This is the fourth post in our series about children with ADD/ADHD and supporting our children.  These posts are meant to stimulate your own interest in research and dialogue with your child’s individual educational and health care provider teams, and also to link where I can to current research and current practice in this area, because this can be important in dealing with more mainstream educational and medical models .

Today, we are exploring executive functioning and what this term really means, and how we may strengthen it.  Executive functioning generally refers to a set of cognitive processes that develops and changes over the course of a lifetime of an individual and includes things such as attentional control, inhibitory control, working memory and flexibility in thinking, as well as reasoning, problem solving, and planning ahead.  This is shaped by physical growth and changes in the brain as well as by life experiences.  We often see difficulties with executive functioning in both people with ADD/ADHD, and also in people with addictions.

The sort of normal course of development of these cognitive actions takes place over the lifespan, often in spurts, with growth being particularly marked at the ages of 7-12 months, ages 3-5, ages 8-10 with a spurt around 12 of “goal directed” activities, throughout adolescence with a peak at around age 15 for increased attention to task and an increase in working memory, and then a peak in executive functioning skills in the 20s.  Declines are usually noted around age 70, although I suspect this might be changing with longer life spans.

There are many facets to executive functioning, but here are some varying ideas for areas related to executive functions with possible ways to help your child.  Take what works for you, and use these ideas as possibilities to talk about with your child’s health care and/or educational team.

Working Memory and Recall:  -One study found some teens with ADHD have the working memory of a seven-year old due to executive functioning deficits.  Working memory and recall affects holding facts in your memory and being able to retain them long enough to work with those facts, sequencing of information and getting organized and down on paper, memorizing facts.

• Possible ways to help:  teaching your older children how to visualize things in their mind’s eye (ages 10 plus, I would say); have your child teach you because in order to teach you will remember things better; play games that teach visual memory (ages 6 plus); make up categories to help remember things; connect emotions and senses to teaching methods (and visualizing)

Activation and alertness – Difficulty in activation of a task, staying alert throughout a task to complete it, finishing work – this can stretch over variability in school work during the day and over the week.  Some days are better than others.

• Possible ways to help:  make to do lists; make projects by breaking bigger projects down; give clear instructions; hold a steady rhythm;  manage sleep problems through a sleep specialist or clinic; use as graphic organizer; write ideas down in clusters; use manipulatives since physical activity leads to a higher level of mental alertness; use a timer or chime to indicate it is time to start work; if student is drifting off take a “brain break” with Brain Gym type activities or tap on the desk; fidgeting and chewing gum holds real value for increased alertness

Complex problem solving and difficulties with time management – Students with ADD/ADHD may experience trouble with these areas in learning, especially during the teen years as they need to write, memorize, comprehend reading,do algebra, be organized for deadlines for projects and homework with increased time awareness and planning ahead for the future.

• Possible ways to help:  allow enough time for activities and schedule backwards from due dates or times when you have to be somewhere; practice estimating time; block off time for homework if in traditional school or in homeschooling may need scheduled block of time to finish projects; use weekly or monthly planners; use a master calendar on wall;  work during peak energy times for your child;

Control of Emotions – low tolerance for frustration, emotional blow-ups.  This included difficultly internalizing behavior and difficulty using “self talk” to guide behavior; also usually difficulty in learning from past behavior so misbehavior is often repeated; diminished self-awareness; difficulty inhibiting speech or behavior

• Possible ways to help:  keep track of when blow-ups happen – many times they are around transitions or when there is a personal crisis (in teens this can especially be true); if a child is on medication it can be when the medication wears off and this would need to be addressed with your child’s health care team; teach your child to go and cool off (easier said than done, I know); help your child learn to recognize internal feelings of anger, rage, frustration and have a plan  in place for when those feelings occur – some schools are using a chart with a gauge of frustration to try to teach children with poor emotional control that not every situation demands the same level of frustration or response and then teach cooling off techniques – breathing, exercise, meditation

Please share with me your best strategies for helping executive challenges.  There are executive functioning specialists who do nothing but work with children and teens with these challenges; perhaps if you have a child with these challenges that is struggling there could be hope in an individualized plan from one of these professionals as well.

Many blessings,

Carrie