Executive Functioning Support for Kids with ADHD
Jen Dryer and Gabriele Nicolet
Twelve-year-old Miles has forgotten to turn in his math homework for the second time this week, and he bristles when his frustrated mom asks why.
For those of us raising children with ADHD, this is a relatable scenario. Our kids are smart, but distracted; they have the best of intentions, but the worst time with follow through. What we may not realize is that in this scenario, executive functioning challenges, or executive dysfunction, are primarily to blame for the behaviors that cause so much frustration.
The reality is that all children with ADHD have some form of executive functioning challenges, but the good news is that EF skills can be learned when taught explicitly, methodically, and collaboratively.
Executive functioning skills are housed in the part of our brain that’s responsible for overseeing all the other brain functions: the frontal lobe. These are the “manager” skills that, as EF expert Sarah Ward explains, help us see ourselves moving through space to get from point A to point B to point C. EF skills help our brains know what to pay attention to and what to filter out. They help us think of, begin, and finish little tasks, like throwing trash away into the garbage can, and big tasks, like writing a term paper. They help us track a conversation by remembering what was said and by whom. They help us express or inhibit the things that we’re thinking. They help us devise solutions to problems. EF skills are always operating in the background, and we don’t seem to notice their presence until we notice their absence.
Ryan Wexelblatt, also known as ADHD Dude, tells us to think of EF as a “brain coach,” the internal voice that gives us feedback and directions. For kids with executive dysfunction, the volume of that internal voice is turned down so much that those key messages are never received, and hence often the same mistakes will occur over and over.
The key: help your child create helpful systems
Let’s go back to Miles for a minute, and see what might be happening in his brain. Doing the assignment is almost never the problem: the work might even be easy for Miles. And this is the part that trips us up as parents. We think, “My kid is smart. Why can’t he do the simple things he needs to do?” Well, here’s a list of just some of the EF skills required to turn in a homework assignment:
- Organizing. Putting the completed assignment into the right folder to be turned in the next day.
- Working memory. Recalling the priority of turning in homework, recalling the consequences of failure to submit homework, and recalling and visualizing the process (the how, when and where) of submitting it. Miles’s brain has not integrated and prioritized submitting the homework as an important part of the task, and struggles to visualize and recall the consequences.
- Planning and problem solving. Envisioning (like seeing a “movie in your mind”) the process of turning his homework in: seeing himself move through space to take out his work, put it into the homework bin and walk back to his set. Miles struggles to really “see” this happen in his mind ahead of time, so his brain has not planned for him to turn in his work.
- Inhibition and impulsivity. NOT doing something else at the moment when it’s time to turn in the assignment.
So, what are we to do to help our children’s brains get through those day-to-day tasks more effectively? Learning specialist Susan Kruger, MEd, suggests that we work to “make the invisible visible” for our children. To do this, we can think about all the planning that needs to happen invisibly in our minds for us to complete a task, and then think about how we can make those steps as visible as possible for our kids. That can include a simple checklist (with pictures for younger children), a specialized agenda that includes the “how” for work submission, folders and clearly marked labels for different subjects, and other organizational supports and scaffolds that will help your child “see” what needs to get done more effectively.
In the math homework example, we might rehearse with Miles when, where, how, and to whom he’ll turn in his homework. We might have him imagine going through the steps to turning in his assignment. We might also have him create a “homework turn-in folder” or similar system and have him put a sticky note somewhere to remind him to check it.
The key is to help your child create helpful systems to remind them of the things that sometimes fall by the wayside. Notice we did not say, “create the system for your child.” It is critical that the child help create and be involved in the process and have buy-in for any strategy to be successful. If we serve as our children’s EF system, then they will never learn to develop their own.
The next step, after collaboratively setting up the system, is to revisit the systems in regular intervals to see how the interventions are going. Circling back helps model self-reflection, self-awareness, and self-assessment for our children, all of which are things that children with EF challenges also struggle with.
Executive function skills: five takeaways
Here’s what to remember about the importance of EF skills:
- Executive function is fundamentally visual: you need to “see” the task/goal completed and “see” yourself moving through space to get there.
- The lack of these skills is not a behavior or attitude issue (until we make it one by forcing shame on our kids).
- In kids with EF challenges, the prefrontal cortex development can be up to thirty percent behind. So a twelve-year-old may act more like a typically developing nine-year-old. This can be helpful to keep in mind as your child’s skills develop.
- Buy-in and self-efficacy are key to the use of any strategy. Kids need to feel ownership and acceptance of their own brains and how it learns best.
- Explicit practice of EF strategies is essential for kids to improve their executive function skills.