A Parent's Guide to Supporting Your Child's Executive Function Skills

Ali Farquhar - 3/18/09

Executive Function (EF) refers to the set of skills we use to plan, organize, initiate, and complete activities. These skills help us to sustain our attention and persist in the face of frustration.

People with strong EF skills can manage their emotions, self-monitor to work efficiently, and find effective ways to problem solve. Success in school depends on reasonably intact EF skills, particularly as a student advances into higher grades.

Being able to get started on assignments, to break long-term projects into more manageable pieces, and to think about how to approach a problem and to structure a paper, all require planning and organization. Persistence and goal-oriented effort are essential if students are to complete “boring” assignments; to read large quantities of text; to write complex, well-argued papers; and to manage their time. These skills and others are what we refer to when we talk about Executive Function.

EF is neurologically based and largely seated in the frontal and pre-frontal cortex of the brain. The bad news for parents is that these frontal lobes are the last part of the brain to develop fully, usually in late adolescence. In children with ADHD, this maturation may take place even later. The good news is that we can help children who struggle in this arena in a variety of ways, and with consistent parental and school support, they can learn to improve these skills over time.

Why do Executive Function Deficits Become Apparent in Middle School?

Many children “fly under the radar” because their EF deficits may cause few apparent problems until they enter Middle School. A number of factors explain this phenomenon.

Middle School places new and different demands on students both organizationally and academically. First of all, students have to change classes for the first time - managing lockers, binders, folders, and time so that they turn up in the right place, at the right time, and with the right materials throughout the school day. In addition, they need to understand the varying expectations and styles of not just one but many teachers. Mrs. Smith may write the homework on the board at the start of the class, whereas Mr. Jones may give it verbally just before the bell. Ms. Gonzales may have a homework in-box and expect students to put their assignments in it independently, whereas Mr. Jimenez may always collect it by hand. Meantime, the work itself is becoming more challenging with abstract concepts taking over from the concrete learning that characterized elementary school. Homework becomes more onerous and may include long-term assignments that require planning and scheduling, along with occasional collaborative work with other students. And to cap this all off, hormones are starting to rage and social concerns are becoming more distracting. No wonder this is often the first time that Executive Function deficits rear their head.

Assessing Executive Function

Assessing EF is not as simple as it might seem. A variety of different factors may affect EF skills including depression, anxiety, fatigue, situational stress, and a diagnosis of ADHD. For appropriate intervention and to obtain the right school supports, a good assessment is important.

One of the ongoing debates in this field is the difficulty of obtaining accurate diagnostic data. Students who appear to have significant EF deficits may perform paradoxically well on EF tests. This is often explained by the nature of the testing environment -- the child is in a novel situation, has the one-to-one attention of an adult, and may experience test anxiety, all of which raise attention levels and improve performance! In addition to formal assessments, a good case history must be taken for a truly accurate diagnosis and it must be supplemented by classroom observation and everyday work samples.

What Can You Do?

There are two approaches that can be taken to help a child with EF deficits: change the child’s environment to make it more supportive and/or change the child by working on skills that shore up the underlying weaknesses. Changing the environment can make it easier for the child with weak Executive Function to be successful but in the long term, skills must be learned, internalized and generalized to new situations, if sustainable change is to take place.

Changing the Environment

Four main tactics can be employed to change the environment:

• Changing the physical environment
• Changing the nature of tasks
• Changing the way cues are provided
• Changing the way parents, teachers, and caregivers interact with the child

We will look at each in turn and give some specific suggestions to help your child at home and at school.

Changing the Physical Environment

The aim of changing the physical environment is to remove obstacles and to put helpful systems in place to encourage healthy Executive Function. At school, you might request that your child be seated at the front of the class, away from doors and windows, and separate from chatty friends. In addition, you might ask that your child be placed with teachers known to offer a structured classroom environment. At home, choose a homework location that has all necessary materials close at hand so that the child isn’t constantly jumping up and down to fetch card paper, highlighters or Wite-Out. Try to establish a homework routine that works and encourage your child to stick to it. The routine has to be tailored to your child or it will not work. Some students have to eat a large snack the moment they walk in the door; others need to unwind and put the school day behind them before they can face the evening’s work. John Ratey’s recent book, Spark: The Revolutionary New Science of Exercise and the Brain points to the value of exercise in clearing and focusing the brain, so if you can encourage your child to stretch her legs outdoors before getting down to work, she may be able to pay better attention.

Changing the Nature of Tasks

Tasks can be modified in a wide number of ways to help a child achieve success. They can be shortened or broken into smaller chunks with built-in breaks along the way. The steps to reach the final product can be made more explicit by providing “scoring rubrics” that can be used as a guide. Instead of simply asking your child to tidy her room, make the requirements plain by saying, for example, “Your room will be tidy when dirty clothes are in the hamper, clean clothes in the dresser, toys in the basket, and books on the shelf.” It is always helpful to build in variety and choice to make tasks feel less confining, and if you can inject a little humor along the way the results will be even better.

