Have you heard of EF?
I recently presented some information on Executive Function with an Occupational Therapy colleague. During our planning and session with Speechies and OT’s I discovered that while we are all working on Executive Function we may not be calling it executive function.
So what is Executive Function?
Executive function is a neuropsychological concept referring to the cognitive processes required to plan and direct activities including task initiation and follow through, working memory, sustained attention, performance monitoring, inhibition of impulses and goal directed persistence. – Executive Skills in Children and Adolescents Dawson & Guare, 2004.
Executive functioning is not the “what” of knowledge but the “how”. It’s not the information needed to complete a project or piece of work, it’s the brain functions dedicated to how a child cleans their room, plays or completes a project. It’s the skills we need to get the job done. I have a client in prep who has been working hard on his concept knowledge and ability to follow instructions, which he has demonstrated in other tasks. So I decided we would increase the task and work with a barrier game – with pieces but also coloured pencils. This is when his poor executive function was so obvious. We had pieces on the floor – pencils shooting off the table, he really struggled to organise his materials. This was all evident before we had even started.
So what are we looking for?
This helps us think before acting. People with weak impulse control may blurt things out inappropriately in class or engage in risky behaviour.
This helps us keep our feelings in check and respond with the right emotional meter for the situation. People with weak emotional control often over react, have difficulty dealing with criticism and struggle to move on.
This allows us to adjust to the unexpected. When things change we are able to readjust and continue.
This helps us keep key information in mind for use. People with weak working memory have trouble remembering the information they need to get the job done.
This allows us to evaluate what we are doing. People with weak self-monitoring are often surprised by a bad mark or negative feedback.
Planning and prioritising
This helps us decide on goals and to develop a plan to meet them. People with weak planning and prioritising skills have difficulties with project work due to a reduced ability to separate the project in to tasks.
This helps us initiate tasks and get started. People with weak task initiation struggle to get started.
This helps people keep track of things physically and mentally. People with weak organisation skills can lose their train of thought as well as their belongings.
The challenge is that we often have to use more than one of these skills at once. Depending on what we are doing, the brain needs to filter distractions, prioritise tasks, set and achieve goals, control impulses, not to mention get started. When we reflect on our clients and the therapy goals they are working on, we see varying levels of EF which are required. We also reflect on how we balance on the tightrope of support and learning.
So what do we do?
At times we find ourselves supporting aspects of children’s EF. This is ok, however we must keep in mind how we are going to transfer these skills back to them in future tasks. We work through the task with them analysing the task at hand, supporting them to break the task into steps. An important strategy in supporting EF is to use a coaching approach rather than telling. Coaching helps them work through and learn new skills. We also think about hierarchies in our therapy, exposing clients to challenges while remaining well supported. We use visual schedules. Visual schedules are universal design. They benefit everyone. We might also use some published products which target aspects of EF. These include my favourites: Social Thinking – Michelle Garcia Winner and Zones of Regulation – Leah Kuypers.
We should also note that our own Executive Function is vulnerable to many factors. For example, if we are stressed, anxious or sleep deprived we often struggle with tasks requiring EF. So I wonder if you were like me, working and supporting EF but not calling it that, or using it in all your discussions. I haven’t changed my practice when working with kids but I am now calling it EF in discussions with colleagues and parents.
I have just started exploring the topic of praxis which I see has many facets of executive function intertwined … hmm, maybe a discussion for another time.