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Building Blocks Pediatric Occupational Therapy Services

Fairfield Connecticut Occupational Therapist

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Executive Functioning Skills (Part 1/2)

February 18, 2022 By admin

This is part 1 of a 2 part blog post series discussing what executive functioning skills are, as well as the tools and strategies that can be utilized at home or within the classroom to help your child become more independent and functional in his/her everyday life.

Executive Functioning Skills

The development of executive functioning skills is a necessary component of cognitive processing. Executive function refers to a child’s ability to plan and direct activities, initiate tasks, have working memory, maintain sustained attention, and persist towards an end goal.

These skills help with the regulation of emotions, enabling a person to organize behavior and override any initial reactions in favor of long-term goals. The skills that allow a child to regulate their behavior and perform optimally are as followed:

  1. Planning and Organization: the ability to create a roadmap towards an end goal and complete a task. This allows a child to be able to focus on what is important and avoid what is not important.
  2. Time Management: the ability to estimate how much time he or she has, as well as how to function within those time limits.
  3. Working Memory: the ability to hold information in one’s mind while performing a complex task. This includes drawing on past experiences and applying them to a current task. This skill is crucial for problem-solving.
  4. Metacognition: the ability to observe how oneself is problem-solving, by asking the questions, “How am I doing?” or “How did I do?”
  5. Response Inhibition: the capacity to think before acting, establishing enough time to evaluate a situation and determine how a specific response will influence the outcome.
  6. Self-regulation: the ability to manage emotions so that an end goal may be achieved.
  7. Task Initiation: the ability to begin a task in a timely manner.
  8. Flexibility: the ability to revise plans when there is an obstacle or a setback. This is the ability to adapt to changes.
  9. Goal-directed Persistence: the ability to follow through with a task despite competing interest or demands.

These skills are required in order to face new challenges and tasks that are not innate. It should be noted that these skills continue to develop from infancy all through childhood into adolescence. Children are constantly facing new tasks as they get older, challenging their executive functioning skills and further developing them.

Researchers now know that most executive functioning skills develop in the area of the brain known as the prefrontal cortex, a system of the brain that does not fully develop until late adolescence. In infancy and early childhood, parents act as the frontal lobes for their children. They demonstrate appropriate limits and guidelines that children will first observe, then mimic, and then independently initiate without the presence of an adult as they get older.Also, important to be noted, is that the frontal regions of the brain control much of human behavior, which is why executive functioning skills can be impacted by several different factors. Depression, anxiety, attention disorders and even fatigue can all impact a child’s ability to think critically, problem solve, and successfully engage in various other executive functioning skills.

To help a child develop or enhance these skills, an occupational therapist will design an intervention that utilizes two different strategies.

Environment: Changing conditions within an environment may be beneficial if your child has difficulties with executive functioning skills. Altering an environment means more than just physically changing an area, but also includes adjusting the nature in which tasks are completed or the cues that are given to assist.

Physical Change Examples:

  • Altering seating arrangements within a classroom to assist children who have a difficult time sustaining attention
  • Condensing the size of social groups for children who have challenges with flexibility or impulse control

Changing the Nature of the Task Examples:

  • Altering the type of directions given (written, spoken, visual, etc.) or the number of steps needed for completion

Changing Cues Examples:

  • Giving verbal prompts or reminders, (first…then…), visual cues (post it notes in prominent places), or schedules (either for a specific event or for the course of a timeframe).

Person: It is probable that the reason why your child may have poor organizational skills or impulse control, is not a cause of intentionally poor behavior, but rather the inability to use executive functioning skills they have not learned yet. In a circumstance like this one, the development of these skills is accomplished by teaching your child. Here is a template on how to accomplish this:

  1. Establish a step-by-step: this can be done by creating a checklist to guide your child through the steps required in order to complete the task.
  2. Supervise: in the beginning, before your child is able to independently perform, he/she will most likely need to be walked through the entire task. They will benefit from receiving cues to initiate the task, positive reinforcement for steps completed appropriately, and guidance for steps that have room for improvement.
  3. Evaluate: reflect on the performance given; think to yourself, “Do more cues need to be given here?”. At this stage, it would be beneficial to incorporate your child into the evaluation process, so they may problem solve with you and help determine additional ways to help in task completion.
  4. Fading Supervision: gradually remove cues given until your child is able to functionally and independently perform.

Motivation is a huge factor in development of executive functioning skills as well. When you notice that your child has engaged in an appropriate behavior, acknowledge and praise them. Incentive systems are another way of motivating your child, offering them the chance to earn points to be traded for a reward. You may have used this form of motivation with your child in the past, creating a Behavior Contract to explain the rules and responsibilities to your son or daughter, in exchange for a reward.

In the following blog posts, we will walk through the various executive functioning skills and discuss ways to teach and enhance these skills for your child.

 


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