Executive Function Challenges and Strategies to Improve Them – Part 3

Executive Function Challenges and Strategies to Improve Them – Part 3
4
Nov

Executive Function Challenges and Strategies to Improve Them – Part 3

The ability to regulate (or control) our thoughts and actions is a critical part of our higher-level thinking or executive function skills. When someone struggles with one or more of these skills then self-regulation is more difficult. In prior articles we covered the skills of planning, organizing, time management, task initiation, working memory, and metacognition. In this article we will explore self-control, attention, perseverance, and flexibility.   

Difficulty with controlling impulses, staying focused, sticking with a task, and/or adapting to change can make day-to-day activities seem frustrating and unmanageable. This can look like behavior problems at home and school, when in reality it is a deficit in these underlying executive function skills. Let’s look at how we can address these difficulties to make life a little easier.

  • Self-Control is the ability to regulate our own thoughts, actions, and emotions. Children who are impulsive, introverted, act-out, or struggle with obsessive thoughts or worry have difficulty with various elements of self-control. Constant thoughts about video games or worry about the weather, for example, make it difficult to be present in the moment and learn. Children who over or under-react to everything have difficulty engaging with their world and learning new things.  Regulating thoughts, actions and feelings has a huge impact on readiness and willingness to learn. There are many different strategies for supporting self-regulation, and here are a few good starting points:
    • Model – Children learn to regulate their emotions by first regulating with the adults in their environment. The term for this is co-regulation. If the milk spills and the adult jumps up screaming and running around, the child will begin to model these behaviors when small things happen. This tends to lead to even bigger reactions to more significant events. When adults regulate their own emotions and reactions it helps children learn to do the same. This can be a challenge, but remember that your child is always watching you to learn from your response! Try a little self-check now and then to see if your child is actually just reacting in ways you have modeled for him.
    • Get active – Children given movement opportunities throughout the day tend to have more success with regulating their actions and emotions. When the physical body is regulated then the brain can stay regulated as well. Even something as simple as a 2-minute dance party can help support regulation. When tackling something difficult, start with a movement activity and take another movement break part way through. Movement goes a long way in reducing frustration for all of us, but especially for children!
    • How big is the problem – Some children struggle with understanding that problems come in different size, and they don’t all require the same reaction. Labeling the size of the problem and working on possible reactions based on size can be very helpful for children that go from 0-60 no matter the issue. Start by making a thermometer that goes from 0-10 and is broken into three sections – green (0-3), yellow (4-7), and red (8-10). Next, spend time talking with the child about problems that might fall in the green, yellow, or red areas, and where we would rate those problems. Practice this rating skill by giving examples of the reactions we might have in each of the zones. Next, have the child think of some of their own problems and place it on the scale. Talk about whether their assessment is accurate or not, and how you view it. When problems arise you can use this system to discuss the reaction they had and whether that seems like the best response in hindsight. The key is to practice, practice, practice. With enough practice and guidance kids can start to determine for themselves what size problem they are encountering and the appropriate level of reaction.

  

