A hot topic recently with many of my client’s caregivers has been executive functioning skills, or rather, the lack thereof, in their children and adolescents. So what is are they, and what makes them important?

Executive functioning skills include: task initiation and completion, emotional control, working memory, attention, organization, impulse control, problem solving, self-talk, and many more. A comprehensive list can be found on The OT Toolbox website. Most parents, guardians, caregivers, and teachers notice an executive functioning skill is lacking when it comes to organization, impulse control, and attention. These are the kids with a backpack or desk full of completed classwork and homework; making noise during quiet time; having difficulty being self-motivated; tends to act on needs in the here and now, and does not understand the concept of delayed gratification. Some of these kids are already labeled as lazy, ADD/ADHD, stupid, bratty, et cetera, and many may be on medication. But what if it goes beyond laziness and ADD/ADHD?
WedMD gives a definition of what Executive Function Disorder is. To summarize, executive functions are those parts traditionally connected with the prefrontal cortex, or the front part of the brain that takes the longest to develop in human beings, and is where our “thinking” brains reside. The prefrontal cortex is the part of the brain that is last to fully develop, taking as long as 40 years to be complete, but typically around 25 years to be more whole. Reading over the WebMD definition, one might ask how that differs from ADD/ADHD. ADDitude magazine and Understood.org have you covered! The most notable difference is that ADD/ADHD is an official diagnosis, whereas executive function disorder is not presently. And not everyone with Executive Function Disorder has ADD/ADHD; for some, the comorbidity lies with Learning Disorders.

So how do we treat executive function disorder? Similarly to ADD/ADHD and Learning Disorders: get a diagnosis; do skills training (organizational skills, self-regulation, mindfulness, et cetera); have patience (with yourself and your child); make it a team effort (don’t go at it alone, ask for help!); and occasionally, get medication, in addition to the previously listed parts.

Pertinent Links/More Information
Executive Function and Self-Regulation (Center on the Developing Child at Harvard University)
Is ADHD a Behavioral Disorder or an Executive Function Disorder? (ADDitude magazine)
Understanding Executive Function Issues (Understood.org)