Helping Kids Who Struggle With Executive Functions

Learning specialists discuss how to get organized 

Rachel Ehmke

Senior Writer
CHILD MIND INSTITUTE

The first time you hear that your 7-year-old son is weak in "executive functions" it sounds like a joke. No kidding—that's why he's a first-grader, not a CEO. But executive functions are the essential self-regulating skills that we all use every day to accomplish just about everything. They help us plan, organize, make decisions, shift between situations or thoughts, control our emotions and impulsivity, and learn from past mistakes. Kids rely on their executive functions for everything from taking a shower to packing a backpack and picking priorities.

Children who have poor executive functioning, including many with ADHD, are more disorganized than other kids. They might take an extraordinarily long time to get dressed or become overwhelmed while doing simple chores around the house. Schoolwork can become a nightmare because they regularly lose papers or start weeklong assignments the night before they are due.

Learning specialists have devised ways to bolster the organizational skills that don't come naturally to a child with poor executive functioning. They teach a mix of specific strategies and alternative learning styles that complement or enhance a child's particular abilities. Here are some of the tools they teach kids—and parents—to help them tackle school work as well as other responsibilities that take organization and follow-through.

Checklists

The steps necessary for completing a task often aren't obvious to kids with executive dysfunction, and defining them clearly ahead of time makes a task less daunting and more achievable. Following a checklist of steps also minimizes the mental and emotional strain many kids with executive dysfunction experience while trying to make decisions. Ruth Lee, MEd, an educational therapist at the Child Mind Institute, explains, "Often these kids will get so wrapped up in the decision-making process that they never even start the task. Or, if they do begin, they're constantly starting and restarting because they've thought of a better way to do it. In the end they're exhausted when the time comes to actually follow though." With a checklist, kids can focus their mental energy on the task at hand.

You can make a checklist for nearly anything, Lee notes, including how to get out of the house on time each morning—often a daily struggle for kids with executive dysfunction. Some parents say posting a checklist of the morning routine can be a sanity saver: make your bed, brush your teeth, get dressed, have breakfast, grab your lunch, get your backpack. Lee also recommends completing as many of the morning tasks as possible the night before. Lunches can be made ahead of time, clothes can be laid out, and backpacks can be packed and waiting by the door. It takes a little extra planning, she adds, but doing the work ahead of time can prevents a lot of drama the next day.

Set Time Limits

When making a checklist, many educational therapists also recommend assigning a time limit for each step, particularly if it is a bigger, longer-term project. Matt Cruger, PhD, Director of the Child Mind Institute Learning and Development Center, likes to practice breaking down different kinds of homework assignments with kids to get them used to the steps required—and how long they might take. He describes recently working with a fifth grader who could think of only two steps required to complete a book report—writing the report and then turning it in. The time involved in reading the book slipped his mind.

Use That Planner

Educational specialists also highlight the cardinal importance of using a planner. Most schools require students to use a planner these days, but they often don't teach children how to use them, and it won't be obvious to a child who is overwhelmed by—or uninterested in—organization and planning. This is unfortunate because kids who struggle with executive functioning have poor working memory, which means it is hard for them to remember things like homework assignments. And working memory issues tend to snowball. Dr. Cruger explains, "Kids don't remember that they won't remember their homework if they don't write it down. It doesn't matter how many times they forget. Once a frustrated father told me, 'It's like he has thisdelusion that he'll remember it!'" As a backup to planners, many schools are also using software platforms like eChalk to create webpages teachers use to post homework assignments and handouts—giving kids with executive dysfunction one less thing to worry about.

Spell Out the Rationale

While a child is learning new skills, it is essential that he understand the rationale behind them, or things like planning might feel like a waste of time or needless energy drain. Kids with poor organizational skills often feel pressured by their time commitments and responsibilities, and can be very averse to delay. "It's almost like they're making neuroeconomical decisions," Dr. Cruger says. "They're constantly weighing things to see if it's worth their effort, and planning can feel like a waste of time if you don't understand the rationale behind it." Older kids are particularly resistant, because they're more stuck in their ways. "They'll say, 'This is what works for me,' even if their method really isn't working," says Dr. Cruger. Explaining the rationale behind a particular strategy makes a child much more likely to commit to doing it.

