An Introduction on Interventions for Executive Functioning

As discussed in my previous blog “What is Executive Functioning”, executive functions are the skills that help organize and guide a child through daily life.
There are many aspects of executive functioning:

• Organization

• Planning

• Problem solving

• Working memory

• Initiation of tasks

• Impulse control

• The ability to monitor the effectiveness of one’s work

While these are different skill sets that require various accommodations and interventions, they all have several things in common.  The most common link between the various interventions is that they must involve a real-world, structured approach to teaching problem solving during everyday activities. The problem that we see all too often with clinical interventions, which don’t include practice in the child’s ‘real-world,’ is that the child may be a rock-star when completing tasks in a contrived clinical setting but still may struggle within the classroom.

I strongly urge parents to be on wary of “executive functioning tutoring” with a clinical emphasis and no focus on the child’s real-world executive skills. Ideally, the child will learn the skills in a clinical setting; however, the focus must quickly generalize to providing interventions within the home and school environments.

The next consistent theme is that the child’s daily environment must be simplified as much as possible. For example, having Johnny go upstairs and complete a list of five items likely won’t happen and will ultimately lead to failure. Instead, keep it simple – have him complete one task, and let him see success before adding on additional tasks.

Finally, the executive strategies should be implemented by the people who have the most contact with the child on a daily basis (e.g. parents, teachers, coaches). The goal of the intervention process is to teach the skills to the child and then act as a “coach” for the people who work with that child daily.

All interventions and therapy must be customized to fit the child’s specific needs and concerns.   However, a few universal factors are needed for any intervention to work:

1. a real world setting
2. simplifying the child’s environment
3. focusing not only on working with the child, but also on the people who spend the most time with that child on a daily basis

The next blog will touch on various interventions for children who struggle with initiation or quickly starting action on tasks.