What Executive Functioning Difficulties May Look Like at Home and How to Help
Executive functioning skills become solidified as children grow. The most dramatic increase in executive functioning occurs between the ages of three and five as children enter preschool and kindergarten. Executive functioning skills continue to require growth and refinement throughout elementary school into adulthood in order to follow expectations at home and school. As children become increasingly more independent throughout childhood and into adolescence, several executive functioning skills continue to develop to allow for more autonomous and effective participation in daily life.
Speech Language Pathologists and Occupational Therapists work with children of all ages on a daily basis to support growth with their executive functioning skills from a linguistic, cognitive and sensory perspective. The table below provides the functional presentation of each executive function, along with practical tools and tips to address and improve each area while your child is home during this period of remote learning (and beyond).
If you have questions or concerns about your child’s executive functioning skills, reach out to us here at McLean Speech and Language and we would be more than happy to help!
Executive functioning can be broken down into the following eight areas:
- Task Initiation: the ability to start a new task
- Impulse Control: the ability to control emotions and behaviors
- Time Management: the ability to use time effectively and productively
- Working Memory: the ability to store and manage information required to complete tasks
- Organization: the ability to arrange items and ideas logically and efficiently
- Sustained attention: the ability to focus on a task over an extended period of time
- Shift: the ability to change your behavior or thoughts in response to new, unexpected events
- Self-Regulation: the ability to control your own emotions and actions
|What parents may see functionally||Tools to Help|
|Task Initiation||Difficulty getting started with both school assignments and daily living activities manifested in task avoidance, difficulty making choices and difficulty generating ideas.||§ Break down information into smaller components to make the task more manageable. This can be done for written work as well as any other daily function, like showering or eating.
§ Utilize “first/then” language.
§ Implement a visual checklist for expected work tasks to remove reliance on verbal directions only.
§ Show your child a video or a social story of someone performing the task, and then verbally evaluate the steps.
§ Provide a choice of 2 activities to improve motivation and allow for child perceived control (e.g. say: “Do you want to pick up your toys or empty the dishwasher first?”) as this may help them get started.
|Impulse Control||Tantrums, engaging in unsafe behaviors, and continuing an activity even after being told to stop.||§ Present positive reinforcement using reward charts.
§ Provide break time in expected increments.
§ Participate in board and card games as a family that require turn-taking as your child will have to tolerate waiting as well as potentially having their turn skipped to play by the rules.
§ Play games such as Red Light, Green Light, Musical Chairs and Simon Says which all require waiting and listening to auditory input (verbal directions and music) prior to acting.
|Time Management||Difficulty prioritizing important school/home activities, work tasks may take longer than expected, and your child may accomplish less than planned in a set period of time.||§ Adaptive solutions include giving a visual representation to time, such as using a visual timer.
§ Children with executive functioning difficulties have trouble perceiving time, so using more concrete transition warnings will be of benefit to them (e.g. state: “two more problems” rather than “five more minutes”).
§ Play the “price is right” except substitute prices for the amount of time an activity may take to assist with estimating the time in which it will take to complete a task.
§ Use a calendar visual to discuss seasons, months, days of the week as well as important events happening such as birthdays and holidays. Calendars can also be used with older children to discuss due dates for both short-term and long-term assignments.
§ Discussions can be had revolving breaking down assignments into incremental steps (e.g. plan to read 10 pages a day for 10 days to finish a 100 page book before the due date).
|Working Memory||Difficulty recalling multi-step instructions, or difficulty remembering the last instructions in a sequence, having initial thoughts but forgetting them once they need to be recalled in a group or class setting, forgetting key details, or being unable to separate the main idea from details.||§ Give directions in smaller, more manageable steps.
§ Have your child verbally repeat back to you the multistep directions that they have been given prior to the child attempting to complete them.
§ For older children, encourage writing down details of important tasks in a planner.
§ For children of all ages, prompt and encourage self-advocacy skills (e.g. prompting the child to ask: “Can you say that again?”).
§ Utilize graphic organizers to help separate the main idea from details while reading and to compare and contrast concepts in the text prior to writing a narrative.
|Organization||Losing papers and other personal items frequently, scattered thoughts and lack of coherence during storytelling, or increased wait time required to respond to questions.||§ Use adaptive solutions like color-coding.
§ Develop a system to store materials, either physically or virtually with clearly labeled binders and folders.
§ Remove visual and auditory distractions from the environment.
§ Utilize graphic organizers and checklists to ensure adequate work completion.
§ Lead by example and utilize a calendar or planner for important family events and appointments.
§ Teach word relationships by strengthening vocabulary (e.g. synonyms and antonyms, homophones) and discuss cause-effect relationships of various daily occurrences to promote increased informational access speed from a language and processing standpoint.
|Sustained Attention||Frequent elopement from tasks, especially those that are non-preferred and require active participation (i.e. pretend play, board/card games, completion of school assignments), getting distracted easily, tasks taking longer to complete than expected, losing train of thought while telling stories or answering questions.||§ Engage in play using board and card games such as Candy Land, Go Fish, Chutes and Ladders and UNO from start to finish.
§ Remove visual and auditory distractions from the environment, including having a clean, clutter free workspace.
§ Whenever possible, provide two options of expected tasks to allow your child to have their own say in the order of tasks (e.g. say: “Do you want to do math or reading first?”) which may lead to increased motivation to ultimately attend to and finish task(s).
§ Schedule movement breaks at expected time increments to allow the body and brain the time it needs to reset.
|Shift||Struggling with transitions away from activities or feeling the compulsive need to “finish” everything (even if it is cleaning), becoming stuck on one topic and being unable to transition off of the topic during speech sessions.||§ Play games that require shifting such as Bananagrams, Spot It, and Pit.
§ Utilize visual timers, concise and clear transition warnings, and “Plan A/Plan B” language with your child (e.g. say: “I see that you really want to finish this, but right now it is not a choice. What can we do instead?”).
§ If the child is already melting down because of a transition, automatically pull a self-regulation strategy and model it without asking, because during meltdowns, it is unlikely that they know what they want.
|Difficulty regulating their own emotions or responses to input and events, becoming very upset over “small” problems and not appearing to know the distinction, or having varied and intense responses to “small” things, like the light changing or a door closing.||§ Click here for part two of the executive functioning series where you will find self-regulation strategies as they relate to executive functioning skills outlined by a licensed Occupational Therapist.|