Judi A. Hughes, M.Ed. School Psychologist/Educational Consultant - Maximizing Your Potential
Blog
2/12/2012
excerpted from Late, Lost, and Unprepared by Joyce Cooper-Kahn, Phd. and Laurie Dietzel, Ph.D
 
What Is Executive Functioning?

The Basics
  • The executive functions all serve a "command and control" function; they can be viewed as the "conductor" of all cognitive skills.
  • Executive functions help you manage life tasks of all types. For example, executive functions let you organize a trip, a research project, or a paper for school.
  • Often, when we think of problems with executive functioning, we think of disorganization. However, organization is only one of these important skills.
The term "executive functioning" has become a common buzzword in schools and psychology offices. This is more than just a passing fad. In fact, neuropsychologists have been studying these skills for many years. We believe that the focus on executive functioning represents a significant advancement in our understanding of children (and adults!) and their unique profile of strengths and weaknesses.
 
A Formal Definition of Executive Functioning:
The executive functions are a set of processes that all have to do with managing oneself and one's resources in order to achieve a goal. It is an umbrella term for the neurologically-based skills involving mental control and self-regulation.
 
What mental control skills does this involve? Different researchers and practitioners have their own favorite lists, although the overall concept is basically the same.   Cooper-Kahn and Dietzel use the list proposed by Drs. Gerard A. Gioia, Peter K. Isquith, Steven C. Guy, and Lauren Kenworthy. These psychologists developed their understanding of executive functions through sound research and created a rating scale (Behavior Rating Inventory of Executive Functions- BRIEF), that helps parents, teachers, and professionals understand a particular child, adolescent or adult,  and think more specifically about how to help.
 
Before looking at the list of specific characteristics encompassed by the broad category of executive functions, Cooper-Kahn and Dietzel, in their book , Late, Lost and Unprepared, offer an example that makes the concepts more concrete.  They propose  "Understanding Executive Functions by Looking at Life without Them ; Thinking about what life is like for someone with weak executive functioning gives us a better understanding of the way these core skills affect our ability to manage life tasks. "  Their story illustration:
 
