The frontal lobe in the human brain, and specifically the prefrontal cortex, is responsible for managing executive function. Research has shown that anything that damages the brain tissue of this area can impact an individual’s executive functioning skills, but damage to the prefrontal cortex is not the only cause of executive function challenges. Research has also shown that some neurodevelopmental conditions involve frontal lobe effects and executive dysfunction symptoms too. Neurodevelopmental conditions include Attention-Deficit/Hyperactivity Disorder (ADHD), Autism Spectrum Disorders (ASD), and other learning disorders, which alter how the brain develops.
Regardless of your child’s diagnosis, or lack of one, you may be able to notice executive function difficulties by paying attention to how they manage and handle their daily tasks and interactions with others. Children with executive function challenges are often more disorganized than their peers, might forget to follow through on chores or tasks they are given, will leave doing their homework until the last moment, will often lose items, might blurt out in class or interrupt others in conversation, and may have a difficult time changing plans, taking perspectives of others, and regulating their emotions. Executive function consists of working memory, cognitive flexibility, and inhibition control, and these are all important skills for succeeding in daily life at school and work. All kids are going to have some challenges with inhibition, disorganization, and attention, because these functions of the brain are still being developed. It is normal for all kids to struggle with these demands throughout childhood. Even so, neurodevelopmental differences may further exacerbate age-appropriate executive function challenges beyond that which is typical of their peers.
If a child is struggling with executive functioning challenges, whether they have been diagnosed with a neurodevelopmental condition or not, the good news is that executive function skills can be learned and strengthened. Many approaches to enhancing executive function abilities in youth are parent-driven, because it is typical that these abilities are not established in youth, and especially in youth with neurodevelopmental challenges. Behaviorally based interventions that involve caregivers, like implementing structure at home, Behavioral Parent Training, and Parent-Child Interaction Therapy, are front-line treatments. In many ways, these interventions help caregivers supplement the executive function system of their child's brain.
Here are some at-home strategies for strengthening executive functions:
Use checklists for repeating responsibilities, and break down large tasks into smaller steps
For kids who struggle with executive functioning, checklists can be a great way to help them stay on track with chores or daily responsibilities. Oftentimes, responsibilities like “getting ready for school” are made up of many smaller steps that can be difficult for a child to remember. When a child with executive function challenges is given three commands at once, it is highly likely that they will forget what they are and will get distracted somewhere in the process. Having a list that they can use every day with each step broken down can keep them moving in the right direction without parents having to repeat the steps to their child. Caregivers can try applying this for morning and bedtime routines, homework routines, and weekly chores.
Help minimize distractions in workspaces
Children with executive function challenges will have a harder time than other kids resisting impulses to get distracted by both external and internal stimuli (like a conversation going on in the kitchen, a cool toy, or unrelated thoughts to the topic). As a result, getting homework done can be a battle. If your child struggles to do homework, help them create a workspace that has minimal fun distractions, limits noise interference, and contains only work-related items. Having this homework-only space will create more distance between fun time and work time.
Use a rewards system and praise your child’s efforts
Kids with executive function challenges have a hard time resisting short-term pleasures to reach long-term goals. Rewards are a great way of allowing for short-term pleasures that reinforce behaviors that you would like to see. Rewards can create external motivation for tasks that would otherwise be unappealing to children. When using a rewards system, it is important to be consistent. If your child learns that rewards come when you tell them they will, they will be more likely to follow through with the expected behaviors. Consider keeping the rewards chart either in their homework area, or by the chore chart, to build motivation to complete tasks. Praise is also very powerful. Acknowledging to your child that you know the tasks are difficult for them, but that you are proud of the effort they have put in is a great way to encourage hard work and build resilience. Oftentimes, executive functioning difficulties can lead to low self-esteem because of frequent negative feedback from others. Praising your child when you see them working hard can counteract this.
There has also been great research done on evidence-based treatment programs that help kids and teens learn and strengthen their executive function skills.
Behavioral Parent Training (BPT)
BPT is an evidence-based approach for children who have ADHD and their families. BPT addresses a wide scope of challenges that a child with ADHD may present with, and because of this, it can help structure the positive development of executive function skills. For example, BPT helps caregivers learn about the role of reinforcement in shaping behaviors, how to improve organization and routine within the home and for their child, how to give clear instructions, and how to implement consistent rewards and consequences. Learn more about BPT here.
Parent-Child Interaction Therapy (PCIT)
PCIT is an evidence-based approach for children between the ages of 2 and 7 who present with behavioral difficulties, impulse control, and may have ADHD. PCIT helps caregivers learn about the power of positive reinforcement and praise in shaping behavior, helps caregivers implement structure for consistent and safe consequences, and teaches caregivers how to give effective commands to their children. Learn more about PCIT here.
Organizational Skills Training (OST)
OST is an evidence-based and empirically supported approach for supporting children, teens, and their families in developing and enhancing the child’s executive functioning skills. In an OST program, a clinician would work with your family to improve the child or teen’s time management, planning skills, task completion, and other organizational skills. Research done on OST has found that the program improved organizational skills, inattention, and academic performance in children with ADHD as young as 6 years old. OST is often delivered in a group format, but the same skills and approaches can be implemented in individual child and caregiver treatments.
Camp Baker (or other behavioral camps designed for children with ADHD)
At Camp Baker, kids get to engage in typical summer camp activities like swimming, art, and play, with structured behavioral interventions built into the structure of every activity. Camp also includes one period of academics to address academic and school-related behavioral regression which is common over summer breaks for neurodiverse children. At Camp Baker, social skills are regularly discussed, practiced, and rewarded. All counselors receive training on supportive interventions for children with ADHD and behavioral difficulties, and parents attend weekly training sessions to learn these same skills.
Assessments and Evaluations
If you suspect that your child struggles with executive function challenges, an assessment or evaluation is a great place to start. A neuropsychological evaluation, which is offered at the Center for Effective Therapy, assesses for a child’s learning and memory, general intelligence, visual-spatial skills, language, attention, executive function skills, academic achievement skills, sensorimotor skills, behavioral and emotional functioning, and social skills. This kind of thorough evaluation will give you clear direction in which areas of development may need further support for your child and family. Learn more about assessments here.
IEPs and 504 plans
School-based supports like an IEP or 504 plans can be helpful for children's academic and social functioning and may require documentation of executive function challenges from an assessment. Assessments may also indicate if medication may be useful, but it is important to remember that medication does not teach skills, so the effects are maximized when used in conjunction with effective psychotherapy.