Smart but Scattered?: Understanding Executive Functioning in Children & Adolescents (Part 1)

Is your child smart, but scattered? Children face many challenges in today’s dynamic world, and it can be difficult for them to easily navigate its course. You may be realizing that you personally struggled with the same signs of anxiety, disinterest or frustration that your child is experiencing.  At home, it may seem like harmless daydreaming, frustration over dressing for school, emotional outbursts over changes in plans, or even laziness over not wanting to complete a homework lesson.

Your child may be suffering from a lack of executive functioning (EF) skills, which may be impacting him academically, socially and emotionally. No more yelling or arguments! Instead, it’s time to learn about EF so you can help your child to function at home or school.

Executive functioning allows us to develop and apply problem-solving skills as circumstances arise. We need EF skills to tell us how and when to start or delay reactions to our environment. In the moment, people who lack good EF skills cannot anticipate the impact of their quick decisions.

What is Executive Functioning (EF)?

Before we can learn how to compensate for executive functioning deficits, we need to understand the definition of EF and how it presents itself. Executive functioning (EF) is the umbrella term for the skills needed for goal-directed behaviors. These can include making a new friend, learning a new academic skill, or knowing how to behave in a social situation. Anticipation, judgment, self-awareness and decision-making all require EF skills.

Deficiencies in EF can affect the relationship between the brain and behavior. During childhood, these deficiencies are frequently undiagnosed. In Dr. Mel Levine’s book, The Myth of Laziness, he noted that children are often dismissed as unproductive or “lazy” when in fact they suffer from what he calls “output failure”. Once a child reaches middle or high school, organizational problems become very apparent, and often the adolescent’s EF deficits continue to be overlooked. If left unchecked, the child’s decreased belief in his ability to perform can cause difficulties moving forward.

Executive functioning problems are also associated with a number of psychiatric disorders, including ADHD and learning disabilities. Brain damage related to Alzheimer’s disease, strokes, or head injuries can also lead to problems with executive functioning. In this article, however, I focus on the average person’s difficulties with EF.

Understanding The Brain and Executive Functioning

A child enters the world with all the neurons he will ever have and EF skills start at about nine months of age. Over time the brain forms new connections among those neurons due to experience. Once the basic plan of the brain is laid down, neural network connectively can be enhanced by the complexity of experience and environment. For example, a child who is well regulated and attentive in a structured classroom may be silly and hyperactive at a sleepover.

EF is influenced by the maturation of the brain’s frontal lobe circuitry. This part of the brain directs attention and behavior so your child can use past experiences to guide future decisions and behaviors, to observe, to manage and control emotions, and to change strategies.

Components of Executive Functioning: Hill, Skill and Will

Think of executive functioning as a resource or plan, and not a set of specific functions. The how and when is meaningless without the reciprocal interaction with other cognitive and motor domains of the brain. The parts must work together and be implemented for the goal of a positive end result.

Like an orchestra conductor or chef, EF brings together the thoughts and actions required to reach a predetermined goal. A conductor unites instrumental sounds and actions with the end result of a harmonious performance; whereas, a chef gathers and prepares his ingredients, follows a recipe, and works to present a delicious meal. Parents and educators will also offer their own EF skills to help young children whose EF skills are not yet fully developed and need help hanging up a coat, doing homework, or dressing for school.

Executing functioning is often explained by using the words Hill, Skill and Will.  The Hill is a metaphor for any plan or goal, and Skill reflects the organization of behaviors over time, as well as the flexibility required to accomplish the goal. Will means that over the course of action, your child will direct and maintain his energy and attention so that he can focus on reaching that Hill.

8 Areas That Comprise Executive Functioning

Below are eight areas (domains) that comprise executive functioning. Some apply to social and emotional behaviors, and others pertain to more task-oriented actions that follow thought. Familiarizing yourself with the areas will help you to better understand where your child’s abilities are falling short, and where you need to assist with executive functioning.

1. Inhibit

Does your child often call out the answer in class and speak out of turn?

Inhibit involves curbing the knee-jerk responses of your child’s immediate reactions in situations and during tasks that require delayed response and the ability to resist and not act on impulse. In difficult or emotional interactions, it is important to inhibit inappropriate physical, verbal or emotional responses.

2. Shift

Does your child become agitated over the last minute cancellation of an extracurricular activity or the replacement of a favorite teacher with a substitute, resulting in angry or anxious outbursts due to poor emotional control?

Shift is the ability to adapt or be flexible when unexpected plans or events occur. It is also exhibited in difficulty changing focus from one topic to another. People who cannot shift are described as rigid, and are often inflexible in their thinking, generate fewer ideas for problem solving, can’t get beyond a specific disappointment or unmet need, and take the same approach, over and over, despite negative outcomes.

3. Emotional Control

Is your child easily brought to tears by a frustrating puzzle or does he throw a tantrum over a sold out video game?

This domain exhibits itself in your child’s ability to self-manage emotions. When emotional control is absent we refer to the individual 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.

4. Monitor

Does your child have a problem sharing and thus fails to recognize the negative effect it has on his playmates’ emotions and his ability to make friends?

All executive functioning domains are dependent on the ability to self-monitor by tracking one’s own social behavior and being aware of its affect on others. If your child is not aware, he cannot tweak his environment and change his strategy. Adults who are not aware cannot tweak their environment or strategy cannot improve their productively, functioning or relationships.

5. Working Memory

Does your child leave his assignment book at school often or have trouble doing math problems verbally?

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.

6. Planning and Organization

Does your child’s simple writing assignment about his favorite sport turn into a fumble over words?

Planning and organization is the ability to hold a plan 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.

7. Organization of Materials

On a daily basis, do you find yourself asking your child to locate his backpack, team uniform, or assignment book because he never puts it in the same place twice?

Organization of materials is the ability to organize the everyday environment with respect to orderliness of work, play and storage spaces. Without it, your child cannot function efficiently because his environment is in disarray.

8. Task Completion

Does your child have problems completing assignments or projects?

Task completion is the ability to finish things in a timely manner thanks to an outcome of well self-regulated problem solving. Although different from Working Memory and Planning and Organization, problems in this area are related to other executive difficulties such as selective attention and self-monitoring of impulse control. If your child cannot hold the goal and task steps in mind, develop an organized plan to approach the task, and inhibit task-irrelevant actions, it will be hard for him to complete the task or goal at hand. A child may have a great idea and plan, but there is a lot going on cognitively behind the scene in order to reach a goal.

Next Steps….

Once you understand and pinpoint your child’s executive functioning deficits, you can provide him with the skills required to become a confident, self-sufficient decision maker. It’s time to end the temper tantrums or lack of motivation. Step back, breathe and begin taking the necessary steps towards a better understanding of your child’s EF needs.

My next blog post offers ways to succeed at executive functioning. In the meantime, please contact me with any questions or to schedule a private appointment.