/ Occupational Therapy

Executive Functioning

If you’ve ever: ---

  • Had to drown out background noise while trying to focus on an important assignment or project
  • Tried to recall the name of your friend’s spouse who JUST introduced themself to you not even 10 seconds ago
  • Come across the most recent act of destruction your child committed and mentally going through a full spectrum of emotions before calmly expressing your displeasure verbally
  • Internally debated whether to skip that second helping of dessert or if that new diet you’re supposed to be on can just start tomorrow
  • Attempted (perhaps successfully!) to finally tackle that storage section of your basement in the hopes of creating a vague sense of organization, instead of the treacherous valley of mislabeled boxes and assorted items it is now.

Then, congratulations! You have exercised your executive functioning skills.

Depending on the context or the source, executive functioning can be defined in a variety of ways. For the purposes of this blog, we will use the definition we most commonly use here at CI:

Executive functioning is an individual’s cognitive ability to direct and manage their own mental processes, especially when problem solving. Sound broad? It sure is! Just look at the examples mentioned at the beginning: we use executive functioning in several facets of everyday life.

So, what does executive functioning look like in children?

Clinical opinions on the true gold-standard of assessments vary, but the Behavior Rating Inventory of Executive Function® (BRIEF) is one that is commonly used in a variety of contexts. The BRIEF utilizes 8 clinical scales to gauge a child’s executive functioning ability:

  • Inhibit - the ability to stop one’s behavior at an appropriate time
  • Shift - moving attention from one idea to another
  • Emotional Control - managing one’s emotions as appropriate for the current situation or activity
  • Initiate - ability to start tasks or initiate ideas
  • Working Memory - ability to hold recently learned information needed for a task. Also can be called short-term memory.
  • Plan/Organize - the ability to plan and organize steps required for activities
  • Organization of Materials - the ability to organize physical materials
  • Monitor - reviewing and correcting one’s work for errors independently

Continued development in these areas set the building blocks for kids becoming independent in setting goals, resolving conflict, solving problems, interacting with peers, and accomplishing tasks. As anyone with any remote experience with children will attest, at any given time, most kids will experience difficulties with any of the above areas (and if we’re being honest, plenty of adults, too!). So if most typically-developing children will experience challenges with the above areas at some point, the issue of accurately determining if a child has executive functioning challenges can be tricky.

In general, executive functioning challenges will most often first manifest in relation to school-based tasks. Difficulty with homework, completing tests within allotted times, paying attention in the classroom, keeping materials organized, and significant difficulty following directions are all hallmark signs of executive functioning challenges.

Additional challenges that may be signs of executive functioning challenges include, but are not limited to:

  • Becoming overly emotional over small matters
  • Fixating on excessively positive or negative emotions
  • Frequent "meltdowns”
  • Easily losing track of time or forgetting responsibilities
  • Difficulty completing multi-step activities

If you suspect your child may have challenges with executive functioning, sharing these concerns with your child’s pediatrician can help you get referred to the correct specialist (typically a psychologist or neuropsychologist). Specialists may diagnose other conditions that are closely related to executive functioning challenges, including ADHD, anxiety, or depression. Referral to proper specialists can help rule out extraneous causes and ensure the correct course of care.

Therapists at CI are among the resources available to help address children’s executive functioning challenges. We can help clients develop tailored organizational strategies that are effective for them, implement strategies to help them better attend to information and directions, manage and control their emotions, and develop other skills conducive to executive functioning.

Activities you can implement at home to practice executive functioning skills at home are numerous! Consider the following resources for ideas:
The OT Toolbox
Developing Child Guide
Understanding Executive Functioning

Written By: Ismail Umer, MS, OTR/L

Executive Functioning
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