Often students with EF deficits also struggle with short-term memory weakness so mnemonics can be particularly valuable. When vocabulary or other facts have to be learned, make up ridiculous rhymes and silly sentences to help with retention. If idea generation is a challenge when writing, use Post-It Notes to brainstorm, arrange, and rearrange ideas. If writing is a real barrier but the child knows the material, allow him to dictate his work to you from time to time to showcase his knowledge and find some success. Be sure to let the teacher know that you did so. Lastly, whenever possible, talk about what the end product should look like and share examples if any are available.

Cheat Sheets and Templates

Rubrics or templates can provide a child with EF challenges a great way to scaffold their work, allowing them to focus less on form and more on content. A few are offered below. Choose the ones that work for your child and discard those that aren’t helpful. Be sure to ask your child’s teacher if she uses any particular templates so that you can provide consistency between school and home. On the other hand, if the school format doesn’t seem to work, don’t be afraid to try something new. Once again, it might be a good idea to share what does work with the teacher. PLAN (pre-writing mnemonic)

• Review the assignment - think about things such as the purpose and audience
• List the main topics you plan to write about, along with details for each
• Assign an order for the topics
• Note ideas in complete sentences

C.O.P.S. (for writing review)

• Capitalization
• Organization
• Punctuation
• Spelling

P.L.E.A.S.E. (Writing strategy)*

• P Pick a topic, audience and format
• L List information on the topic
• E Evaluate list
• A Activate paragraph with topic sentence
• S Supply supporting sentences
• E End with a concluding sentence and Evaluate *(The Please Strategy: A Metacognitive Learning Strategy for Improving the Paragraph Writing of Students with Mild Learning Disabilities" by Marshall Welch, 1992, Council for Learning Disabilities)

Kidspiration/Inspiration Software for Graphical Structuring of Writing

Kidspiration/Inspiration software is an ingenious tool to help students who have difficulty structuring their thinking to create a paper outline and then turn it into a thoughtful and well-organized piece of work. The student can “throw” ideas onto the screen, creating a mind-map without particular order, linking connected ideas with arrows, and adding details as they come to mind. Then, with one click, this graphical web of ideas can be turned into an outline and exported to Word for further elaboration. Various templates exist for different types of writing and the computer interface makes what is often an overwhelming task much more appealing.

Concept Format Model (Gloria Wilson, Hofstra University)

The Concept Format Model helps students see both the wood AND the trees using a deceptively simple grid to organize information. Let’s take an example of a history paper that a student has to write on the Civil War. The first step would be to have a conversation about the features that all wars share and then to pick the four most important ones. Let’s say you come up with participants, important events/people, causes, and results; each category would be written into one of the 4 quadrants of a two-by-two grid with "Civil War" placed in an oval in the center of the grid. That grid could then be used by the student to organize and write notes as she reads. If specific questions are part of the assignment, the grid categories could be based on those instead. When students are assigned a “compare and contrast” essay, the student can place two of these same grids side by side, filling the two grids with reading notes that relate to the two topics she is comparing. Let's say the two topics are the Battle of Gettysburg and the Battle of Fredericksburg. Each battle may be placed in the central oval of the corresponding grid. This method makes comparisons obvious and gives a ready structure for a paper.

The Concept Format Model can be used across subjects and serves to clarify and illustrate salient details that students need to remember. For example, in English, the grid could be set up for character, setting, plot, and theme for a book (with the book title written in the central oval). Digging deeper, an individual character could be assessed for personality traits, physical traits, importance, and quotes. Two such grids placed side by side could serve for a comparative essay about two principal characters. In science, the grid could be used to organize facts about, for example, the circulatory system, with the four quadrants representing structure, function, diseases, and possibly a diagram. In theology, different religions could be compared according to founder, holy book, beliefs, and rituals. The options are almost endless.

Reading Strategy

For some students who struggle with EF, the thought of reading a whole chapter in social studies or science can be daunting. One reading strategy that can prove helpful breaks the task into steps and gives repeated exposure to the main ideas. Under this strategy, the student first reads only the chapter title and introduction. Then, he flips to the end of the chapter and reads the summary, if there is one. Next, he scans the chapter sub-headings. Then, he flips back to the start and looks at all illustrations and captions, as well as at any charts and diagrams. After that step, he reads any pull-out quotes and sidebars. Subsequently, he notes any words that stand out in bold and are in different colors, underlined, or italicized. Lastly, he reads the full text. This approach may seem cumbersome but it goes surprisingly fast, and because the student already has a good idea of what is coming when he reads the full text, the reading goes faster and is more easily absorbed. If time is very short, or the student is on homework overload, he could be allowed to read only the first sentence or two of each paragraph rather than reading the full text. Research shows that the most important information tends to be contained there anyway.

