Executive Functioning in Kids, Here’s How We Can Help (From Your Speech Therapist)

Executive functioning is a set of mental skills that our kids use every day to actively engage in daily life skills, learn and play. Executive functioning is responsible for your child’s ability to sustain attention, organize and plan, initiate and complete, problem solve and regulate emotions. There are many different ways to address breakdowns in the area of executive functioning. Your therapy team works together to address ‘the whole child’ so they can perform at their best. Check out some ways in which speech therapy can focus on improving your child’s executive functioning skills. 

Think of executive function as the CEO of the brain, controlling all the skills required to plan, execute, and complete tasks and projects. These skills can be divided into the broad areas of working memory, flexible thinking, and inhibitory control. When executive function is impaired, children may display difficulty with initiating tasks, memory, organization, planning, time management, emotional control, understanding the perspectives of others, and paying attention.

Many kids tend to be disorganized and distracted at times, but those who are struggling with executive function may take a very long time to get dressed, pack a bag for school, and perform simple chores. Executive function disorder is common among children who are diagnosed with attention-deficit/hyperactivity disorder (ADHD).

HOW SPEECH THERAPY CAN HELP WITH EXECUTIVE FUNCTION

1. Initiation 
   • Initiation refers to a child’s ability to begin a task or activity and independently generate ideas, responses, or problem-solving strategies. Initiation also includes being able to overcome procrastination, something that we all experience.
   • Initiation affects many areas of executive function including planning, organizing, time management and working memory. Developing strong task initiation skills reduces anxiety and stress, gives you momentum, reduces poor work habits, and helps you to complete tasks sooner and on time. Children with initiation difficulties typically want to succeed but can’t get started independently. This can be exhibited in a variety of ways:
     • Behaviorally, such that they cannot get started on physical activities like getting up to begin physical activities.
     • Socially, such that they have difficulty calling friends our going out to be with friends.
     • Academically, such that they have trouble getting started on homework or other assignments.
     • Cognitively, such that they have difficulty coming up with ideas or generating plans.
   • How do we treat initiation? Basic aspects of intervention include providing additional external structure, prompting and cueing, and helping with organization and planning.  Increasing structure for routines and reducing overwhelm can be beneficial in improving initiation skills. Teaching children how to chunk tasks or break them down into several smaller parts can be helpful for any task, but especially those that seem overwhelming at the start. Additionally, teaching your child how to make a plan for how to start their work can have a big impact on their ability to get started. Planning to start a task or assignment trains your brain to get ready for a task. Once the plan is complete, your child will find it easier to start things right away without putting things on hold.
2. Planning and Organization
   • Planning encompasses the ability to anticipate future events, set goals, and develop appropriate steps ahead of time to carry out a task or activity. It requires imagining a goal or end state, determining the most effective approach, and sequencing a series of steps to attain the goal. Organization involves having an efficient and effective system to order and complete tasks.
   • Teaching your child to become a good planner reduces anxiety and stress, helps increase productivity, reduces poor work habits, gives them time for other activities, and provides practice for positive life skills. Planning isn’t something your child will only do for school. It is a life skill they will use forever, both in their personal lives and their future careers. Teaching your child how to stay on top of organization can help them get started right away, allows them to think more clearly, allows them to do well on tasks, increases confidence, and provides a system they can rely on. The whole goal of being organized is that it is a system you will have for now and for the future. Children with poor planning and organization skills may not start assignments in a timely fashion or may start projects without thinking through the materials or steps needed. Additionally, children who have difficulty organizing their thinking, behavior, or work may have difficulty keeping their tasks or schoolwork in order. They may have good ideas but be unsuccessful in expressing them and may be overwhelmed by large tasks or amounts of information.
   • How do we treat planning and organization? Provide your child with systems and strategies to improve their executive functioning skills. Sarah Ward, M.S., CCC-SLP has devised a number of visual systems that are used to improve planning and organizing. Using the Get Ready- Do- Done model is one visual used to predict future outcomes, generate and organize a plan, and self-monitor the success or failure of actions upon the completion of tasks. The Get Ready- Do- Done concept is designed to teach students to develop awareness of what the end result of a task/project will look like, problem solve the steps required to match the future picture, and determine the materials needed for task completion.
3. Working Memory 
   • Working memory is the capacity to hold information in our brains while we are working with it. It enables one to think about problems, to focus on a goal, to carry out multistep activities, complete multi-step problems or follow complex instructions.
   • Appropriate working memory is necessary to sustaining performance and attention.  Having stronger working memory skills can help your child be clear on directions, finish tasks quicker, have better performance at academic tasks and have increased attention. Children with reduced working memory have difficulty holding an appropriate amount of information in mind or in active memory for further processing. Difficulty sustaining working memory has a negative impact on a child’s ability to remain attentive and focused for appropriate lengths of time. Additionally, those with limited working memory can have trouble remembering instructions, lose track of what they are doing as they work, or forget what they are supposed to retrieve/complete when sent on an errand or given a direction.
   • How do we treat working memory? Working memory can be improved through use of external memory supports and strategies. Providing a written checklist of steps required to complete a task can serve as an external memory support. The following strategies can be used to improve your child’s working memory skills:
     • Teach auditory rehearsal: have your child repeat information over and over until a task has been completed. This is often a helpful method of increasing the amount of information encoded into memory.
     • Use mnemonic devices: these are helpful tools that help children learn and recall basic skills and facts.
     • Encourage requesting repetitions or assistance when appropriate.
     • Provide external memory supports: children with memory deficits often demonstrate difficulties keeping track of more than one task at a time. Providing a written checklist of steps, using phone reminders or a planner can serve as an external memory support and can alleviate some of the burden on working memory.

Remember, just because your child may be struggling it does not mean they are incapable of accomplishing anything they put their mind. Through education, practice, and strategies, you can support your child to meet their optimal potential.

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