  • Attention refers to a person’s ability to focus on a task for a set period of time, as well as being able to shift attention when needed. This is probably the executive function skill that is most familiar to people. The ability to keep your mind from wandering is difficult, especially when you find the task boring or unappealing. Have you ever found yourself at the end of a page of text and realized you have no idea what you just read? Have you walked into the room where your daughter is watching her favorite tv show and she doesn’t even know you are there? If so, you have experienced the kinds of attention difficulties that we all experience sometimes. If your child is struggling with staying engaged or shifting his focus, then these tips can be helpful:
    • Stop and wait – Imagine you are talking with your child and she is looking around, fiddling with her phone, or her eyes have glazed over. This means she is no longer attending (or maybe never was attending). Instead of continuing to talk, stop and wait for her to adjust her focus back on you. You can also try talking very quietly to draw her attention back. Stopping and waiting is very effective at helping kids shift their attention back to what is important. If you need your child’s attention while he is engaged with the tv, a video game, book, etc. this strategy can also work. Turn off the tv, put a hand over the book or on his shoulder, and stop and wait for him to look to you. Once his attention is back with you then proceed with saying what you need to. 
    • Move – Physical activity was mentioned above for supporting self-control, but it is also very helpful for improving attention. When our brain is stimulated and awake it is much easier to attend during less active tasks. Giving your brain a movement break every so often allows for a rest and recharge so you can continue your tasks. Movement breaks can be interspersed with more focused tasks, and don’t need to last for long periods of time. Even just 2 minutes of movement can do the trick! After doing 10 math problems have your child get up and do 10 jumping jacks before tackling then next set of problems. You might also try doing some physical activity before starting a more focused activity. For example, go for a 15-minute bike ride or shoot hoops for 10 minutes before sitting down to do homework or starting chores. This will get your child’s brain refreshed, recharged, and ready to focus. 
    • Play games – Most children love games and they make for a fun way to work on improving challenging skills. You can work on attention by playing games that require focus and attention. Some examples include Simon Says, red light-green light, freeze dance, musical chairs, or telephone. There are also many board games that require focused attention, especially while the other player is taking a turn. You can even come up with your own simple in-the-moment games that allow your child to practice attention skills.
  • Perseverance is the ability to stick with a task and not give up, even when it is difficult. We have all heard expressions like “Don’t give up!”, “You’ve got this!”, or “Try try again”. These expressions remind us that sometimes things are hard and we have to keep going – even when we feel like giving up. Isn’t is an awesome feeling when you have been struggling through something and you finally accomplish it?! Some of our children really struggle to stick with or even start difficult tasks because they perceive that the task it too difficult or because they are afraid of failing. Teaching children how to persevere takes time, but these tips can help:
    • Model – Be a model of perseverance. Show your child how you stick with tasks even though they are difficult. Use self-talk as you work through a tough problem to allow your child to hear your thoughts for keeping yourself going. If your child isn’t around for one of these tough times, take some time to share the story with your child. Talk about the task, how you were feeling and what you were thinking, and then share what you did to keep yourself going and how it felt to finish. Children will then start to internalize these kinds of thoughts and feelings to apply them when they encounter similar situations.
    • Watch and Read – There are several great children’s and young adult books, as well as TV episodes and short films that demonstrate perseverance. A few of my favorites include The Most Magnificent Thing by Ashley Spires and the short film Ormie the Pig. Both the book and film are great examples of what it means to stick with something even when your first attempt does not work. As you read or watch, talk with your child about what the character is doing and feeling. After you are finished discuss the ending and talk about the different ways the character kept trying. If possible, compare the story to a time when you or your child kept trying until you accomplished the task.
    • Do it together – Working on something together is very helpful to get practice until your child can do it alone. If your child is faced with what seems to be a really difficult task, work together. Don’t do all the work for your child. Instead, try to lead her toward making new discoveries or trying a different way. Provide enough support that she can accomplish the task and feel some success. For example, if your child is really struggling with learning how to tie his shoes then start by having him just do the last step of pulling the knot tight. Or you can start by having him just cross the laces and you finish tying the shoe. Once your child is feeling competent with this step move to the next until he is ready to try it on his own. Be patient and provide encouragement. When your child accomplishes tying his shoes take a few minutes to talk about how difficult it was, but by staying with it and practicing he was able to be successful. This sense of accomplishment makes it easier to tackle hard things the next time!
  • Flexibility refers to the ability to comfortably deal with changes and adjust to new situations. It’s a fact that change can be hard sometimes, but it is a large part of our everyday lives. Having the ability to adapt to change can make many situations easier to manage. If your child struggles with inflexible (rigid) thinking then you know how difficult it can be to move throughout your day. Here are some ways to help kids become more flexible thinkers:
    • Demonstrate what is means to be flexible. Most children respond best to seeing things in action. One way to demonstrate the concept of flexibility is to show them things that are rigid and things that are flexible. Talk about the differences they see and feel. It can also help to play a game using soft balls (like ping pong balls or large pom pons). Tell the child to throw the balls at you, and stand perfectly still to allow the balls to hit you. Then switch roles and throw the balls at the child, but tell them they need to move to avoid being hit (they have to stay in a small area, but they can bend, twist, duck, etc. to avoid the ball). This activity is a concrete way to talk about how the adult was rigid and the child was flexible. Discuss what it means to be flexible when change occurs, and provide examples to determine situations when it is better to be flexible or rigid. Spotlight the problems that can come up when the child is too rigid with their thinking or actions.
    • Practice change in everyday routines. Start by choosing a routine or activity that you do on a regular basis. Select one part of that routine to change, and then practice the change with your child. For example, if you always put on pjs and then brush your teeth, try brushing your teeth first. If you always sit in the same spot at the dinner table, try switching seats. If the soap is always in the right side of the sink, put it on the left side. For some children these changes will be easy, but for others the change will be very difficult. If your child struggles with even these small changes you will have to start with even smaller changes. For example, you might switch seats at the table for just the last minute of the meal or for dessert only. As your child becomes comfortable with small changes in routines, then you can start to make bigger changes. When you first begin, don’t try to make too many changes at once. Focus on one change a day and build up from there as your child becomes more flexible. 
    • Provide a heads-up when you know a change will be occurring. Most of us do not like to be surprised by changes, especially people who struggle with being flexible. Whenever possible, provide your child with some warning that a change will be occurring until he has had a chance to practice small changes with your support. For example, if you know on Thursday that this weekend’s soccer game was moved from 10:00 to 1:00, tell your child on Thursday. This gives him time to process the change and be more receptive of it when Saturday rolls around. Some children respond better to a visual cue that a change will occur rather than an auditory cue. These kids benefit from drawing or writing out the change on a piece of paper or schedule board. Some children do well with having a visual reminder of changes that are coming later in the day that they can keep in their pocket or notebook to refer to as needed. You will need to experiment with how much of a heads-up your child requires and the best way to present the information. As your child improves with flexibility the need for a heads-up will decrease.

Self-control, attention, perseverance, and flexibility are all necessary skills that allow us to be more efficient, effective, and comfortable in our day-to-day lives. Without the ability to regulate, focus, stick with it, and adapt kids struggle to accomplish tasks. This leads to even greater levels of frustration for them and us. Improving executive functioning can seem challenging, but implementing these strategies consistently and practicing them over time does lead to improvements and greater success.

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