This is the third and final part of a three part blog series on executive functioning and outlines how to help your child with executive functioning deficits. Part one explained what executive functioning is and why it matters. Part two built upon that explaining what may be observed from children with executive dysfunction.
How to help your child with executive functioning deficits
There are a variety of things parents, school staff, and other professionals can do to help children with executive functioning deficits, some of which are outlined below, but there are many other websites offering additional information. Parents can also reach out to professionals (e.g., psychologists) and the school for additional supports.
Schedules
If your child struggles with time blindness and time management, they would likely benefit from clear schedules they can use to know what has been done, what is coming next, and what to anticipate in the future. However, not everything can follow a schedule and not everything goes according to schedule. It is important for children to learn how to adjust to these changes but they need help to do so. Therefore, priming for changes (i.e., warning them beforehand), explaining changes as they happen, and having a plan for unexpected changes can help reduce stress. For example, if a child struggles when there is a substitute but cannot always be warned in advance (such as when a teacher calls in sick the day of), there could be a plan in place with the school as to what the child can do to cope with an unexpected change, such as going to a familiar teacher’s classroom instead.
Having visual schedules and task lists to refer back to will help children reduce anxiety and stay on task. Timers can also help children keep track of how much time has elapsed and how much remains. Children with executive functioning deficits need frequent breaks to reduce the burn out and exhaustion caused by constantly combatting their dysregulation. Therefore, make sure that any schedule or work/break system has clearly defined breaks for them to see so they know there is a light at the end of the tunnel.
Memory tricks
Formal evaluation can help determine the specific memory strengths and weaknesses for a child and fine tune any memory tools that may be beneficial to them. Regardless, many children benefit from the use of mnemonic devices, checklists, and acronyms to help them recall things. The more personally relevant the material is, the more likely they are to remember it. For instance, if the child is fascinated with space and they are learning about the periodic table, they may benefit from learning specifically which elements are most prevalent in the earth’s atmosphere versus Saturn’s.
There are technological advancements that help people remember things that they otherwise would have forgotten. For example, a phone or tablet can be set to have a specific reminder go off (e.g., pack your lunch for tomorrow) at a set time every day. If the child does not have access to technology or parents wish to restrict it, having the child write down what they need to recall has also been shown to be an effective memory strategy.
Clear boundaries and reinforcement
If a child is struggling with executive functions, it may be hard for them to see where the boundaries are. The more clear the rules, limits, and expectations are, the better. However, it also needs to be made clear that the child is not in charge of policing the rules and that sometimes things are a little bit more in the gray area rather than right or wrong (black or white).
Many children benefit from concrete reinforcement systems such as token boards, where they know how many tasks to complete before earning reward. Timers can also be an effective tool, providing them with awareness of time. If/then and first/then charts are beneficial for simplifying expectations into one or two tasks so children know what they are expected to do right now and what will happen once they have.
Children need to be consistently reinforced for engaging in expected behaviors, learning from unexpected behaviors and mistakes, and for trying, even when things are hard. Knowing what a child is reinforced by is crucial. The bigger the task at hand, the bigger the reward should be at the end but smaller rewards can be dispersed along the way. Many children are reinforced by frequent praise and encouragement but not every child is, so the reinforcement should be individualized.
Children should not be punished for their disabilities but also should not use their disability as an excuse. Every child is different. Some are more sensitive and a minor redirection will significantly set them back emotionally. Strategies need to be based on each individual child but whatever they are, the strategies need to hold the child accountable for their behaviors, consistent with their ability level. For instance, if you know your child is capable of focusing for 5 uninterrupted minutes but they stop at 3 minutes, before the timer goes off, this should be brought to their attention.
Sensory overload and distractibility
Many children with executive functioning deficits are easily distracted and overloaded with sensory information. Reducing distractions and overstimulation can help improve functioning and execution of tasks requiring executive functioning.
Occupational therapy (OT) can play a critical role in identifying and treating sensory interests and sensitivities. Parents may wish to consult with an OT to determine how to best help their child. Psychologists also provide information about sensory functioning but not typically to the same degree as OTs.
As discussed previously, children often struggle to keep their place when reading and forget what they have read. This can make reading a chore rather than enjoyable. They may benefit from oral administration of assignments and assessments at school. Similarly, parents can read aloud while their child(ren) follow(s) along or vice versa. Audiobooks are also effective, particularly when children have a typed copy to refer to simultaneously. When the child is reading, help them block all of the unnecessary information on the page other than the line they are on by using tools such as these highlighting strips.
