Executive Function Challenges and Strategies to Improve Them – Part 1

Executive Functions are higher level thinking skills that allow us to use our cognitive skills to plan and carry out behaviors. Whether we are planning out our day, getting chores done, or making sure we are on time for a meeting we are using executive function skills to plan, organize, and appropriately carry out tasks.

These skills develop and grow throughout our lives, and are required more as we get older and the expectations of life become greater.  Babies are initially reliant on caregivers for regulation and executive functioning, but as children grow and learn from the adults around them they begin to develop their own executive functioning skills. When executive functioning skills are well developed, children are better able to function well at home, school, and all other environments. However, when children struggle with any number of these skills life can be difficult.

Children with diagnoses such as ADHD, autism, learning disabilities, brain injury, sensory processing disorder, and related conditions tend to have difficulties in one or more areas of executive functioning. These often get misinterpreted as “behavior problems”, when in reality the child is lacking important cognitive skills for managing the things they need to do. Many of the clients that we work with here at Horizons struggle with one or more of these skills, which makes their day-to-day life a challenge.

What are the executive function skills and what can be done to improve them?

The executive functions include planning, organizing, time management, task initiation, working memory, metacognition, self-control, attention, perseverance, and flexibility.  In this article we’ll start with the first three, as they are the most common challenges kids face (and that make parents and teachers frustrated!). Here are some tips and strategies for improving the skills of planning, organizing and time management:

Planning is the ability to think ahead about how to reach your goals. This is a very crucial executive functioning skill, and one of the biggest areas of difficulty for our clients. If your goal is to achieve a passing grade on your social studies test, what steps do you need to take to reach that goal?  If your goal is to get to bed by 9:00 every night, what needs to be done to accomplish that? There are thousands of examples of short- and long-term goals that we face each day, but when we struggle with planning it can be very difficult to achieve them. Some people are able to make a basic plan, such as “I need to study the night before”, but the plan doesn’t go any further which results in failure.

Here are some specific strategies to improve planning skills:

• If-Then strategy – Make a specific list of action steps needed to reach the goal, and when you will do them. For example: “If I want to pass my social studies test, then I need to study each night from 7-8 PM for a week leading up to the test.” The plan also needs to include what needs to be studied (chapters, notes, etc.).

• Visualize – Teach your child how to make a mental picture of what all of the steps in the process will look like. What will I look like when I am taking the test, what will it look like to study, and what materials do I see myself using? For example: I see myself sitting at my desk in the social studies classroom. I have a pencil in my hand and a packet of papers in front of me. I am reading the questions on the test paper, thinking about what I know, and writing down the answers.

• Write It Out – Make a visual plan by writing it down or drawing it out in pictures. Kristen Jacobson and Sarah Ward of 360 Thinking Cognitive Connections use the Get Ready, Do, Done strategy to help students make a visual plan. Begin at the end to picture what will it look like when I am done (this is the visualization example from above). The next step involves the list of what exactly the child needs to do to study, which might include re-reading chapters in the text, reviewing notes, having discussions, making up rhymes, etc. Finally, the child writes/draws what will be needed for studying. Be sure they include any tools that are needed such as pens, paper, sticky notes, books, study guide, etc.

Organization is the system we use to keep our materials and plans in order. Let’s face it – we aren’t all neat and tidy people, but we can develop strategies for being organized! Even if our shoes are not lined up in neat straight rows in our closet or on the shoe rack, we can at least be organized by having a place to keep them. Joking aside, it can be very frustrating to spend 30 minutes searching for your shoes every day before heading off to school because you left one by the back door and one under your bed. Does this sound familiar (maybe it’s not shoes, but homework, toys, car keys, etc.)? If so, these tips might be helpful in establishing some organization:

• Make it Visual and Tangible – If your child struggles with organizing plans, try using a visual calendar where you can write dates, times, and assignments. Put it in a place where you and your child can see it multiple times a day. To do lists can also be helpful organizational tools when you need to accomplish multiple tasks in a given time frame. Sticky notes, labels, and colored folders can also be good organizational tools for school, work, or home. Bins, boxes and containers are great ways to organize around the home and assist everyone in knowing where things belong. Of course, none of these tools are effective if your child doesn’t know how to use them so some teaching and supervision will be needed at first.

This is a big one, so take it slow and tackle one thing at a time. Trying to organize everything at once will be too overwhelming and failure will be inevitable. This may also require trying different organizational systems before you find the one that words the best for your child. What works for you may not work for him or her, so be flexible.

Time Management involves knowing how long tasks with take and how to use time effectively to accomplish tasks. Kids with time management difficulties are often late, have unfinished work, or are constantly frustrated because they run out of time. Here are some strategies that teach kids the cognitive skills needed to manage their time:

• Routines – Routines are great for helping with time management. Sometimes just seeing a routine written down and posted on the wall is enough to keep the child moving in a more efficient manner. Some people get lost in their thoughts and then just forget what they are supposed to be doing. This ends up wasting time and causing frustration. The visual cue of a list can help kids get back on track when they find themselves lost in thought or distracted. Set up routines for tasks that occur on a regular basis, but be careful that the routine doesn’t become so rigid that you create a new problem with inflexibility.

• Create an awareness of time – Start by timing your child while he is doing a routine task such as brushing teeth. After establishing how much time it actually takes to do routine tasks you can better help your child plan how much time they need to accomplish them. The more you bring awareness to how long certain tasks take, the better your child will become at estimating time. Once your child has a sense of how long things will take you can use this information to plan the day. For example, if it takes your child 45 minutes to complete his morning routine on school days you can then help your child determine what time he will need to get up in the morning in order to be ready for school.

• Visual Timers – These are great tools for helping your child see how much time has passed and how much time she has remaining to complete tasks. You can use a timer that shows time passing for single tasks, or you can utilize timers with changing colors indicating when time is almost up or when it’s time to change to a new task. Some children benefit from using a color-coded system on the face of an analog clock to help them move from one task to another. This can be done simply with a large clear-faced analog clock and a dry erase marker to write on it. Don’t be afraid to experiment with different options to determine why type of visual clock your child will benefit from using. If one timer doesn’t work, don’t give up try something different.

• Planners – The purpose of a planner is to map out the day’s activities. I like to use one page at a time with the day broken down into 15-minute segments, but this may be too overwhelming for your child. You may have to try a few different styles to see what works best for her. Using a day planner will also be more effective after your child has a sense of time as mentioned above. First, create a list of everything that needs to be accomplished that day. Then have your child use the daily planning sheet to determine when she will do each of the tasks, making sure to leave enough time to finish them. This is best done in pencil so things can be moved around as needed to ensure there is enough time to complete tasks. Some children don’t need the whole day planned out, but need to use this type of system for planning how to complete homework or other household tasks.

When someone is unable to plan, organize, or time manage for future events they often find themselves in the ‘last minute’ loop. This results in failure after failure, which can lead to giving up and poor self-esteem. This is why teaching executive function skills is so critical! As we work on these skills kids become better able to project into the future to determine how to plan, organize, and time manage for upcoming events, which stops the failure cycle. No one plans to fail, it is a deficit in not knowing how to plan!