"The Road Trip without a Map
We'd like to tell you a story about our friend, Robin, who lives life without the benefit of strong executive functioning. Robin is a composite of many individuals we have known, and she struggles with weaknesses in executive skills, despite her well-intentioned efforts to reform herself.
One day in May, Robin gets a phone call from her Aunt Sue in Merryville, Missouri. Aunt Sue is planning a family reunion in July, and she wants to know if Robin and her family can come. All of the extended family will be there. The little town will be overrun with relatives and it is going to be a great corralling of the family from all across the United States. Robin is excited at the prospect and eagerly says, "Of course we'll be there! We wouldn't miss it!"
Aunt Sue gives Robin all the particulars, including the dates of the reunion and places to stay. Robin rummages around in the kitchen junk drawer for a pencil while her aunt talks, but she never does find one with a point on it. She promises to herself to find a pencil and write down all the details just as soon as she gets off the phone. But by the time she hangs up, she can't remember the specifics. She makes a mental note to call back soon to get the dates.
That evening, Robin excitedly tells her husband and two children about the reunion. Her husband asks when it will take place. "Some time in July. I don't remember exactly." He says, "Well, please find out this week because I have to request vacation time at work." Their fifteen-year-old son exclaims, "Hey, I thought July was when I was supposed to go to Band Camp!" "Didn't you remember?" Robin's daughter practically shouts, "I'm going to Ocean City with Julie and her family sometime in July." Robin blows up at them all, yelling, "Why are you all being so negative? This is supposed to be fun!"
About once a week, Robin's husband reminds her to get the information about the reunion. She promises to do so. (And she really means to get around to it!) Finally, in June, Robin's husband gets very annoyed and says, "Do it now! I'm going to stay right here in the kitchen until you call!" Robin makes the call and gets the dates as well as the other particulars. Her husband harrumphs around the house the rest of the evening because now he has only three weeks left before the requested time-off. Luck is on their side, though, because he manages to arrange the vacation around work, and the reunion dates do not conflict with the kids' activities.
Over the next three weeks, thoughts about the trip float through Robin's head from time to time. She thinks about how the kids will need to have things to do in the car since it's a long trip. She thinks about taking food and snacks for the ride. She thinks about getting her work at the office cleared up in advance so she can be free of commitments for the vacation. She thinks, "I really should take care of that stuff."
A few days before it is time to leave for the two-day drive to Missouri, she starts piling stuff into the van, including clothes and other supplies. (You can only imagine what the inside of this van looks like!)
Finally, it's time to pile the people into the van, too. On the way out of the house, one of the kids asks, "Who will be taking care of the cats while we're gone?" Robin moans, "Oh no! I forgot about that. We can't just leave them here to die and there's no one to take care of them! Now we can't go. What will we tell Aunt Sue?" Her husband takes over, and starts calling around the neighborhood until he finds a teenager who can do the pet sitting. The crisis passes. The cats will be fine.
So, they're off. Robin's husband drives the first shift. He pulls out of the neighborhood, gets onto the main highway, and then asks, "So, what's the game plan? What's the route?" Robin answers, "Missouri is west, so I know we have to go west." He looks at Robin incredulously and says, "You don't know any more details than that? Well, get out the map. We can't just head west with no more information that that!" And, of course, Robin says, "What map? I don't have a map." Robin's husband sighs and shakes his head. "Oh no! Another road trip without a map! Why didn't you tell me you were having trouble getting it all organized? I could have helped." Robin replied, "I didn't have any trouble. Everything is fine. We're in the car, aren't we? We'll get there. What are you so upset about?"
Do you think Robin had made reservations for where to stay along the way? Do you think she had planned out how much cash they would need for the trip or made it to the bank ahead of time? These and many other details, of course, had escaped planning."
 
With this example in mind, Cooper-Kahn and Dietzel refer back to the question of the  specific abilities covered under the umbrella term of executive functioning and provide a list of executive functions identified from Dr. Gioia and his colleagues as referenced above.  They  include a specific illustration of each executive function from the story of Robin in parentheses after each definition:
 
 
  1. Inhibition - The ability to stop one's own behavior at the appropriate time, including stopping actions and thoughts. The flip side of inhibition is impulsivity; if you have weak ability to stop yourself from acting on your impulses, then you are "impulsive." (When Aunt Sue called, it would have made sense to tell her, "Let me check the calendar first. It sounds great, but I just need to look at everybody's schedules before I commit the whole family.")
  2. Shift - The ability to move freely from one situation to another and to think flexibly in order to respond appropriately to the situation. (When the question emerged regarding who would watch the cats, Robin was stymied. Her husband, on the other hand, began generating possible solutions and was able to solve the problem relatively easily.)
  3. Emotional Control - The ability to modulate emotional responses by bringing rational thought to bear on feelings. (The example here is Robin's anger when confronted with her own impulsive behavior in committing the family before checking out the dates: "Why are you all being so negative?")
  4. Initiation - The ability to begin a task or activity and to independently generate ideas, responses, or problem-solving strategies. (Robin thought about calling to check on the date of the reunion, but she just didn't get around to it until her husband initiated the process.)
  5. Working memory - The capacity to hold information in mind for the purpose of completing a task. (Robin could not keep the dates of the reunion in her head long enough to put them on the calendar after her initial phone call from Aunt Sue.)
  6. Planning/Organization - The ability to manage current and future- oriented task demands. (In this case, Robin lacked the ability to systematically think about what the family would need to be ready for the trip and to get to the intended place at the intended time with their needs cared for along the way.)
  7. Organization of Materials - The ability to impose order on work, play, and storage spaces. (It was Robin's job to organize the things needed for the trip. However, she just piled things into the car rather than systematically making checklists and organizing things so important items would be easily accessible, so the space would be used efficiently, and so that people and "stuff" would be orderly and comfortable in the car.)
  8. Self-Monitoring - The ability to monitor one's own performance and to measure it against some standard of what is needed or expected. (Despite the fact that they're off to Missouri without knowing how to get there, with almost no planning for what will happen along the way, and without a map, Robin does not understand why her husband is so upset.
 
