Executive Function

What is Executive Function?

As stated, executive functions are a series of processes that all have to do with controlling one’s own resources (like time and attention) and self-regulating  in order to attain a goal. It can be split into two basic categories:

• Organization functions: Obtaining, gathering and organizing information from the world and organizing it to make decisions about what to do and how to act.
• Regulation: Taking stock of your environment and adapting what you will do as a result. This includes emotional control, and stopping behaviors that are not appropriate for the moment.

What Causes Executive Function Disorder?

Some people have poor executive function from birth. These skills are frequently problematic in people with ADHD, depression, or learning difficulties. A lesion, stroke or traumatic brain injury to the frontal lobe of the brain might make it difficult to stay focused and can affect executive functions. Problems may arise as a result of Alzheimer’s disease. Early childhood stress has also been shown to impact executive function disorder.

What are Some Red-Flags for Executive Function Difficulties?

Executive function abilities develop at a different rate in each person. As a result, determining whether a behavior is cause for alarm or is typical of a child’s age can be difficult. For example, many young teens struggle to keep up with the growing tasks at school and need some instruction on how to organize their activities and responsibilities. What It really depends on is whether the behaviors or red flags listed below continue causing problems over time. Some red flags for difficulties with executive function skills include:

• Easily distracted
• Disorganized and cannot complete goals
• Consistently can’t keep track of belongings
• Understanding the “big picture” is difficult, tends to get lost in the little details
• Having difficulty communicating things in a logical, sequential order
• Not in sync when socializing (e.g., when monitoring talking time, maintaining topics of conversation, etc.)
• Memorization and retrieval of information from memory are difficult (e.g., forgets what happens/comes next, can’t remember names or where objects were left)
• Difficulty planning tasks and how to complete them (like homework or longer projects)
• Not knowing how to start tasks
• Poor time management including avoiding tasks, procrastinating, often running out of time
• Hard time estimating how long a task will take
• Poor emotional regulation
• Trouble transitioning to new activities and moving to a new task before the previous one is finished

This list can seem intimidating and many parents and adults might recognize these behaviors. Yet there are thankfully many reliable ways that children or adults with executive function disorder can improve their skills.

How is Executive Function Disorder Diagnosed?

“Executive function disorder” is not a specific recognized diagnosis that will appear in the DSM-5, the diagnostic handbook used by clinicians. Instead, professionals will look at the signs and symptoms listed above and test a child or an adult on other tasks that require them to use their executive function skills. Sometimes, a disorder like ADHD might be the real diagnosis behind the issues with organization or regulation. Speech therapists are well equipped to evaluate for executive function disorder. At an evaluation, the speech therapist might:

• Discuss strengths and weakness of the child or adult
• Ask the client to complete a self-report questionnaire as to what problems they are having
• Use standardized tests for verbal reasoning, memory or tests that evaluate tasks of increasing complexity

How Can Speech Therapy Help with Executive Function Skills?

Speech therapists are trained to assist children and adults with problems like these, and they can collaborate with families to develop plans and methods to help them function well and complete everyday tasks. Speech therapy can help with improving executive functioning skills by:

• Teaching age appropriate task management strategies
• Assist in how to identify goals and create a plan
• Assist in organizing strategies like using graphic organizers for completing reports
• Help with initiating interactions, topic maintenance, and ending/wrapping-up a conversation.
• Help establish strategies for time management
• Help develop an “inner voice” for problem solving
• Teach how to “attack” activities that seem overwhelming
• Teach schemas so that children can make better predictions

What Can You Do at Home to Support a Child or Adult with Executive Function Disorder?

Parents can do a lot to help their child if they notice them having some of the issues listed above. Executive function disorder in adults can be managed in similar ways and with similar strategies practiced in speech therapy:

• Use visual aids for organization.
• Use a step-by-step approach for tasks
• Use time organizers (calendars), alarms, apps for organization (be careful not to use too many apps that distract; try to pick one that works well enough)
• Use daily schedules, and refer to them several times a day.
• Ask for instructions to be written whenever possible.
• Plan enough time for transitions or shifts in activities.
• Make checklists, and try to estimate how long each task will take before starting
• Divide long assignments into chunks and create due dates in advance
• Use simple language for children that need multi-step directions
• Avoid noisy environments when needing to focus

How Can Therapy Works Together Evaluate and Treat All Ages Online?

Therapy Works  Together helps families connect online with a licensed and certified speech therapist that is a trained expert in diagnosing and treating a variety of speech, language and communication issues. Speech therapy is delivered online at home with video conferencing applications. The age of our clients as well as their diagnosis and goals is important in determining how speech therapy online will be delivered. Speech therapy for babies and toddlers: For kids age 0-3, we usually work on early communication skills like joint attention, social communication, or increasing language skills in late talking toddlers. Parents work with their assigned speech language pathologist, usually in a parent coaching model, to learn tips and strategies that speech therapists use so they can be adept at practicing teaching their child after the session is over and at home. You can read more here about how important it is for parents to be involved in their child’s speech therapy at home. Speech therapy for preschoolers: For kids age 3-6, speech therapists target age appropriate articulation, language delays, reading readiness and more. Parents join in for online video sessions with the child so that both learn the speech strategies and skills from the speech therapist. Learning how to use these skills after the session helps kids improve. Speech therapy for school age kids: for children age 7 and up, speech therapists might work on academic skills, increasing vocabulary, social skills for kids with autism, stuttering and more. Children this age can come to online video sessions on their own. Our speech therapists keep parents informed by sharing tips and homework. Speech therapy for adults: Adults attend speech therapy sessions online after becoming stroke patients, for stuttering, for accent modification and more. They come to sessions on their own from the comfort of their home or office. Often, they bring a caregiver or family members to learn strategies if they will need help communicating with others.