilities
• Inattentive or distractible
• Difficulty initiating assignments and projects
• Does not write assignments down or does so inaccurately
• Loses things or does not bring home the appropriate materials

Children with under-developed executive functions are not lacking interest or motivation; their internal system is not following the normal course of development and may require intervention.

How can I help my child if I suspect he has poor executive functions?

• Have your child formally evaluated by a neuropsychologist to assess underlying deficits
• Give your child ample opportunity to problem solve on his own and develop organizational strategies
• Teach executive and organizational techniques in a relevant context

Who treats executive function disorders?

A variety of professionals can address different aspects of dysfunction. A neuropsychologist can diagnose and treat an executive function disorder.

Since there is an increased risk of executive function disorder in children with learning disabilities, a Learning Disabilities Teacher Consultant (LDTC) can be an important team member in addressing a child’s deficits.

A child with executive function disorder can benefit from occupational therapy when motor planning and everyday life is affected. Motor planning is the process of conceiving of (ideation), organizing (planning and sequencing), and carrying out unfamiliar tasks (execution). It is the instinctive knowing of how to move your body and make it do what you want without having to consciously think of every step. The ability to accurately perceive and process sensory information from one’s body and the environment is essential for figuring out how to do daily tasks.

References:

Executive Functioning: Getting with the Program. Dr. Jane Healy, neuropsychologist.

Blog written by: Aviva Goldwasser, MS, OTR

Chaye Lamm Warburg, MA, OTR, Director POTS