HOW CAN WE HELP CHILDREN WITH DEFICIENT EXECUTIVE FUNCTIONS?

It is important to have in mind that executive functions are about execution of actions, not knowledge. The child, whose executive functions do not function properly, may know how to behave but be unable to use this knowledge in actual performance!

We will not help this child by:

• encouraging to „focus“, „try harder“ or „put himself together“;
• scolding, criticizing;
• promising incentives for adaptive behavior, motivating;
• repeating rules.

We may use one of four general strategies to help children with underdeveloped executive functions

1. Structured training of specific executive functions.

The development of executive functions depend on biological maturation and experience. While children normally develop their executive functions simply by interacting with their natural environment and participating in education, children with underdeveloped executive functions may benefit from structured and organized training, directed specifically on particular executive abilities. Various computer tasks and games are often used for this purpose. The training may be considered successful if there is evidence for the transfer effect (that is, children become more adept not only in the particular task he has been practicing, but on some other related form of functioning too) and durability of the effect. The transfer effects are usually found to other tasks targeted at the particular executive function that has been trained and to the lesser extent – to more general cognitive tasks that supposedly require using the executive function trained. The training effects don’t generalize to other, non–trained executive function tasks.

Regardless of the type of training (computer based or non-computerized), successful executive function training has one important feature: the difficulty of the task is increasing progressively, so that executive functioning is constantly challenged. It is also very important that children find such training entertaining and rewarding, so it is best if the training task is designed to resemble a game.

It seems that executive functions differ in how easily they can be improved by training, possibly due to the underlying processes of neural development. The effectiveness of working memory training in preschool and school aged children have been studied the most and was repeatedly found to be effective, while there is much less research data on the effects of inhibition and mental flexibility training,

The younger the child and the greater the deficiency, the more effective will specific training be.

2. Other more general interventions shown to aid executive functions development

Research shows that to improve executive functions, focusing narrowly on them may not be as effective as taking more holistic approach and addressing emotional, social and physical development of children. Here are some interventions that have been proven to be beneficial in terms of executive function development:

Aerobic exercise and sports. It is evident that aerobic exercise significantly improves prefrontal cortex function and executive functions in children as well as adults. The beneficial effects of increasing physical activity for executive functions are most evident in sedentary, overweight children. It is possible that organized sports may benefit executive function development even more because it not only provides children with constant opportunities to greater physical activity but also directly challenges various executive functions. However, for the very same reason, caution should be taken that children with deficient executive function may be less successful at organized sports than their peers and failure in sports in addition to academic failure is definitely not what they need.

Martial arts. Traditional martial arts emphasize self-control, discipline (inhibitory control), and character development. Children getting traditional Tae-Kwon-Do training were found to show greater gains than children in standard physical education on all dimensions of executive functions studied.

Teaching children mindfulness and reflection. Training children to step back, reflect on their actions and inner states and become more aware of the situation improves their everyday functioning and is related to higher scores on executive functions tasks.

Pretend play. Pretend play is the most natural and surprisingly effective way for children of preschool age to master their cognitive and social skills. The nature of pretend play requires a child to plan ahead, hold rules in mind, continuously shift between the pretend mode and real life mode and control their impulses. Children with week executive functions are usually less skilled players, but providing them with numerous opportunities to play freely with more adept peers may make a big difference.

3. Trying to compensate for executive function deficiencies teaching child compensatory strategies and using his cognitive strengths

All children should be taught strategies for planning, learning and organizing materials, but children with week executive functions may benefit tremendously when mastering these techniques. Planning time, prioritizing tasks, making lists, taking notes, highlighting key information, stepping back and monitoring one's progress are just some of the important techniques. Research show kids may benefit from ‘self talk’- the habit of telling oneself in mind what needs to be done next.

4. Adapting the teaching strategies and tasks so that requirements for executive functions were minimized as much as possible and a student could use his other abilities and skills such as abstract reasoning, creativity etc. to their best.