What exactly are executive functions? They have been described as the processes required for planning, organising, prioritising, memorising, shifting (eg moving from one idea to another), self-regulation and self-monitoring. They are like the brain’s “CEO”. All teachers have across students who exhibit difficulties that interfere with their learning: students who are inefficient with their work, are forever forgetful and disorganised and who have difficulty getting started on tasks, have difficulty memorising facts, being on time, controlling emotions, showing what they know, difficulties with integrating subskills and co-ordinating it all together along with difficulties studying, planning, writing essays, taking notes etc. Unfortunately, they can be labelled unmotivated or lazy and heading for failure.
- Organize and get started on tasks.
- Attend to details and avoid excessive distractibility.
- Regulate alertness and processing speed.
- Sustain and, when necessary, shift focus.
- Use short-term working memory and access recall.
- Sustain motivation to work.
- Manage emotions appropriately
He likens ineffective executive functioning as being an impairment of the brain’s cognitive processes and likens it to the operation of a symphony orchestra, where even though individual members may possess specific skills, without an effective conductor to manage them they will not perform well.
Although deficits in executive functioning are common attributes for individuals with conditions such as Autism Spectrum Disorder, Attention Deficit Disorder, Fragile X Syndrome, schizophrenia and other disorders, students without a diagnosed disorder may also be affected (Meltzer, 2010; Brown 2007; Landon & Oggel, 2002). Such findings deliver an important message to educators:
Any student who struggles to achieve may well be faced with the challenges of impaired executive functioning and not just those with a diagnosed disorder.
Executive Functions and ADD
A great deal of research has been done on individuals with Attention Deficit Disorder without widespread identification that individuals diagnosed as such experience deficits in executive functioning. ADD has been described as the most the most commonly diagnosed, extensively studied, as well as the most controversial of disorders. It is estimated that the prevalence is around five to seven percent of all school-aged children, which translates to there being at least one or two children with ADD per classroom (Heward, 2009; Brown 2007; Sherman, Rasmussen & Baydala, 2008). The clinical description of ADD is that the condition displays hyperactive, impulsive and inattentive behaviours presenting frequently and severely compared to peers of comparable development (Heward, 2009; Guereasko-Moore, Dupaul & White, 2007; Sherman et al, 2008). For decades then, ADD has been diagnosed as inattentiveness or hyperactiavity behaviour problems and managed with medication.
It’s not a simple behaviour disorder, but rather a complex syndrome of impairments in the management system of the brain. – Thomas E Brown
Such behaviours are examples of impaired executive function in self-regulation which undoubtedly affects cognitive performance. The prognosis for these individuals is generally poor, including greater risk for low academic achievement, school non-completion, expulsions, increased chance of engagement in higher-risk behaviours, ineffective relationships and increased risk for psychological and emotional problems (Huang et al. 2009; Guereasko-Moore, Dupaul & White, 2007; Barkley, 1997; McQuade & Hoza, 2008; Klassen, 2004; Wolraich et al, 2005). Additionally, it has been identified that ADD individuals have at least one other problem to contend with, or are at greater risk of conditions such as oppositional conduct disorder, anxiety, mood disorders or depression (Wolraich et al, 2005; Dendy, 2004; Klassen, Miller & Fine, 2004).
It is therefore extremely enlightening that a newer model of ADD has begun to emerge recognizing the role of executive functioning in the disorder (Brown, 2007; Meltzer, 2010, McCloskey, 2008).
Although deficits in executive functioning are common attributes for individuals with conditions such as Autism Spectrum Disorder, Attention Deficit Disorder, Fragile X Syndrome, schizophrenia and other disorders, students without a diagnosed disorder may also be affected (Meltzer, 2010; Brown 2007; Landon & Oggel, 2002). Such findings deliver an important message to educators: any student who struggles to achieve may well be faced with the challenges of impaired executive functioning and not just those with a diagnosed disorder.
“Individuals with ADD are found in all IQ levels” – Thomas E Brown
Brown recommends that all stakeholders become familiar with the new model of ADD and with appropriate intervention, most students can achieve their potential. CHADD is a non-profit making organisation, assisting students and adults in managing ADD/ADHD in their lives.
