November 20, 2018
Executive Functions is one of those “buzzy” terms that teachers use a lot these days. It’s a general term that refers to processes such as:
Twenty years ago, no one talked much about executive function (EF) skills. The term wasn’t very well defined in those days and we didn’t yet realize how important these skills are to successfully navigate the world in which we live. Because we now appreciate the importance of EF, particularly in school-aged children and transitional age youth, we’ve gotten better at assessing EF. We can assess these skills in a variety of ways – by observation, by rating scales that quantify our observations, and by measuring these skills directly using specific tests.
To understand what these tests and observations are measuring, it might be useful to think of EF as similar to the jobs that executive secretaries perform. They keep track of the boss’s calendar, handle and prioritize correspondence, determine which phone calls are necessary for the boss to take, and organize most aspects of the day-to-day running of an office. A good executive secretary must be able to think about many things simultaneously and decide which of these things are most important and which of them can wait.
The frontal lobes of the brain do much the same thing for us. This area of the brain is responsible for planning, future-oriented behavior, attention, and self-regulation. This part of the brain doesn’t fully develop until sometime in late adolescence or early adulthood and is the part of the brain responsible for EF. This is why most kids don’t have perfect EF skills – they haven’t yet developed them.
But what about those kids with significant EF problems?
Brain imaging research has confirmed what neuropsychological tests have indicated, that this part of the brain works somewhat differently in people with Attention Deficit Hyperactivity Disorder (ADHD). Although not all of those with ADHD perform poorly on direct tests of executive functions, most do – and the greater the number of impaired scores on executive function measures, the greater the likelihood that ADHD is present.
Kids with other learning differences such as dyslexia and dyscalculia can sometimes have problems with EF as well, though their impairments are generally milder than those with ADHD. People who have had significant brain injuries, such as a stroke or brain trauma (especially in the prefrontal cortex), can have more significant EF challenges as a result of their injuries.
As you might have surmised by now, EF is a pretty broad concept that can be applied to a wide range of kids (as well as adults). It’s a complex issue, and finding tests that perfectly measure abstract concepts can be tough. It’s one thing to measure a child’s reading skill, but how do you measure his ability to complete complex, open-ended tasks in an unstructured environment?
It’s hard to do that in a typical testing environment where the evaluator is monitoring the child’s academic performance, so sometimes kids who have poor EF skills at school can do well on tests administered in a quiet testing room. That doesn’t mean that they don’t have real EF problems. It just means that their problems are less significant when they are in a structured and quiet setting.
Keeping in mind those challenges, psychologists try their best to use a variety of measures to evaluate EF. Some of these are formal tests and others are more informal. They include the following elements:
A good evaluator will use several measures of executive functions, along with observations and information provided by the parents and teachers. If you’re concerned that your child might be struggling with EF, talk to your child’s teacher and school psychologist. The psychologist can help you determine whether a more formal evaluation is needed, provide a classroom observation, and/or administer questionnaires assessing EF. For children with mild EF weaknesses, a comprehensive assessment that includes many measures is likely unnecessary. For kids with more complex problems that are significantly interfering with the ability to perform successfully in school, and in situations where parents and teachers disagree or are confused about the underlying issues, a more comprehensive assessment is usually beneficial.
Finally, keep in mind that the goal of any assessment is to provide direction for treatment. Regardless of the type of assessment measures used, at the end of the evaluation process you should expect answers to these questions: “What are the EF challenges that my child has?” and “What can we do to help him?”