Exercise can also increase focus and reduce overstimulation. It has also been shown to have positive effects on overall mood and emotional well-being. Parents can have their children participate in sports, go on walks together, or play video games that require full body movement.
Planning and organization
It can be overwhelming for children to be told to do tasks that seem large to them, even if they do not seem large to the adult instructing them. To help them know where to start and what to do next, they might benefit from assistance breaking tasks into “bite size” chunks. These steps can be written or drawn out for them to refer back to. After each task is completed and emotions around the task have subsided, it may be helpful to have a conversation about what worked and what did not to help make a plan for the next large task at hand.
Any type of visual support (e.g., calendar, schedule, checklist) helps children keep track of where they are, what they have completed, and what is coming next. Timers can be used to set visual representations of the amount of time left. There are timers such as this that change from green to yellow to red to indicate time is running out. There are also several phone applications that can be used to help children keep track of time and monitor their behavior, such as those found here.
Speech therapy
If the child is experiencing social deficits along with their executive dysfunction, parents can consult with a speech-language pathologist about possible evaluation and services for pragmatic (i.e., social) language deficits. Furthermore, parents can rule out whether any additional speech and language problems are hindering their child.
Social skills and counseling
Similar to speech therapy targeting social deficits, children may benefit from direct social skills instruction targeting areas of need such as seeing the perspectives of others, identifying emotions, and developing coping strategies. These skills be addressed through direct social skills instruction in and out of school as well as through individual counseling.
Parents are encouraged to model expected behaviors for the children. Children can also partake in interventions such as video self-modeling and social autopsies where they watch themselves perform the expected behavior and analyze the actions they took in social situations, determining what they did well and what they could improve upon.
Social stories can aid children in understanding social dynamics, their role in relationships, and how to handle various social situations. Other stories that children can personally relate to can also be beneficial. In particular, Julia Cook has written several books describing what it is like to be a child with executive functioning deficits such as her books: Planning Isn’t My Priority, I Can’t Find My Whatchamacallit, I Can’t Believe You Said That, I Just Want to Do It My Way, and It’s Hard to be A Verb.
Communication
Children make the most progress when parents, staff, and any outside providers regularly communicate with each other about what is and is not working, what is going on in the child’s life, and how the child is doing overall. The more consistency the child has across people and settings, the more progress they will make and the better they will do.
Study skills training
Many children with executive dysfunction, especially those in middle school or higher, would benefit from study skills training, also known by some as ADHD coaching and executive functioning training. Some schools offer study skills courses for Special Education students and others for general education students, but not every school has these options. Parents can choose to pursue these resources from outside providers, such Gray Area.
These resources would work on many of the aforementioned skills and strategies as well as many others. The goals for study skills training would be individualized for each child but often revolve around prioritizing tasks, learning how to break assignments into chunks and set your own due dates, and self-monitoring tools.
Talk to them
Parents, other adults, outside professionals, and anyone that works with children in any capacity is encouraged to keep an open line of communication with the child. Admit when you have a made a mistake, admit when you do not understand why they are struggling or why something is not working, and model for them how to handle such situations. Check in with them regularly to see what is working and what is not. If you feel your relationship is being strained as you try to manage their executive dysfunction, acknowledge that with them and get their input on how to proceed. Do not assume that your way or their way of doing things is best. Work to find a middle ground you can both agree on and buy into.
Summary
This was the final blog post in a three part series on executive functioning. You have now learned what executive functioning is and why it matters, how it looks, and what can be done about it. Executive functioning is a hot topic that people, particularly those who are around non-neurotypical children, hear on a daily basis. There are many diagnoses that are often associated with executive dysfunction, such as ADHD and autism. Understanding what executive functioning is, how it can manifest in children, and what can be done to help children with executive functioning deficits better equips people to help children develop these skills and navigate the world around them. There are many strategies that can be used to help children and adults compensate for these deficits but they must be individualized and tried to determine which are most effective.
Children with executive dysfunction do not choose to struggle or make mistakes. They struggle to do tasks that neurotypical people often find basic. This can be highly frustrating and emotionally draining. However, the more seen, heard, and understood they feel, the more progress they will make. And the more the world around them starts to realize it is not their fault, the more they will begin to believe it themselves.