Explore Different Ways of Learning

Because everyone learns differently, educational specialists like Mara Ravitz, MA, one of the founders of the learning company Smarten Up, advocate using a variety of strategies to help kids with executive dysfunction understand—and remember—important concepts. Using graphic organizers as a reference for visual learners is one such example. Students learning how to write a paragraph might follow the hamburger paragraph model, a diagramed drawing of a hamburger in which each sandwich component matches a part of a paragraph—the top bun is the thesis, the three supporting sentences are the lettuce, tomato, and patty, and the bottom bun is the conclusion sentence. Some versions of the hamburger paragraph act as a visual aid while others double as forms that a child can fill in.

Other kids remember things better if there is a motion supporting it, like counting on your fingers, which is good for visual and tactile learners. Younger children benefit from self-talking to reduce anxiety and Social Stories, which are narratives about a child successfully performing a certain task or learning a particular skill. Social Stories are told from a child's first-person perspective and are similar to self-talk, but they can also double as a checklist because they break tasks into clear steps and can be referred to later.

As kids get older and are expected to memorize a lot of dry factual information, Ravitz recommends mnemonic devices as a way to structure information in a more memorable way. But with all of the different learning strategies out there, Dr. Cruger stresses the importance of not overwhelming kids. Ideally the educational specialist should be working with your child on one new skill at a time, and spending at least two weeks practicing before evaluating how effective or ineffective it is and moving on to anything new.

Establish a Routine

This is particularly important for older kids, who typically struggle more to get started with their homework. Educational specialists recommend starting homework at the same time every day. Expect some resistance from older kids, who often prefer to wait until they feel like doing their work. Dr. Cruger strongly advises against waiting to start homework. "Realistically, the desire to start homework probably isn't going to come. A kid who is waiting for inspiration to strike will still be forced to start his homework eventually, but it will probably be at 11 o'clock. That's clearly a bad work model." Ideally, kids should come home, unpack their bag, have a snack, and then get started. Homework is best done in a quiet, well-lit space fully stocked with paper and pencils because a search for supplies can quickly derail homework time. Any space with minimal distractions is good. Some families find doing homework on the kitchen table works best for their child, particularly if a parent is nearby to supervise and answer questions.

Use Rewards

For younger kids, Ravitz recommends putting a reward system in place. "Younger kids need external motivators to highlight the value of these new strategies. Something like a star chart, where kids see the connection between practicing their skills and working towards a reward, works very well." Besides, Ravitz notes, "It's also a good way to communicate to kids that their parents and their teacher also value this skill." If you're using a reward chart, hanging it in the designated homework area can be a good incentive. For older kids who aren't as motivated by things like rewards, parents should still be encouraging. Ravitz recommends parents checking in with older kids. "Ask how things are going or offer help. Tell them you appreciate all the hard work they're doing. School is really hard for a lot of kids—it shouldn't be a given that learning these things is easy."

Developing new strategies for learning isn't easy either. Initially, it can put kids who are already self-conscious even further outside their comfort zone, but it's worth the effort. We use our organizational skills every day in a million ways, and they are essential to our success in school and later as adults. They even give us more time to play videogames
.

Understanding Key Executive Functions

School Visits

Flying fish, art museums, too many cups of coffee, too many pints of beer, and three school visits. That pretty much sums up the last ten days of life. Needless to say, my trip to Seattle was great, but very busy! Seeing what other schools are doing in terms of learning support really provided me with some clarity. I just want to highlight a few bits and pieces from each program.

My first visit was to Klahowya Secondary School, where I spent the first four years of my teaching career. Great people, great kids, but way too driven by data, test scores, and state standards. I was mostly interested in their zero/zero program and a program they call academy. The zero/zero program targets students who turn in late work and the academy program is set up for all students, providing access to extra support at the end of each school day. One program was reactive, while the other was very proactive. I liked the academy program, as it was available to all students, implemented school-wide, and was developed using existing structure and staff. The zero/zero program seemed to be fulfilling it purpose in that kids are not turning in late work, but many of the teachers that I spoke with questioned its impact on learning and its punitive approach.