Change the Way Cues are Provided

Often children have difficulty initiating tasks, completing them in a satisfactory way, or remembering to do them at all! If we give them the right cues, they can become more successful and reliable in managing and completing tasks. The first kind of cue is simply verbal: “Did you remember to pack your lunch, gym clothes, and permission slip for the field trip?” The issue with this approach, even though we all use it very often, is that the child isn’t learning to think for herself. The goal is to get the child to engage her frontal lobe rather than rely totally on you. Here are some ways to do it:

• When you know the child needs to remember something or a series of items, ask her to come up with the list. You can prompt if necessary, but let the child do the heavy lifting. When a list or a schedule is needed, make it VISUAL. Write down the rules, steps to a process, or list and post it in a visible place and when the child needs a prompt, tell her to check the list or schedule. This starts to move responsibility for remembering from you to the child.
• Audio cues can be used in a number of ways that don’t have to involve the parent. A watch called the WatchMinder2 allows to do’s and reminder alarms to be programmed into what looks like a normal wrist watch. The Attention Training System is a classroom tool that allows a teacher to deduct a point each time a student’s attention wanders, setting a small reminder light blinking on the student’s desk, and bringing him back on topic. Relaxation tapes can be purchased that help children find calm and get to sleep at the end of the day. After repeated listening, children can often generalize the techniques and learn to relax without the aid of the external voice.
• Children can also be helped to self-cue when working on tasks. Sarah Ward, a Speech and Language Pathologist specialized in Executive Function who practices in Lincoln, suggests that we teach children when they are tidying their rooms to repeat out loud cues such as “Books, books, books” and “Toys, toys, toys” until each type of item has been completely put away. This approach serves to focus their attention through completion of the task.

Whatever cues you choose to use with your child, try to figure out your child’s preferred learning style and play to it. If she is more visual, favor visual prompts. If he responds better to auditory cues, then make those your preferred method.

Change the Way Others Interact with the Child

Adults are better able than children to anticipate problem situations and take action to avoid or prepare for them. Try to teach this skill to your child by previewing and reviewing situations. If your child encounters a problem, ask her to think about what happened and to identify the possible causes. Ask her, too, what she might do another time to improve the process. When a child is about to go back into a situation that didn’t work out well on a previous occasion, preview what could happen and ask the child how he might avoid the same results. All this can be done without blaming or shaming. The point is to help the child become more successful. Equally, be sure to communicate to your child your belief in his ability to succeed. If you expect bad behavior, a child will know it, and the likelihood of a good outcome will drop accordingly.

Change the Person: Work on Skills

Learning EF skills doesn’t happen overnight. At first, you need to act as your child’s frontal lobe so that she can observe, practice, and absorb each skill. You do this by providing a plan and directions; monitoring performance; providing encouragement, motivation, and feedback; problem solving when things go wrong; and determining when the task is complete. Long-term, this doesn’t teach the child to think for herself, so the aim is to step back gradually over time, supporting, allowing practice, then slowly fading your role. Whenever possible, you need to have your child engage his frontal lobe. Do this by beginning with the end in mind and talking about it. You can ask: “What will a tidy room look like?” “What does your essay have to include?” “What are the steps to organizing your desk?” You can make the end visual by, for example, taking a photograph of the child’s room when tidy, or of the items that need to go in the backpack, and asking the child to “match the picture.”

As you hit the occasional bump along the way, use neutral problem-solving language. Ask: “What worked? What didn’t work? What can you try instead? How can I be helpful to you?” Anything you can do to normalize the child’s experience will act as encouragement. For example, you might say: “Lots of kids in Middle School find this hard. Learning new skills is difficult for everyone.” Also, be sure to explain that mistakes are not only acceptable but a necessary part of learning. After all, if they knew it all already, they wouldn’t have to go to school!

Another aspect of Executive Function that students often find troublesome is time management. Talk about time often, and make its relation to getting things done plain. Ask: “When is this assignment due? Are there any interim deadlines? How much time do you think it will take? Let’s count backwards from the due date. What other commitments do you have?” Then after the fact, review a completed task and have the child figure out how long it actually took. Help her connect the dots by asking what she will do next time given the difference between her time estimate and the actual time taken.

Whenever feasible, make time visible. A useful tool for this is a “clock” called the Time Timer that shows how much time remains with a shrinking colored pie segment. Learn more at www.timetimer.com. If your child has difficulty deciding which tasks to address first, you can help him prioritize by using an Urgent/Important grid. This grid has four quadrants with "Urgency" written along the vertical line (with least urgent in the lower quadrants) and "Importance" written along the horizontal line (with most important in the right two quadrants). Your child makes use of this approach by first listing the tasks that need to get done and then placing them on the grid. (Clearly, any item that is both High Urgency and High Importance - in the upper right quadrant -must get addressed first).

