Is your child or teen having trouble making decisions, planning, actively listening, managing information, switching tasks or even remembering to hand in homework? That sounds like they may have difficulty with executive functioning and self-regulation, which centers on controlling behavior, emotion and cognition. They’re crucial life skills that equip people to get along with others, focus, set and achieve goals, function well in the workplace and more.

Over the past two decades, there’s been increasing research interest in this area. Researchers are still refining an agreed definition. Generally, though, executive function is a “specific set of attention-regulation skills involved in conscious goal-directed problem solving”, says the National Center for Special Education Research[1]. It includes the skills of cognitive flexibility, working memory, and inhibitory control.

Gemm Learning looks at 10 consequences of poor executive functioning skills that may surprise you. First, here’s an overview.

Executive functioning like air traffic control

Harvard University’s Center[2] on the Developing Child likens executive function and self-regulation to an air traffic control system at a busy airport. That system has to manage many aircraft departing and arriving on multiple runways. And, you guessed it, not everything goes to plan.

Executive functioning skills are inter-related cognitive processes linked to controlling your thoughts and actions. They allow you to prioritize your attention to what’s relevant and important at a particular moment. Atlanta Public Schools[3] list the skills as setting goals, planning, prioritizing, organizing, remembering, shifting and flexible problem solving, self-monitoring and emotional self regulation.

Difficulties with executive functioning don’t mean you think differently. It’s more a struggle with the “process of coordinating, prioritizing or managing information needed to perform tasks successfully”, says pediatric neuropsychologist Laura Tagliareni, PhD, on understood.org[4].

What good executive functioning skills look like is this, according to the National Center for Special Education Research[5]: “… the attention-regulation skills that make it possible to sustain attention, keep goals and information in mind, refrain from responding immediately, resist distraction, tolerate frustration, consider the consequences of different behaviors, reflect on past experiences, and plan for the future.”

Keeps developing through to adulthood

The front third of the brain – the prefrontal cortex – is important for regulating executive function. But, we’re not born with these skills. We have the potential to develop them by early adulthood. Some people just need more support to do so. It takes time, as US researchers[6] have noted, and until that happens impulsive and risky behaviors may come to the fore.

“Studies of housed youth using magnetic resonance imaging (MRI) have shown that the brain continues to mature and develop until individuals are well into their twenties; this highlights the protracted developmental period associated with executive skill development.”

“…Until these processes of maturation and remodeling are complete, individuals are more prone to seek out and engage in impulsive actions, like risky behaviors, due to the fact that their executive functioning capacities are less developed and less successfully managed neurologically.”

According to the National Center for Learning Disabilities[7], physical changes in the brain, life experiences such as school and beyond shape a person’s executive function abilities. Adverse experiences including stress or poverty can dint them, too. Parental care and other child care, families’ cultural beliefs and practices, plus socio-economic circumstance in which children are raised can also make an impact[8].

“Early attention to developing efficient skills in this area can be very helpful, and as a rule, direct instruction, frequent reassurance and explicit feedback are strongly recommended,” says the center.

By the way, this study published in Nature[9] found little difference in executive function between females and males.

Here are our list of the consequences of executive functioning difficulties that might surprise you.

1.There’s no stand-out single comprehensive test for it

The National Center for Learning Disabilities[10] says there is no single test for educators, psychologists or speech-language therapists to identify all the features of executive functioning in a person. However, performance based tests (rather than questionnaires) are becoming the ‘gold standard’ says the National Center for Special Education Research[11]. Even these have a challenge of “measurement impurity” where many different processes make up individual differences in the performance of any executive function task. Consider, too that the child or teen taking the test has to be willing and engaged in it, too.

Tests used include:

  • Wisconsin Card Sorting Test
  • Trail Making Test
  • Progressive Figures and Colour Form Tests
  • Category Test
  • Stroop Test
  • Go/No Go Visual Reaction Time

Some of these, for example, test just one aspect of executive functioning such as working memory. Here’s more detail from the BrainLine organization about each of the tests and how assessments are made. In short, you’d use the tests, your own views as a parent and those of teachers including formal assessments and observations of how your child operates in class. Ruminate over the question: how well does your child cope in everyday life?

2. No special education services for a diagnosis

Generally, those diagnosed with an executive functioning difficulties won’t be able to tap into special services for precisely that disorder. That may be because it’s hard to measure and compare, as mentioned above and a review of the research[12] has echoed.

The research study said: “Because executive functioning is too broad to enable computational implementation or consensus measurement, it must either be operationalized more narrowly or fractionated to be useful for research.”

However, executive functioning difficulties have been linked to the Autism Spectrum Disorder. But, there’s a wide difference between individuals and by age[13]. There’s also a link with people who have ADHD, but keep in mind that people without ASD or ADHD may have executive functioning problems, too.

If your child does not have an Individualized Education Program, consider asking their teacher to share their tips and strategies on helping children organize, plan, tackle and complete their work. Your child will need support at home, too, to get focused on homework.