My second school visit was with Seattle Academy. SAAS is a GREAT school. It is one of those schools that makes you wish you could go back to high school and be a student there (a very scary thought, especially for me)! The faculty at SAAS was very genuine and welcoming. The school has a "culture of performance" that resonates throughout their multi-block urban campus. SAAS has a learning support department that is available to student who need extra support and assistance in navigating their school experience. Their learning support classes have a 4:1 ratio and focus on "helping students understand their strengths and weaknesses, learn how to access resources to overcome their weaknesses, set personal goals, collaborate with peers and adults, and advocate for themselves." Along with learning support, SAAS has developed a note-taking resource for their struggling and excelling note-takers. Basically, students who take really great notes can post their notes in a share file and receive service hours. Students who are more challenged when it comes to taking notes can access these notes to help them study, prepare, or learn how to take better notes. It is a wonderful system that I noticed the students in the support classes using on a regular and very consistent basis. Probably the best part of my visit was hearing the perspectives of the academic teachers, regarding the support department. All of the teachers felt very positive about the learning support program, noting that it really took the burden/responsibility off of their shoulders, as they felt they were not alone in supporting students with learning challenges.

My third visit was with Lakeside School. Both the upper and middle school offer learning support services. I was fortunate to sit down with the learning resources coordinator at both levels.

Middle School
The middle school has a student life department that is staffed by a student support team. The student support team includes a counselor, two brain and learning lab specialists, and a family support liaison. The student life department also oversees the life skills curriculum. The life skills curriculum is taught at the fifth, sixth, seventh, and eighth grade level, with each grade level driven by three essential questions: Where have I come from? Where am I going? Who am I now?

Upper School
The upper school houses a learning resources center. The learning resources coordinator, Rosalyn Schiller, wears many different hats. First, she coordinates all on-site peer and professional tutoring. She facilitate a student support team who meet weekly to develop action plans for students. She documents the post evaluation process, creating student profiles. Lastly, she keeps track of extended time and the communication between parents, teachers, and students about eligibility for accommodations on National Standard Exams. She probably does more jobs than I have listed here. She is an incredible resource! I am so glad that I had the opportunity to meet her.

All of my school visit were extremely insightful. I am so grateful that I was able to sneak a peek at different models. I feel like I have more of a sense of what is doable, manageable, and sustainable.

Effective Learning Strategies

Last week I presented a video to our Math Department that focused on effective learning. The video showed both students and teachers answering a series of questions. The questions were: describe a successful learning experience, describe an unsuccessful learning experience, define an effective learner, and describe how 'they' learn best. What emerged were general themes:

The teacher is important in creating a successful learning experience.

Relationships and interactions are essential for learning.

Breaking down the information into manageable pieces is an effective learning strategy.

Students who are the most successful know themselves and know how to be a
self-advocate.

Part of the feedback that I received from the meeting was to include more specific learning/teaching strategies that are effective in helping students who struggle academically. With that focus in mind, my upcoming posts are going be devoted to highlighting effective learning strategies. Here are just a few to get me started.

These strategies are used when working with material/content:

1. Clarify or simplify written directions - This year, I've had the pleasure of working with one of our science teachers who really does this well. This teacher tries to be as simple and specific as she can. Directions written in paragraph form with a lot of information can be overwhelming. To help her students navigate the directions, this teacher underlines and highlights the significant parts of the directions. Having students rewrite the directions is also helpful.

2. Present a small amount of work - Pull out only a few problems and/or questions at a time instead of giving them all at once. This prevents students from getting overwhelmed, anxious, and discouraged about the amount of work they need to complete.

3. Block out extraneous stimuli - I used to do this when teaching my junior high students about the basic structure of an essay. I would block out all of the other parts and just focus on each piece. This helped my students who were easily distracted by visual stimuli that is present on a whole worksheet or page.

4. Develop reading guides - A reading guide provides the student with a road map of what is written and features periodic questions to help him or her focus on relevant information. This year, I have worked with two Biology teachers who use reading guides. It helps students understand the main idea, remain engaged during reading, and sort out numerous details related to main ideas.

International Reading Association

During our last department meeting, many teachers expressed concerns about the decline in proficient readers. This is a concern I have heard over and over again. When I went to the TRLD conference this past January, I went to a really informative session on developing confident, eager, and fluent readers. During the session, the presenter, Scott Marfilius made the comment that EVERY TEACHER needs to be a reading teacher. In a way, I agree. While reading tasks may differ from content areas, subject-specific teachers have the opportunity and qualifications to teach students how to actively think about texts in their particular classes. During the session, Scott presented effective reading comprehension strategies and before/during/after reading strategies. If you are interested in how to incorporate reading strategies into your content area please come see me.