“Students with AD/HD experience roughly a 30 percent developmental delay in organizational and social skills. Many of these students appear less mature and responsible than their peers. A thirteen-year-old adolescent with AD/HD, for example, may have executive skills that are more like those of a nine-year-old child. To ensure academic success for these students, parents and teachers must provide more supervision and monitoring than is normally expected for this age group.” Barkley, PhD researcher
How students can be helped:
Intervention strategies for academic success
Approximately 50% of students with ADD/ADHD have learning disorders. It is therefore important to identify the learning problems that require support (math, reading, written expression) and to identify their executive function deficits (eg poor working memory, forgetfulness, disorganisation) and provide accommodations to address the deficits.
The following strategies will assist each of the executive function areas where weaknesses are identified.
Planning: helpful strategies include explicit teaching, breaking tasks into manageable steps and teaching students how to use a planner/diary.
Prioritizing: teaching how to highlight main points, using visual learning aids and supports such as graphic organizers as well as allocating time frames to specific tasks.
Organising: guided practice, consistent routine, using outlines such as graphic organizers, teaching summarizing skills for example, key points on index cards or ‘post-it’ notes, note-taking strategies, and using colour coding for organising tasks will support organizational deficits. Also using folders, trays, boxes and files to organize the environment and reduce clutter.
Shifting: implementing practice in rephrasing tasks and activities which incorporate multiple meanings and representations, instruction on how to identify key points as well as note-taking training will assist this deficit.
Memory: the use of a planner/diary and wall calendars to help with day-day management tasks, implementing a well-structured daily schedule and visual aids to provide reminders for routine and applied strategies. For learning, using repetition, acronyms, mnemonics, chunking, attaching meaning, reciting and recording. To assist with deficits in internalisation of verbal working memory, visual cues can be linked to verbal prompts.
Self-monitoring can be managed via aids such as self-assessments, self-recording, clearly defined rubrics, exemplars, feedback, checklists and reinforcers (Heward, 2009; Dendy, 2004; Meltzer, 2010; McKloskey, 2008).
Other strategies include paired learning, modified assignments, testing and grading, provision of support and where appropriate, the use of technology. Modifying teaching methods to accommodate challenges, for example, work does not always have to be in written form; alternatives can include using diagrams, drawings and oral recordings (Meltzer, 2010; McCloskey, 2008; Heward, 2009; Dendy, 2004).
The value of behavioural and academic interventions and their efficacy have been well documented and school focused interventions have been found to be superior as opposed to a singular behavioural management approach. Implementing research-supported behavioural strategies include a focus on the consequences of behaviour. Behaviour management that has been effective includes clear rules and procedures and enforcing them consistently, providing encouragement, rewards and praise, teaching and modeling modulation and supporting positive self-reflection and self-talk on tasks on achievements (Sherman, 2008; Wicks-Nelson & Israel, 2009; Heward, 2009). Graham-Day, Gardner & Hsin, (2010, p. 219) concomitantly express “simply making students aware of and accountable for their behaviour also teaches an important life skill”.
Additionally, successful school intervention strategies to improve appropriate classroom behaviour include knowing students’ weaknesses and equipping students with skills that can enable them to manage their situations as well as teacher-intervention support when needed. Additional strategies include social skill instruction, social stories, teaching de-stressing strategies, opportunities for role-play, differential reinforcement, metacognitive strategies such as self-monitoring strategies, self-evaluation aligned with positive behaviour reinforcers and the use of report cards (Gureasko-Moore, DuPaul & White, 2007; Menzies, Lane & Lee, 2009).
Classroom environment and management
A well-organised, structured environment with clear routine, rules and procedures, minimal distractions, allocated seating arrangements, teacher use of hand gestures, visual aids, frequent feedback and checklists are effective strategies for maintaining external control (Sherman et al, 2008; Wicks-Nelson & Israel, 2009; Heward, 2009; Rief, 1993; McCloskey, 2008). Furthermore, Students will work more effectively in an environment where there is variety, choice, regular feedback, praise and rewards. When structures are in place and students have strategies to manage self-regulation inhibitions (such as frustration, anxiety and intolerance), they are more able to access their cognitive resources. (Wicks-Nelson & Israel, 2009; Heward, 2009; Rief, 1993; McCloskey, 2008; Meltzer, 2010).
For comprehensive strategies I strongly recommend What Works for Special-Needs Learners: Promoting Executive Function in the Classroom, Lyn Meltzer, 2010.
CHADD has excellent strategies, tips and ideas for managing executive functions at home and school.
