By Dr. Jennifer Imig Huffman, The ABLE Center
In last month’s Healthy Cells Magazine® article we introduced executive functioning in children and the common skills that are related to this important cognitive function. This month we will review what happens when executive functioning skills are delayed in children and common accommodations that may be helpful for them at home and school.
Children with executive functioning difficulties may show the following:
• Struggling with working independently at home or school
• Difficulty with sense of time, including getting easily lost within a task, especially if it is a preferred task
• Difficulty paying attention to tasks that require sustained effort, are complex, or are viewed as boring to the child
• Difficulty ignoring the distractions around them
• Difficulty sustaining attention for more than short periods of time
• Needing extra prompts, or cues, from a parent or teacher to get started on a task
• Low motivation to do tasks that require sustained effort, are complex, or are boring
• Easily emotionally overwhelmed and frequently described as moody
• Struggling with disorganization and forgetfulness at home and school
• Cognitively inflexible, especially when it comes to trying new things (i.e., new foods)
• Difficulty accurately writing down information from the board, writing down their assignments, or remembering to do chores at home
• Unable to start a task or follow through on complex chores or assignments without prompting
• Often viewed as “lazy” or “uncaring” when they truly don’t know how to perform the behavior consistently or when the demands of their environment have outpaced their own ability
• Unable to freely recall information, efficiently or accurately, but do significantly better with prompting due to inefficient memory storage and retrieval system (the memory file has been saved but they don’t know how to retrieve it until a prompt points them in the right direction)
• Prompt and/or cue dependent recall
• Inflexible memory storage and retrieval of information and may study the information and understand it in one format but be unable to produce this information if asked in a slightly different way
If a child shows many of these characteristics they may have a disability, such as ADHD or a learning disability. If the child has a disability and there is a significant impact on their functioning, or if the symptoms “substantially limit” their ability to learn, he or she may be eligible for special education through an IEP or Section 504 services. Discuss your concerns with your child’s school team and/or doctor for more information.
What are helpful supports or accommodations for children with executive functioning difficulties at home and school?
• Work for small amounts of time with scheduled breaks
• Work in non-distracting environments
• Highlight the important information for the child
• Allow paper and calculator when required to work on problems in their head
• Use a visual chore chart in the home with concrete and salient reinforcers
• Use scaffolding when presenting new information
• Have a teacher check that they have written down the assignment correctly and have all supplies needed to complete assignment
• Check in and check out with a resource teacher
• Use word banks, formula notes, or lecture notes for tests
• Allow for alternative testing if the child does poorly on a test, such as oral or multiple choice
• Allow extra time to complete standardized and non-standardized tests and assignments
• Use visual maps, brainstorming sessions, and outlines for written assignments
• Teach organizational, planning, time management, long-term goal setting, and metacognition skills at home and school
• Consider allowing the child to use assistive technology, such as a tablet or smart phone, to provide accommodations and support
In addition to modifications to their environment, children with executive functioning may benefit from specific training in the areas in which they are showing developmental lags at home and/or school. Cognitive training programs, such as Cogmed© or PlayAttention©, also exist which work to specifically target weak working memory and executive functioning skills. Some children with weak executive functioning skills may benefit from stimulant or nonstimulant medication along with cognitive behavioral therapy to better support their functioning in this area. If you have concerns about your child’s executive functioning, consider discussing your concerns with your child’s school and their doctor.
For more information, contact Dr. Jennifer Imig Huffman at The ABLE Center in Bloomington, IL at 309-661-8046. Dr. Huffman, founder of The ABLE Center, is a developmental neuropsychologist. She and her staff work closely with the child, the parents, the school, and other community providers involved in the child’s care to help them succeed at home and school.
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