One other great find is the International Reading Association podcast. Listen and let me know what you think.

Two Million Minutes

I came across an article for this new documentary, Two Million Minutes. It looks extremely intriguing, and makes me think about many ideas Alan November presented at our curriculum day. Are we preparing our students the best that we can for a 21st century world? Are we falling behind? Are we using all the resources available to us to help our students become 21st century critical thinkers and readers? If we are, how? If we aren't, why? I hope this flick comes to Honolulu! In the meantime, I think these are important questions we should be asking ourselves. Here is the trailer...

A little more from the Brain Conference

Do you have a fixed mindset or a growth mindset? One the presentations that I really enjoyed was Carol Dweck's keynote about mindsets. For much of my life I have lived with a fixed mindset. During my middle and high school years, I convinced myself that I was not as smart as others or, on my really pretentious days, smarter than others. This thinking was a direct product of my environment. Everyday, there was chatter surrounding class rankings, SAT scores, intelliengence quotient, grades, and so on. I don't think it was until college, or maybe until I started teaching that I truly valued learning as an opportunity for growth. I think that most teachers want their students to relish in learning, but some students may not know how. Teaching students about growth mindsets seems invaluable. The results from Carol Dweck's work support that notion.

Below is an article published by the Standford New's Service regarding Carol Dweck's work:

Stanford Report, February 7, 2007

New study yields instructive results on how mindset affects learning

BY LISA TREI

When psychology Professor Carol Dweck was a sixth-grader at P.S. 153 in Brooklyn, N.Y., she experienced something that made her want to understand why some people view intelligence as a fixed trait while others embrace it as a quality that can be developed and expanded.

Dweck's teacher that year, Mrs. Wilson, seated her students around the room according to their IQ. The girls and boys who didn't have the highest IQ in the class were not allowed to carry the flag during assembly or even wash the blackboard, Dweck said. "She let it be known that IQ for her was the ultimate measure of your intelligence and your character," she said. "So the students who had the best seats were always scared of taking another test and not being at the top anymore."

Asked what seat number Dweck occupied during that memorable year, the professor paused, and silently raised her right index finger. "But it was an uncomfortable thing because you were only as good as your last test score," she said. "I think it had just as negative an effect on the kids at the top [as those at the bottom] who were defining themselves in those terms."

From that experience, Dweck became fascinated with intelligence, convinced that IQ tests are not the only way to measure it. "I also became very interested in coping with setbacks, probably because being in that classroom made me so concerned about not slipping, not failing," she said.

Dweck, a soft-spoken, elegantly attired woman, joined Stanford's faculty in 2004 as the Lewis and Virginia Eaton Professor. Before that, she taught at Columbia for 15 years, as well as at Harvard and the University of Illinois. A native New Yorker, Dweck earned a bachelor's degree from Columbia and a doctorate in psychology from Yale.

According to Dweck, people's self-theories about intelligence have a profound influence on their motivation to learn. Students who hold a "fixed" theory are mainly concerned with how smart they are—they prefer tasks they can already do well and avoid ones on which they may make mistakes and not look smart. In contrast, she said, people who believe in an "expandable" or "growth" theory of intelligence want to challenge themselves to increase their abilities, even if they fail at first.

Dweck's research about intelligence and motivation, and how they are variously influenced by fixed and growth mindsets, has attracted attention from teachers trying to help underperforming students, parents concerned with why their daughters get turned off math and science, and even sports coaches and human-resources managers intent on helping clients reach higher levels of achievement.

The journal Child Development is releasing a paper Wednesday, Feb. 7, co-authored by Dweck titled "Implicit Theories of Intelligence Predict Achievement Across Adolescent Transition: A Longitudinal Study and an Intervention." The research shows how at one New York City junior high school students' fixed and growth theories about intelligence affected their math grades. Over two years, she said, students with a fixed mindset experienced a downward academic trend while the others moved ahead.

The psychologists then designed an eight-week intervention program that taught some students study skills and how they could learn to be smart—describing the brain as a muscle that became stronger the more it was used. A control group also learned study skills but were not taught Dweck's expandable theory of intelligence. In just two months, she said, the students from the first group, compared to the control group, showed marked improvement in grades and study habits.