Barkley, R. A. (1997). Behavioral Inhibition, Sustained Attention, and Executive Functions: Constructing a Unifying Theory of ADHD. Psychological Bulletin, 121(1), 65-94.
Barkley, R. A. (2005). Attention deficit hyperactivity disorder: A handbook for diagnosis and treatment, (3rd ed). New York: Guildford.
Brown, T. E. (2007, February). A New Approach to Attention Deficit Disorder. Education Leadership, 22-27.
Dendy, C. A. (2004). Executive Function … ‘What is this anyway?’ Retrieved September 16, 2010, from http://www.chrisdendy.com/executive.htm
Gander, M. (2010). Failure to Launch. University Business, 13(2), 44.
Gilmore, L., Campbell, J., & Cuskelly, M. (2003). Developmental Expectations, Personality Stereotypes, and Attitudes Towards Inclusive Education: community and teacher views of Down syndrome, International Journal of Disability, Development and Education, 50(1), 65.
Graham-Day, K. J., Gardner, R. & Hsin, Y. W. (2010). Increasing On-Task Behaviors of High School Students with Attention Deficit Hyperactivity Disorder: Is it Enough? Education & Treatment of Children, 33(2), 205-221.
Guereasko-Moore, S., DuPaul, G. J., & White, G. P. (2007). Self-Management of Classroom Preparedness and Homework: Effects on School Functioning of Adolescents With Attention Deficit Hyperactivity Disorder. School Psychology Review, 36 (4), 647-664.
Heward, W. L. (2009). Exceptional Children, An Introduction to Special Education, (9th ed.). Colombus, OH: Pearson.
Huang, H. L., Lu, C. H., Tsasi, Chao, C. C., Ho, T. Y., Chuang, S. F., Tsai, C. H., & Yang, P. C. (2009). Effectiveness of Behavioral Parent Therapy in Preschool Children With Attention-Deficit Hyperactivity Disorder. The Kaohsiung Journal of Medical Sciences, 25, (7), 357-365.
Klassen, A. F., Miller , A., & Fine, S. (2004). Health-related quality of life in children and adolescents who have a diagnosis of attention-deficit/hyperactivity disorder. Pediatrics, 114, (5), 541-547.
Landon, T., & Oggel, L. (2002) Lazy Kid or Executive Dysfunction? CCC-SLP Innovations & Perspectives, 5( 2), 1-2.
McCloskey, G., Perkins L. A., & Van Divner, B. (2008). Assessment and Intervention for Executive Function Difficulties, Hoboken: Routledge.
McQuade, J. D., & Hoza, B. (2008). Peer problems in Attention Deficit Hyperactivity Disorder: Current status and future directions. Developmental Disabilities Research Reviews, 14(4), 320-324.
Meltzer, L. (2010). Promoting Executive Function in the Classroom, New York: Guildford Press.
Menzies, H. M., Lane, K. L., & Lee, J. M. (2009). Self-Monitoring Strategies for Use in the Classroom: A Promising Practice to Support Productive Behaviour for Students with Emotional or Behavioural Disorders. Beyond Behavior, 18(2 ), 27-35.
Rief, S. F. (1993). How to Reach and Teach ADD/ADHD Children, West Nyack, NY: Jossey-Bass.
Shah, S. (2007). Special or mainstream? The views of disabled students. Research Papers in Education, 22(4), 425-442.
Swanson, J. M. (2003). Role of Executive Function in ADHD, Journal of Clinical Psychology, 64(14), 35-39.
Wasserstein, J. (2005). Diagnostic issues for adolescents and adults with ADHD, Journal of Clinical Psychology, 61(5), 535-547.
White, H. L., & Rouge, B. (2003). Ritalin Update For Counselors, Teachers, And Parents. Education, 124,(2), 289-296.
Wicks-Nelson, R., & Israel, A. C. (2009). Abnormal Child and Adolescent Psychology, (7th ed.). New Jersey: Pearson.
Wolraich, M. L.,Wibbelsman, C. J., Brown, T. E., Evans, S. W., Gotlieb, E. M., Knight, J. R., Ross, E. C., Shubiner, H. H., Wender, E. H., & Wilens, T. (2005). Attention-Deficit/Hyperactivity Disorder Among Adolescents: A Review of the Diagnosis, Treatment, and Clinical Implications. Pediatrics, 115(6), 1734-1746.