What is Executive Functioning?

Executive functioning refers to the skills that allow us to organize, plan, problem solve, inhibit responses, transition between tasks, and monitor work and other behaviors.

What causes executive dysfunction?

There is no single cause for executive dysfunction. The most common reason for a child to struggle with executive functioning is Attention Deficit Hyperactivity Disorder (ADHD). There is a genetic predisposition for ADHD and thus a predisposition for executive dysfunction as well. There are also numerous medical conditions, such as traumatic brain injury or stroke which can cause various executive functioning impairments.

How do I know if my child has impaired executive functioning?

Difficulties with executive functioning can negatively influence all areas of life including academic performance, social skills, and/orExecutive Functioning home life. Typically an individual with executive dysfunction presents with a discrepancy between their cognitive aptitude and their academic performance. This is frustrating for teachers, parents, but most importantly for the individual. As it relates to social engagements these individuals sometimes do not demonstrate appropriate self-awareness and therefore may not realize that their behaviors are negatively impacting those around them.

Executive functioning can be observed in the tasks your child completes throughout the day. For example: Does your child have a set plan for a morning routine, or is it chaos on a daily basis? Is her room organized, so that anyone walking in knows where items should be? What about her backpack or locker? Does he forget to turn in homework assignments that he has completed? Does the child forget to write down daily assignments or forget to bring home necessary materials? Does the child struggle planning activities with friends?

How can I help treat my child’s executive functioning?

There are a few things to keep in mind as you work to help your child with impaired executive functioning.

  1. It is important to work within a real world setting. Focus on steps to help them clean their room more independently or complete their bed time routine.
  2. Simplify your child’s environment. You may have to work slowly and focus on only one or two steps at a time. Allowing them to be successful will motivate them.
  3. Don’t only focus on issues at home. Get help from others in your child’s life such as teachers, coaches, etc. The people that are in contact with your child the most should be working as a team to help your child with his or her executive functioning.

Also, keep in mind that all treatments should be customized to fit your child’s needs, so don’t give up. What worked for one child might not work for another.

Our approach to executive functioning at North Shore Pediatric Therapy

At North Shore Pediatric Therapy, we take a multidisciplinary approach to treating executive functioning impairment. The first step is typically a consultation or evaluation with a neuropsychologist to identify your child’s strengths and weaknesses in the area of executive function. Following the evaluation your child would most likely be referred to work with either an Applied Behavior Analyst, Occupational Therapist or Academic Specialist who is trained in executive functioning; in conjunction with you, and your child’s school/teacher, the therapist would assist in developing the most appropriate strategies for your child. Clinical treatment would focus on introducing the strategies to your child, practicing strategies in the clinic and then helping them to generalize for use in other settings.