3. Often people think they’re just lazy or not smart

A key issue of executive functioning difficulties includes problems with working memory (Research psychologist Alan Baddeley’s work[14] is useful to dive into for more information – he set the standard for the concept). Issues with working memory might mean your child or teen struggles to retell a story whether it be in writing or verbally. That skill draws on the need to communicate details with a structure, often chronologically. They may even forget a phone number while in the act of dialing it. That involves trying to hold short-term information in your head while using that info to successfully ring the number. Most people can hold seven numbers in their working memory[15].

A PsychCentral case study[16] of a teen, Jared, with executive function difficulties was someone thought of as lazy and perhaps defiant by his parents. He’s described as having “selective disabilities”. That is being able to hyperfocus while playing computer games. Yet, shirking “hard work” needed for school.

Psychologist Dr Lynn Margoiles says: “Though Jared appeared unfazed and uninterested in how he was doing at school, privately he felt stupid, frustrated and mad at himself. He had trouble keeping track of homework, felt overwhelmed by research papers, and often lost points for careless mistakes.

“Jared comforted himself by doing things that distracted him and gave him a sense of mastery, such as ‘gaming’ or socializing on Facebook.”

Like his parents, you’d be forgiven for thinking he’s lazy. There is a whole lot more to the behavioral problems that deficits in executive functioning can create.

4. Affects the ability to read

Executive functioning issues can affect a person’s ability to read. The British Journal of Educational Psychology[17] cites a range of research highlighting executive functioning as important for word reading, reading comprehension and writing ability. Meanwhile, ParentingUnderstand.org[18], a website for parents of children with learning and attention issues, points out the soft spots: recognizing letters, sounding out letters, words with different meanings, passive voice and focus.

Kate Kelly writes on the Understand.org site that working memory and flexible thinking are important executive functions which help children become good readers.

“Kids who have trouble in this area can struggle with understanding what they’ve read. With extra support and resources, these kids can become fluent readers,” she writes.

There are neuroscience-based programs that conveniently offer the support your child may need through an online course they tackle regularly for say, half an hour a day. Gemm Learning recommends the Fast ForWard Program, which focuses on executive functioning, academic and language skills. It offers various adaptive exercises that harness deep-seated cognitive and language processing skills to boost learning and reading efficiency. The program has demonstrated it can activate the reading and language centers of the brain in just six weeks. Find out more here.

5. Problems later on

A US study[19] shadowed 11,000 kindergarten students from 2010 to grade three. It found if they presented early in their schooling with executive function deficits. They continued to have academic difficulties.

The researchers said: “Our study … helps to establish that working memory deficits constitute a general risk factor for repeated academic difficulties across elementary school, with this increased risk evident whether for mathematics, reading, or science difficulties.”

The biggest problems were working memory deficits. Moreover, specialized interventions, particularly early in a child’s schooling, may help these children, the researchers said.

But for those who might not have had such support, get an insight into what it’s like for an adult to struggle with executive functioning skills as part of her ADHD diagnosis. Check out Liz Lewis’ A Dose of healthy Distraction blog[20]. In her post, The Lazy Girl’s Guide to Crushing Your Executive Functions, she shares how she likes to “deal with each of my own EF deficits”. They’re practical tips she’s road tested including mono-tasking to help with focus.

6. Difficulty in focusing

Telling someone to focus is about as effective as telling stressed people to ‘calm down’. Often we need a better strategy than a retort. Children diagnosed with ADHD may have been prescribed medication such as Ritalin to help them concentrate more effectively. And that continues to be option for many. However, evidence-based braining training apps are also offering hope as an alternative, too.

Recently, for example, Cambridge University[21] in the UK launched its app, Decoder, which successfully increased attention and focus for people without ADHD who used it.

The researchers said: “Those who played Decoder were better than those who played bingo and those who played no game. The difference in performance was significant and meaningful.  It was comparable to those effects seen using stimulants, such as methylphenidate … also known as Ritalin.”

Put this into context, too, that the pre-frontal cortex doesn’t fully evolve until people are in their early 20s. So, until then, they’re more likely to act impulsively and take risks. 

7. False starts – maybe can’t finish projects

People with executive functioning difficulties can find it tricky to plan a project, appreciate how long it will take to finish and tackle setting goals. They can have issues getting started on a project and staying on task, searching for more information and asking for help when they need it. They may struggle with switching tasks or getting a feel for how well they’re performing on the project. It In the workplace that means they won’t be as productive as others. This could negatively impact employability and promotion at work.

ADDitude magazine[22] gives an example of what it’s like to struggle with finishing large projects. Despite breaking the work down into steps, you might miss pieces or spend too long on less important tasks. And you might not be motivated to work on a project even when the deadline is looming large.

“People with executive functioning disorder commonly lack the ability to handle frustration, start and finish tasks, recall and follow multi-step directions, stay on track, self monitor, and balance priorities,” says ADDitude.