"What was important was the motivation," Dweck said. "The students were energized by the idea that they could have an impact on their mind." Dweck recalled a young boy who was a ringleader of the troublemakers. "When we started teaching this idea about the mind being malleable, he looked up with tears in his eyes, and he said, 'You mean, I don't have to be dumb?'" she said. "A fire was lit under him."

Later on, the researchers asked the teachers to single out students who had shown positive changes. They picked students who were in the growth mindset group, even though they didn't know two groups existed. Among them was the former troublemaker, who "was now handing in his work early so he could get feedback and revise, plus study for tests, and had good grades," Dweck said. The research showed how changing a key belief—a student's self-theory about intelligence and motivation—with a relatively simple intervention can make a big difference. Since then, Dweck and her colleagues at Columbia have developed a computer-based version of the intervention, dubbed "Brainology," that has been tested in 20 New York City schools.

Although "Brainology" is not yet commercially available, Dweck has brought her work to public attention with her latest book, Mindset: The New Psychology of Success. The author of many academic books and articles, Dweck noted Mindset was her first foray into mainstream publishing. "My students [at Columbia] kept saying to me, 'You write for these professional journals and that's important, but what about people in the world?' We are in a profession that talks to each other and writes for each other. That's what we're rewarded for. But my students kept saying, 'Everybody should know this.'"

Mindset certainly resonated with Ross Bentley, a world-renowned car racing coach based in Seattle. Unlike coaches who stress technical skills, Bentley focuses on teaching mental competitiveness. He said great drivers strive to attain "a state of flow—a moment when you lose yourself in the act of driving, when it becomes effortless and time slows down. When you get into the flow, or the zone, you're at your peak."

Bentley was thrilled to learn that Dweck's research confirmed his personal approach to coaching. "One of the things that's fascinating for me is that someone with her knowledge has verified things I've known," he said. "She brings a scientific approach and we're able to give her real-world experience. The majority of champion racing drivers have a growth mindset."

This month, Dweck and Bentley are launching a study of about 40 racing-car drivers to learn how applying a growth mindset approach improves their speed times during the 2007 racing season. Bentley explained that car races can last hours and drivers may lose their concentration at pivotal points, making it possible to lose a race by only a few seconds. The objective of coaching is to help drivers recover quickly and maintain an optimal state of flow, he said. The research, carried out by psychology graduate student Fred Leach, will use surveys to gauge the mindset of drivers before, during and after races to see if there is a correlation with their race results, Bentley said. "The goal is to build a growth mindset," he said.

In addition to sports coaches, parents and teachers have written to Dweck to say that Mindset has given them new insight into their children and students. "One very common thing is that often very brilliant children stop working because they're praised so often that it's what they want to live as—brilliant—not as someone who ever makes mistakes," she said. "It really stunts their motivation. Parents and teachers say they now understand how to prevent that—how to work with low-achieving students to motivate them and high-achieving students to maximize their efforts." The point is to praise children's efforts, not their intelligence, she said.

Last year, Dweck taught a freshman seminar based on Mindset. She chose 16 students from more than 100 who applied, selecting those who expressed personal motivation rather than intelligence. "You can impress someone with how smart you are or how motivated you are, and I picked students who expressed their motivation," she said.

It turned out that embracing a growth mindset was critical to the students' transition to Stanford. The freshmen loved being on campus and quickly became involved in activities, Dweck said, but failed to anticipate the approach of midterm exams. "They were just really overwhelmed," she said. "How did they deal with it? They told me they would have dealt with it poorly, thinking they weren't smart or were not meant to be at Stanford. But knowing about the growth mindset allowed them to realize that they hadn't learned how to be a college student yet. They were still learning how to be successful as a Stanford student." Dweck described the seminar as a "peak experience" in her long teaching career. "The students were fantastic," she said.

Dweck continues to conduct research into what motivates people and what holds them back. Based on the success of Mindset, which is being published in nine countries, Dweck has been asked to collaborate on other non-academic projects involving business and sports. "I'm such an egghead," she said with a smile. "My book was my first foray into the real world. Articles go out into the [academic] field and it's very gratifying, but a book goes to all corners of the earth. People take a lot from it, and they introduce themselves into your life."

Dweck's work is to be featured on National Public Radio and in New York magazine. She also will present her research at the upcoming annual meeting in San Francisco of the American Association for the Advancement of Science.