Executive Functioning is a relatively new term used to describe a series of cognitive skills that are associated with Learning Disabilities and/or Attention Deficit Hyperactivity Disorder(ADHD). It refers to problems with memory, organization and planning, but it does not fit neatly into any model used to diagnose learning disabilities in many school systems. Instead, these students are often labeled as being “lazy” or “unmotivated”. However, Executive Functioning problems can often explain why an otherwise bright, capable student is not achieving to his potential.
What is Executive Functioning?
Typically diagnosed by neurologists, neuropsychologists, and psychologists, Executive Functioning difficulties relate to behaviors which deal with memory, inhibition, planning, organizing, sequencing, and strategizing. Different definitions have emerged: Dr. Martha Denckla, a research scientist at the Kennedy Krieger Institute in Baltimore, MD, presents the acronym ISIS to stand for AInitiate, Shift, Inhibit, and Sustain; to plan, organize and develop strategies or rules.@ Dr. Russell Barkley, author of Taking Charge of ADHD, states that Aexecutive functions (are) critical to planning, organizing, and carrying out complex human behavior over long periods of time.@
At Spodak, Stefano & Associates, we define Executive Functioning as “an umbrella term that is used to describe the higher-level cognitive skills that impact the ability to demonstrate intellectual capabilities. Included in this domain are behavioral controls (impulsivity, emotions, regulating work efforts) and cognitive controls (monitoring and modifying attention and effort level, planning ahead, managing time, following through on tasks, organizing materials).”
Many students with ADHD demonstrate symptoms of Executive Functioning difficulties. However, these symptoms may not be evident if the initial diagnosis of ADHD is made in early childhood before the Executive Functions have fully developed. Although some aspects of Executive Functioning are expected to be developed at an early age (like the ability to transition from one activity to another easily), the more complex skills such as organization and planning ahead emerge as children move into middle school and enter adolescence.
How are Problems in Executive Functioning Identified?
Many different measures can be used to assess Executive Functioning. Although there is much overlap between these measures and those used to assess attention and memory, there is no uniform single test or series of tests to diagnose Executive Functioning. This is partly because the concept is complex and difficult to define and also because so many inter-related skills are involved. For example, Executive Functioning is an integral part of higher level reading, writing and math abilities. For example, a student with difficulty in planning and organization may be unable to develop his ideas adequately on an essay. Similarly, problems with working memory can affect reading comprehension because the student cannot remember what she has read and cannot integrate the information with her prior knowledge.
Executive Functioning can also impact a student=s grades independent of his skill level in any one subject area. In other words, if the student has difficulty planning and managing his time, this will affect his performance in all subjects. While these abilities are separate from the student=s academic skills in a particular discipline, they can dramatically impact the student=s performance and grades in school. For example, a student may know his math facts, but fail to complete his homework on time; or he may have completed his homework but failed to bring it to school or to turn it in. He may have studied for a test but be unable to answer test questions because they are presented in a novel format. These issues could signal deficits in Executive Functioning which would affect that student=s grades despite adequate academic skills in that subject.
A comprehensive assessment of Executive Functioning must therefore include measures of many skills including planning, cognitive flexibility and working memory. The examiner must be sufficiently knowledgeable to recognize the symptoms when they occur, and parents must be explicit about the problems they are seeing so they can determine if the particular evaluation will address those issues. Furthermore, if not previously assessed, an evaluation should also include measures of basic academic skills, as well as application of these skills to determine whether the student is experiencing difficulty due to deficits in basic skills or Executive Functioning or both.
How Can Executive Functioning Problems be Remedied?
Once deficits in Executive Functioning have been identified, there are several approaches to address them. Although classroom teachers typically work on some of these issues within their classrooms, students who have these problems usually require additional individual work outside the classroom setting. Tutors specially trained in this area are often called AAcademic Coaches@. To address organizational difficulties, coaches teach explicit strategies to keep track of assignments, plan how much time an assignment is going to take, develop test-takin strategies, etc. These will vary with the age of the student and his particular learning style. Planning tools like master calendars, electronic organizers, watches with alarms, and timers are often very helpful. The computer has become a valuable asset for many of these students; not only the word processing features, but the calendars, the outlining programs, the ability to use graphics and color coding are all important tools. In addition, students need to be explicitly trained in the skills they are lacking: mnemonic devices, visual imagery for memory enhancement; self-talk and self-monitoring techniques to help sustain attention; organizational strategies to address various reading and writing requirements. Most importantly, these skills cannot be addressed in the abstract; the student must be taught how to apply these strategies to his daily assignments. Perhaps one of the biggest advantages of working with an Academic Coach is that it can remove parents from the stressful role as homework enforcer.
Besides academic consequences, students with Executive Functioning problems may also experience problems in the social arena which may extend beyond the classroom. For example, these students often have problems with the concept of time. They cannot estimate how long a task will take and they do not plan for contingencies. As a result they procrastinate and are typically behind schedule. This means that homework assignments and projects are often turned in late. It also means that they are late for school or don’t show up on time when meeting a friend. After a while, these time management issues may alienate friends and family. Likewise, since they do not monitor their own behavior very well, these students may also have difficulty reading others= responses and changing their behavior accordingly. In the same way that Academic Coaches can address the academic consequences of these problems, Social Skills groups exist to help students develop interpersonal skills for getting along with others. As with the academic application, only those skills which are developmentally appropriate can be taught. Therefore, instruction often must be reintroduced at different phases. In other words, a ten-year- old is only able to grasp certain concepts and abstractions; by the time he is sixteen, he is ready for another round of strategies aimed at a higher level. Therefore, often students need intervention at different times in their lives to address the problems specific to that particular age level. With appropriate identification, intervention, and support, students with Executive Functioning weaknesses can achieve greater success both academically and in their social relationships. Furthermore, since the need for these skills continues into adulthood, developing them at an early age assures a smoother transition to higher education and personal and career satisfaction.
Kenneth Stefano, Psy.D. is the owner of Kenneth Stefano & Associates,a team of clinical psychologists and educational diagnosticians, who specialize in conducting comprehensive evaluations and developing therapeutic strategies for children, adolescents and adults with learning, attention, executive-functioning, and -emotional difficulties. We also assist parents through the IEP process, refer to appropriate professionals when necessary, and identify alternative primary and secondary school placements.
www.stefanoassociates.com
301-770-7507
