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How to manage problems with executive function

It can be hard to manage executive skills, but there are a few ways you can help your child.

General tips

  • Create routines for your child’s day and week
  • Use rewards to help reinforce positive behaviour and avoid punishing negative behaviour
  • Model planning, organisational and time management skills in everyday life
  • Support your child in weighing up the pros and cons of different solutions to a problem
  • Help your child to see the bigger picture and perspective of others

Play games that help practice executive function skills, such as:

  • Strategy games like connect 4, noughts and crosses
  • Games such as monopoly or chess use executive skills such as maintained focus, planning ahead, considering options before acting, and inhibition
  • Practice switching between the rules, so they can practice flexible thinking and working. This could involve playing card games matching colours then suits and so on

Skill-specific tips

This section describes different skills involved in executive function, the associated difficulties, and how to manage this skill.

Attention & persistence

Attention and persistence is the ability to

  • stay focused on a task in the face of distractions, tiredness, or disinterest
  • keep working towards an end goal, even when there are other demands

A difficulty would be a child finding it difficult to focus on tasks such as homework for long periods, and being easily distracted by things around them.

How to manage this skill:

  • Remove distractions
  • Use reminders to stay focused
  • Take regular breaks
  • Find out what time they work best at
  • Stop to check they are on task
Stepping back

Stepping back is the ability to

  • step back and think about a situation objectively, weighing up the pros and cons

A difficulty looks like impulsively jumping into situations without thinking about them first.

How to manage this skill:

  • Before starting something spend a few minutes thinking about it
  • Generate options and consider the pros and cons of each option
Starting a task

Starting a task means the ability to

  • start an activity without prompting or help from anyone.

A difficulty would be a child finding it hard to initiate tasks themselves, feeling overwhelmed, and not knowing where to start.

How to manage this skill:

Encourage a child to ask themselves these questions before starting a task:

  • What do I want to achieve?
  • What steps will help me reach my goal?
  • What are my options?

Then encourage the child to:

  • consider the options available, and decide on the best one.
  • set specific goals and reward themselves for completing tasks.
Sequencing and planning

Sequencing and planning is the ability to

  • break down a task or activity into the individual steps needed to achieve it

A difficulty would be a child finding it hard to identify the main points of the task, struggling to plan the steps needed to carry it out, missing out the steps or completing individual steps in the wrong order.

How to manage this skill:

  • Break the activity down into small manageable steps
  • Create a to-do list, ticking off each step as it is completed
  • Create a time line for longer term projects or goals

Summarising is the ability to

  • gather information and summarise it
  • recognise the important details and leave out what is less relevant

A difficulty would be a child describing a story they have read, struggling to pick out the important details of the story, and focussing too much on more minor points.

How to manage this skill:

  • Spend time considering the main points of what they have read, what is important and what isn’t.  Make sure to step back and look at it as a whole
  • Use the 5 W’s (who?, why?, what?, where?, when?)
  • Try to think about what someone who did not know the story would need to know.

Self-monitoring is the child’s ability to

  • assess something they have done
  • notice if there are any mistakes or room for improvement

A difficulty would be a child failing to notice when the task is not going very well, not picking up on mistakes, or not spotting things that could be better or done differently.

How to manage this skill:

  • Encourage the child to think about how they will know if they have been successful
  • Use checklists or success criteria to work against
  • Encourage the child to check they have achieved what they wanted to
  • Provide explicit feedback.
Flexibility, switching and solving problems

Flexibility, switching and solving problems is the ability to

  • recognise problems or when something isn’t working
  • think differently about something and not get stuck in a particular way of doing things
  • find an alternative approach or solution
  • change and revise plans.  This can involve using feedback or new information to make a revised plan
  • switch to a new approach or plan (this involves switching attention/focus)

A difficulty would be a child finding it hard to adapt to a change of plan, to approach a task/situation differently, or to switch between tasks if asked to do so.

How to manage this skill:

  • Practice reflecting on their progress, identifying what is working well and what isn’t. Talk about alternative ways they could do it, and what options are available
  • Encourage them to look at it from another person’s point of view, or model this to them
  • Prepare for possibility of changes ahead of a task
  • Plan alternatives if things don’t go as expected (for example, if it rains after school tomorrow we can go home to watch a film, instead of going to the park)
  • Give warnings and prepare the child that the task is coming to an end
  • Avoid introducing more than one thing or concept at a time
  • Consider using social stories to help understand possible outcomes

Stopping is the ability to

  • put the brakes on actions (i.e. inhibiting)
  • not expressing thoughts or behaviours that are inappropriate to a situation

A difficulty would be a child saying or doing inappropriate things or engaging in more risky behaviour.

How to manage this skill:

  • Encourage the child to pay attention to how others react to their behaviours.
  • Get the child to ask for feedback from others if they are not sure if they said or did something they should not have
  • Talk about what would have been a more appropriate thing to say or do.

Self-awareness is the ability of a person to

  • understand their own strengths and weaknesses
  • anticipate future difficulties

A difficulty would be a child reporting that they are doing well in a task and being shocked to receive negative feedback or marks.

How to manage this skill:

  • Spend time thinking about what their strengths and weaknesses are. Before starting a task, think about what they will find easy, and what they might find hard
  • Look at feedback from teachers and family
  • When completing tasks, ask the child to predict how well they will do.  After receiving feedback, consider with them if their prediction was accurate.

Strategies for school and education

  • Provide step by step instructions for a task whenever possible
  • Have homework written down in the same spot every day
  • When given homework, always write the due date on the top
  • Explicitly teach executive functioning and study skills
  • Before starting a task, schedule a few minutes to plan and organise what to do
  • Give an extra 3 to 5 minutes to organise before transitions
  • Use external aids to help them plan and organise, such as calendars, weekly schedules, or daily checklists
  • Schedule a weekly organisation time
  • Create routines and practice them often
  • Create an end-of-the-day checklist to remember materials
  • Clearly explain academic and social expectations
  • Keep an extra set of books at home and in the classroom
  • Use countdowns and time checks during work periods
  • To help with time keeping, use timers, reminders or apps, to help track their progress
  • Have students set up homework binders

Harvard activities guide for enhancing and practicing executive function skills

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Please note: this is a generic information sheet relating to care at Sheffield Children’s NHS FT. These details may not reflect treatment at other hospitals. This information is not intended as a substitute for professional medical care. Always follow your healthcare professionals’ instructions. If this resource relates to medicines, please read it alongside the medicine manufacturer’s patient information leaflet. If this information has been translated into another language from English, efforts have been made to maintain accuracy, but there may still be some translation errors. If you are unsure about any of the guidance in this resource or have specific questions about how it relates to your child, always ask your healthcare professional for further advice.

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