After your child has prioritized his tasks, also have a discussion about those items that are either High Urgency/Low Importance (upper left) or High Importance/Low Urgency (lower right) and figure out which should get addressed next. Half the value of the grid lies in the discussion you can have. It is also worthwhile talking about those tasks that for now are neither High Importance nor High Urgency, but that might become more pressing if not scheduled into the calendar in time.

Motivate

Children can become quite demoralized when they don’t succeed. Encourage them by “catching them doing something right”. Increase the positive messages you send and notice when you see improvement, not perfection. Focus on one goal at a time rather than setting the bar so high that success is impossible. In conversation, use “when, then,” rather than “if, then” messages. Saying, “When you have finished your homework you can have half an hour on the computer” expresses an expectation and confidence that your child will accomplish the goal.

Sometimes more is needed to motivate your child than words of encouragement and you may want to design an incentive system to help her work towards behavioral goals. The first step is to describe the problem behavior and set a goal. Let’s take a problem -- not getting down to homework reliably -- and a sample goal: Starting homework each evening by 4:30 pm without reminders. The next step is to decide with your child on a rewards menu and set up a points system. It is always good to have a mix of short (smaller, daily) and long term (larger, weekly or monthly) rewards. Each reward “costs” a certain number of points and the points are earned by sticking to the terms of the contract. When the points system is set up (you can write it up in an incentive planning sheet – see below), write a behavior contract, post it in a visible place, implement it, measure progress, and adjust as necessary. Here are a sample planning sheet and contract:

Incentive Planning Sheet: Problem Behavior: Not starting homework till late in the evening

Goal: Start homework by 4:30 each day without reminders

Possible Rewards: Daily: Extra TV Show Play game with Dad Bedtime ½ hour later Weekly: Chance to rent video game Have friend for weekend sleepover Mom makes favorite dinner Long-Term: Buy video game Play game with Dad Buy CD Eat out

Possible Contingencies: Can play with friends after homework is completed TV/screen time after homework is done

Sample Behavior Contract

Joe agrees to tidy bedroom each Thursday evening without verbal reminders. To help Joe reach goal, Mom and Dad will post a note with the steps to remember and a photograph of the tidy room to be matched. Joe will earn 5 points for each completion without verbal reminder. Points can be traded for items on the reward menu. If Joe fails to meet agreement, he will not earn any points. Other uses for behavior contracts could be: writing homework in the agenda daily; handing in assignments; bringing home the right binders/books; completing homework; or doing chores.

Home-School Collaboration

It is always helpful to a child when school and home talk the same talk. For that to happen, good communication is essential. If you have a concern about your child’s Executive Function skills, get in touch with the school and express your worries. Ask your child’s teachers what they have observed and if they see any problematic behaviors in school. Collaborate on possible interventions, explain what you are doing at home, and above all, avoid being confrontational. After all, you both want the best for your child and the surest route to achieving that is if you work together.

It is possible that your child qualifies for some special education services in the form or a 504 Plan or an IEP (Individualized Education Plan). A variety of accommodations may be available, and if you believe your child might be eligible, make a formal request for an evaluation. The special education system is outside the scope of this article but your child’s teacher can point you to the appropriate resources to learn more. Some final food for thought: if, despite all your support and skill teaching, your child continues to struggle with homework and evenings have become a battleground in your house, consider disengaging completely. You may say to your child, “We’ve realized homework is your job and we aren’t going to nag you anymore.” Explain the possible consequences of your lack of involvement: “Just understand that if you don’t do it, you may fail a test or a course or have to take summer school,” and then stand back and let go. Your child may just surprise you!

Bibliography Several thoughts and suggestions in this article are drawn from the work of Sarah Ward, a Speech and Language Therapist practicing in Lincoln, MA, and specialized in Executive Function in children: www.executivefunctiontherapy.com In addition, the following books contain much helpful information on the subject:

• Executive Function in Education: From Theory to Practice
• ADHD and the Nature of Self-Control
• Executive Skills in Children and Adolescents: A Practical Guide to Assessment and Intervention (The Guilford Practical Intervention in Schools Series)
• Helping Children Learn: Intervention Handouts for Use in School and at Home

Please send any questions to alison@gtlconsulting.com. Ali Farquhar is an Executive Coach who lives outside Boston with her husband and three children. When she isn’t working in organizations, Ali teaches and runs support groups for parents of children who don’t “fit the mold”. She is certified by CHADD to teach Parent 2 Parent, a 7-week course for families living with ADHD, and by Active Parenting to teach the Active Parenting series of programs. She is available to consult with parents of children newly diagnosed with ADHD.