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Executive functioning deficits can make it difficult for children to organise and self-regulate.

Poor executive functioning makes everyday tasks a challenge. Children struggle to switch gears, especially when learning a new skill or task. They find it nearly impossible to keep things organised, which is why their desks are often a mess, pencil cases are empty and desks and school bags are filled with an assortment of sweet papers, long-forgotten school notices and leftover lunch.

Executive functioning (EF) is becoming as common a discussion point as ADHD and related attention disorders.

“Executive functions are the cognitive skills that help us manage our lives and be successful,” say Joyce Cooper-Kahn and Laurie Dietzel, the authors of Late, Lost and Unprepared: A Parents’ Guide to Helping Children with Executive Functioning. “Children with weak executive skills, despite their best intentions, often do their homework, but forget to hand it in, wait until the last minute to start a project, lose things, or have a room that looks like a dump.”

What causes poor executive functioning?

According to the Center on the Developing Child at Harvard University, executive function and impulse control depend on three types of brain function: working memory, mental flexibility, and self-control. These skills or functions are significantly related. Each function draws on elements of the others, and overall success requires them to operate in co-ordination with each other.

Working memory

This controls our ability to retain and manipulate distinct pieces of information over short periods of time.

Mental flexibility

Having mental flexibility helps us to sustain or shift attention in response to different demands or to apply different rules in different settings.

Self-control

Self-control enables us to set priorities and resist impulsive actions or responses.

“Executive function skills have a profound impact on a learner’s school performance, therefore, it is critical to assess whether or not the student with an attention deficit also has deficits in this area,” says Chris A Zeigler Dendy, who has over 40 years’ experience as a teacher, school psychologist, and as an author on ADHD.

“Some researchers believe that students with ADHD, primarily inattentive type, are more likely to have executive function deficits. However, not all students with ADHD have poor executive functioning. The converse is also true; all students with executive function deficits don’t have an attention deficit,” adds Zeigler Dendy.

Though executive function and its link to ADHD is a relatively new phenomenon, Dr Russell Barkley, writing for ADDitude magazine, says that executive function is judged by the strength of these seven skills:

Self-awareness

Simply put, this is self-directed attention.

Inhibition

Also known as self-restraint.

Non-verbal working memory

The ability to hold things in your mind. Essentially, visual imagery – how well you can picture things mentally.

Verbal working memory

Self-speech, or internal speech. Most people think of this as their “inner monologue”.

Emotional self-regulation

The ability to take the previous four executive functions and use them to manipulate your own emotional state. This means learning to use words, images, and your own self-awareness to process and alter how you feel about things.

Self-motivation

How well you can motivate yourself to complete a task when there is no immediate external consequence.

Planning and problem-solving

Experts sometimes like to think of this as “self-play”. Simply put, this is how we play with information in our minds to come up with new ways of doing something. By taking things apart and recombining them in different ways, we’re planning solutions to our problems.

Barkley adds that anyone who exhibits the classic symptoms of ADHD will have difficulty with all or most of these executive functions.

Good news

Despite a great deal of negativity around EF disorders in children, there is good news. Learning specialists and doctors have devised methods to boost organisational skills that don’t come naturally to a child with poor executive functioning. Many parents and teachers are employing practical strategies instead of medication to address functioning deficits.

Dr Thomas Dannhauser, honorary senior lecturer in psychiatry, and research and development lead at Brain Gain Neurofeedback Training, comments: “EF crucially depends on brain activity in the front parts of the brain known as the frontal cortex. Children with ADHD and EF problems commonly have decreased activity in the frontal cortex. Brain Gain uses neurofeedback training that specifically exercises these areas. The training also incorporates specific techniques that allow us to exercise the frontal areas and EF simultaneously. Children can therefore learn how to concentrate more selectively and for longer, and they are taught how to complete tasks.”

Dr Dannhauser also notes: “Some recent evidence suggests that around 20% of children who present with significant attention problems (ADHD and therefore executive function dysfunction) spontaneously recover in their late teens.”

While it’s tempting to list practical strategies, which could help your child cope with organising and planning challenges – like making checklists to tick off, breaking projects down into small, manageable parts or enforcing strict routines at home and in the classroom – researchers mostly agree that there is no one-size-fits-all solution to dealing with executive dysfunction, which is why an educational assessment is vital and the best place to start remediation.

Once you know exactly where your child’s deficits are, you can get professional advice on how to address each challenge with carefully structured tasks so as to always maintain positivity, build confidence and turn their challenges into learning opportunities.

Samantha Page