Smart but Scattered?: Strategies to Improve Executive Function in Children & Adolescents (Part 2)

My last article covered the definition of Executive Functioning (EF) and the challenges children with EF deficits face. Now that you have a better understanding of the eight areas that comprise EF (inhibit, shift, emotional control, monitor, working memory, planning and organization, organization of materials, and task materials), let’s look at a few of them to learn how to assess your child’s EF deficits and to review some examples of how to help.

The domain of Emotional Control exhibits itself in your child’s ability to self-manage emotions. When emotional control is absent we refer to a child as being explosive or emotional, creating drama over seemingly minor events, laughing or crying easily with little cause, and engaging in temper tantrums that are not age appropriate.

Does your child…
• do things impulsively (without stopping and thinking) that he or she quickly comes to regret?
• struggle with waiting his turn in conversations and often interrupt others?
• become very frustrated by events or situations that would most likely frustrate others to a lesser degree?
• lash out verbally or physically at others when angered?

Working memory is the ability to hold information in mind for the purpose of completing a task or generating a response like remembering directions, keeping track of what your child is doing as he works, remembering what he is supposed to retrieve for a specific task, and being able to implement a sequence of activities. A child needs to sustain attention over time to have a good working memory and not be sidetracked by details or minutia.

Does your child…
• frequently not follow multiple-step directions (e.g. Go upstairs. Put your dirty clothes in the hamper. Take a shower. Tell me when you’re done.)?
• struggle with recalling what he or she is trying to say while talking frequently and losing his train of thought?
• forget the directions for daily homework assignments or need frequent reminders?

Planning and Organization is the ability to hold a plan in mind and begin strategizing, sequencing and ordering, managing time, initiating tasks, being persistent, and staying on track to meet a goal. If unable to plan and organize, your child will approach a task haphazardly, be easily overwhelmed by large amounts of information, and have trouble completing a project.

Does your child…
• avoid or have difficulty making decisions about the topic or content of school projects?
• seem to live from “moment to moment” without setting goals or making plans?
• need numerous prompts or cues from adults to complete a task?
• become bogged down during homework and chores by seemingly minor difficulties (just can’t seem to solve problems on his or her own)?

If you feel your child needs assistance on any of these areas, let’s discuss some simple operational strategies that will help him with his executive functioning deficits. Below are some great visual prompts that will help your child on the road to becoming an independent thinker and problem solver.

Simple Strategies to Improve Executive Functioning in Children

I often suggest creating a Manage My Emotions Board (MME) as a way for a child to learn the skills needed to self-monitor and control emotions. All you’ll need is a wipe erase board or a large notepad to get started. On the board, you write a set of questions and your child will respond by writing down his own answers. Younger children will need assistance of course. Some children may also prefer to draw pictures to further describe the responses to the questions or their emotions.Below are the questions that you will write on your MME Board. I also included a few sample answers that your child may respond with.

Using this board daily, you will soon understand the triggers that spur your child’s emotional or behavioral responses and help him to gain the necessary skills to properly respond to situations that are difficult for him.

What Makes Me Mad?
1. When I have to stop doing something fun.
2. When it’s time to do a chore.
3. When my plans don’t work out.

Things I cannot do…
1. hit somebody.
2. break anything.
3. yell at mom or dad.

When I’m having a hard time I can….
1. draw a picture.
2. read a book.
3. listen to music.
4. play with the dog.

Here are a few other questions you can add to your MME Board:
1. What are common situations when I act without thinking?
2. What can I do to stay controlled?

Many of us are all too familiar with list making from the weekly grocery store notes to the daily work priorities. The Checklist can also be a huge help to children who lack EF skills. Checklists (with words or a combination of pictures and words) serve as daily visual guides assisting them to accomplish target behaviors or goals by taking the burden off of Working Memory. A parent or teacher and child can work together to complete the daily checklist.

Be sure to display your checklist in a place where your child can easily see it. Pin it to a low hanging board, tape it to the top of a school notebook, or hang it on the refrigerator – whatever works for your family!

Daily checklists can be used for school and at home. A School Take Home Checklist may include items like textbooks, workbooks, assignment books/sheets, notebooks, folders, binders, pencils, gym clothes, permission slips and notices for parents to sign, report cards and progress reports. Your child will be noting daily if all of these things are in his backpack. A Room Checklist may include actions like make my bed, put dirty clothes in laundry, put clean clothes in dresser or closet, put toys away on shelves or toy box, put books on bookshelves, tidy desk, throw away trash and recycle, return things to other rooms (i.e. dishes, cups, towels, sports equipment). No matter your list, you will be setting the stage for success by visualizing the process for him.

Executive Functioning is a HUGE area and this blog only scratches the surface. There are many resources available on the topic. As a parent, it may seem daunting, but I hope the simple strategies discussed will help you start to gain a greater sense of peace in the home and at school.

Your child’s teacher may also be interested in reviewing Judy Willis MD’s articles on Edutopia.com. She offers a wonderful series of seven blog posts on Executive Functioning strategies for educators. http://www.edutopia.org/user/19536

Suggested Reading:

Executive Function in the Classroom: Practical Strategies for Improving Performance and Enhancing Skills for All Students Appendix 4.1, Executive Functioning Semistructed Interview by Christopher Kaufman, Ph.D.

Late, Lost and Unprepared: A Parents’ Guide to Helping Children with Executive Functioning by Joyce Cooper-Kahn and Laurie Dietzel

Smart but Scattered: The Revolutionary “Executive Skills” Approach to Helping Kids Reach Their Potential by Peg Dawson and Richard Guare

Unstuck and on Target!: An Executive Function Curriculum to Improve Flexibility for Children With Autism Spectrum Disorders by Lynn Cannon M.Ed., Lauren Kenworthy, Katie Alexander M.S. OTR, Monica Werner M.A. and Laura Anthony Ph.D.

Executive Functions: What They Are, How They Work, and Why They Evolved  by Russell A. Barkley PhD

Understand Your Brain, Get More Done: The ADHD Executive Functions Workbook by Ari Tuckman PsyD MBA

Executive Function & Self-Regulation in Children by Jane F. Gilgun Ph.D. LICSW

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