It’s the latest and hottest of new diagnoses: Executive Function Disorder (EFD). What is it? In layman’s terms, it’s a chronic pattern of difficulty in planning, analyzing, setting goals and executing daily tasks. This is not the same as the inability to stay on task which characterizes the hyperactivity or poor attention of ADHD.
People with EFD have trouble with setting and keeping to a schedule; misplacing papers, losing personal items and being disorganized. Many daily tasks require executive functioning skills. For example, asking a student to write a book report requires figuring out where to get the book; estimating the time needed to read it; taking notes that are relevant to the report format; and writing the report by the deadline.
Let’s look at a few key components and strategies that can help with executive functioning.
Brain Activation: This is the ability to organize, prioritize and implement. Individuals with difficulty in this area do not set goals. If you ask them what they want, they say, “I don’t know.” Giving them fewer choices, assisting with lists, providing a visible wipe erase board, visual guide, or study carrel, and checking in regularly can train them on how to plan and execute. Students struggling in this area will need assistance with breaking down projects into manageable pieces. The key here is to let them be the “list keeper” and owner of the process. A list or assignment notebook and schedule are crucial!
Focus: This is the area that most of us think of as ADHD. And it may very well be a part of Executive Functioning Disorder. This area shows up as a lack of attention, concentration or focus. Individuals with challenges in this area may need tools and props to help them stay focused, including timers, schedules, private work spaces and a great sensory diet.
Effort: This is the “keep on going” part of Executive Function. Now that I started, can I finish with speed and accuracy? Those with effort challenges need encouragement and monitoring to be sure they don’t drop off midway. They may need a sensory survival kit or help staying alert through the process or the day. Getting it done may be more reasonable than making it perfect, but in the long run we want to work on “doing your best.” Evaluating each task or project when it’s done is helpful: Discuss what went well and where more effort could be expressed. Again, the student should lead this discussion as more of a self-evaluation than a lecture.
Emotion: Tantrums and trauma can increase under pressure. When all is running smoothly, this area is well maintained and an individual is able to modulate frustration and manage emotions. To help maintain the calm, use tools for emotional regulation and self-expression.
Memory: In this case memory is the ability to retain information, utilizing working memory while completing a task. It also involves accessing information or recall. So if I’m washing dishes, do I remember how I was instructed to stack them or that the detergent needs to be added before I turn on the dishwasher? If I’m working on a paper, do I remember that it should be in 12-point font and needs my name on the title page? Or that the teacher asked us to place the paper in a plastic folder before turning it in? For students, taking notes can keep the details handy for studying, and a checklist can help too. Playing memory games can reinforce these skills.
Action: Are my actions appropriate? Do I call out in class? Tell jokes? This may present as hyperactivity or impulsivity. Can I listen and then respond appropriately? Tools for helping with action may be those that monitor and regulate activity. Reward charts for good behavior or talking about appropriate social skills can assist greatly in this area.