8. On a quest for perfection and it goes downhill from there

Mental inflexibility is a common challenge for people with executive functioning issues. This plays out as perfectionism – wanting to do things perfectly, fearing rather than learning from mistakes and not adapting to change or hurdles. It’s not about aiming high, it’s about aiming to perfect. You’ll find parallels with perfectionism and the fixed mindset as opposed to the (healthier) growth mindset, terms popularized by Stanford University psychologist Carol Dweck[23].

An American Psychological Association[24] article by Etienne Benson talks about some nasty pitfalls of perfectionism.

“In more than 20 years of research, [Paul Hewitt PhD] and his colleagues – particularly psychologist Gordon Flett, PhD – have found that perfectionism correlates with depression, anxiety, eating disorders and other mental health problems. [And] … several new studies were published that help explain how perfectionism can contribute to psychopathology.”

9. Could develop a thought disorder or behavioral problems

Children and adolescents with autism who have poor verbal working memory skills could develop a thought disorder, researchers[25] have suggested. They’ve urged further investigation into the role of executive verbal processing skills.

This is echoed in another study[26], which found that verbal thinking – such as during planning – and executive functioning are “intricately linked”. For example, you’ll prevent inner speech when you repeat words aloud rather than tap your foot.

They researchers said: “A growing line of research has sought to examine inner speech usage in [Autism Spectrum Disorder] as a potential cognitive mechanism driving [executive functioning] impairments, including planning difficulties, which are commonly found in [Autism Spectrum Disorder].”

Interventions

Interventions should target inner speech to overcome the disorder. But how, might be tricky. The researchers said it was unclear if encouraging people with autism to use inner speech could help with self-regulation problems. Perhaps, the focus should be on improving their early social communications skills, they said.

Meanwhile, having poor executive functioning skills interferes with learning and “may lead to behavior problems, suspension, expulsion, or being held back”, says the National Center for Special Education Research[27]. Therefore, those will low skills have a “greater likelihood of behavior problems”. Despite this, it’s not yet clear to what extent the skills shortfall leads to behavioral disorders overall.

10. Those with EF are more likely to be overweight

Meanwhile, other researchers[28] examined almost 70 relevant studies to see if there was link between poor executive function and being overweight – yes, there was, but they don’t know how or why it occurs. They found executive dysfunction was “associated with obesity-related behaviors, such as increased intake, disinhibited eating, and less physical activity”.

Citing a range of studies they had examined, the researchers said: “Overweight children have been found to have poorer executive control than healthy weight children, and obese children have twice the rate of executive dysfunction as the normative population. In an intervention for overweight and obese adolescents, improvements in executive function skill were related to weight loss, suggesting that executive function can improve and have positive implications for reducing weight.”

In other words, the good news is that once there were interventions and executive functioning skills improved, the participants moved to a healthier weight.

Ten down but not out

So, that’s the 10 possible effects of executive functioning difficulties. But, don’t feel overwhelmed. There is hope as the brain is not static. As the National Center for Special Education Research says, “the neural circuitry that supports executive functioning is highly plastic, or modifiable, during development”.

“To some extent, however, [the prefrontal cortex (PFC)] never stops developing as both executing functioning skill and connectivity in PFC peak in early to mid-adulthood and then exhibit gradual decline across the lifespan.”

Useful links:

Executive Function: implications for education report from the National Centre for Special Education Research

ADDitude’s self-test for executive functioning difficulties here

Comprehensive list of executive functioning issues, Positive Partnerships website, http://www.positivepartnerships.com.au/en/fact-sheet/executive-functioning

 

 

Sources

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[13] Ziermans, T., Swaab, H., Stockmann, A., de Bruin, E., & van Rijn, S. [2017]. Formal Thought Disorder and Executive Functioning in Children and Adolescents with Autism Spectrum Disorder: Old Leads and New Avenues, Journal of Autism & Development Disorders, Vol 47: 1756-1768, published online 24 March 2017

[14] https://www.sciencedirect.com/science/article/pii/S0079742108604521 accessed February 2019

[15] http://www.psych.utoronto.ca/users/peterson/psy430s2001/Miller%20GA%20Magical%20Seven%20Psych%20Review%201955.pdf accessed February 2019

[16] https://psychcentral.com/lib/executive-function-problem-or-just-a-lazy-kid-part-2/ accessed February 2019

[17] Follmer, D. J., & Sperling, R. A. [2016]. The mediating role of metacognition in the relationship between executive function and self-regulated learning. British Journal of Educational Psychology. Vol 86, pp559-575. December

[18] https://www.understood.org/en/learning-attention-issues/child-learning-disabilities/executive-functioning-issues/5-ways-executive-functioning-issues-can-impact-reading accessed January 2019

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[26] Wallace, G. L., Peng, C. S., & Williams, D. [2017]. Interfering with Inner Speech Selectively Disrupts Problem Solving, Journal of Speech Language and Hearing Research, Vol 60, pp3456-3460, December 2017

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