Executive dysfunctions can be quite debilitating.  This can undermine successful task execution and contribute to challenges in interpersonal relations and an eroded sense of adequacy.  Directed coaching for the individual with executive dysfunctions as well as  the spouse or parents of someone with executive challenges, can be highly assistive. 
 
11/29/2011
Link to Ohio Valley Branch of Orton Dyslexia Society
10/24/2011
Excerpted from: “ Life Coaching for Adult AD/HD” by Nancy Ratey, Ed.M., ABDA, MCC in Clinical Interventions for Adult ADHD: A Comprehensive Approach, edited by Sam Goldstein, PhD and Phyllis Ann Teeter, Academic Press, 2002:
Coaching intervention can make a real difference in how people with AD/HD negotiate their own particular deficits and cope with life on a daily basis. There are five major deficit areas that can be seen playing out in the lives of persons with AD/HD. The following is a discussion of these areas, and how the coaching relationship can offer successful compensatory strategies.
1. Coaching maintains mental arousal and focus on completing goals.
If attention is under-aroused, chances are motivation will lag also, and vice versa. For instance, people with AD/HD often have a hard time pursuing abstract goals. Coaches seek to bring the more abstract goals to the forefront of their clients’ minds, keeping attention aroused to work on the goal and stay focused until it’s completed.
The coaching partnership provides a “shared awareness”, or mutual consciousness, of goals and their associated challenges so as to sustain the AD/HD client’s vigilance towards an identified goal. The coach works with the client to create deadlines, schedules, meetings and regular phone check-ins around reaching goals. This induces a certain level of “good stress” on clients, keeping their brain aroused, vigilant, and on track to reach stated goals.
2. Coaching helps modulate emotions.
Shame, guilt and fear are demons plaguing many people with AD/HD. Years of being labeled “stupid”, “ditzy” or “irresponsible” create an emotional burden that can derail their actions, throw them off course or even paralyze them. A coach helps clients learn how to identify bad feelings and their triggers, and explores effective ways to modulate emotional responses. Instead of blaming themselves when AD/HD gets in their way, clients can think: “Wait a minute! I know this is my AD/HD at work, and I know I have ways to get around it now.” By isolating the behavior from the emotion, the behavior can be broken down into parts to take the mystery out of it, giving clients an opportunity to think up strategies to contain and change the behavior.
3. Coaching maintains motivation and sustains the feeling of reward .
Motivation is often questioned in people with AD/HD. Although clients may have developed the tools to sustain attention to tasks, they may still lack motivation. By reminding clients of their top priorities and of all the gains they have made, the coach provides encouragement. Self-confidence is bolstered.
The client may under-function in certain situations, especially when it comes to prioritizing, planning, attending to details and following through with projects. In other instances, the client may become overwhelmed with a project, and not knowing where to start, may avoid the task. By breaking large projects down into smaller, more manageable tasks, coaches keep clients more focused on their goals. Other clients might need help in discovering a system of tangent rewards so as to sustain motivation and progress forward.
4. Coaching acts as the “Executive Secretary of Attention. “
Clients with AD/HD are challenged in their ability to “gross prioritize”, to gather and focus their attention in a more global way. By keeping the big picture in mind, the coach helps the client to sustain their attention on their primary goals, pointing out distractions and helping to create strategies when distractions do arise.
5. Coaching supports the client’s ability to self-direct actions and to change behavior
In order to function autonomously, individuals must be able to screen out distractions, sustain their attention and use feedback appropriately. Attentional arousal is a double-edged sword for people with AD/HD. While it is usually the case that their attention needs to be aroused in order to attack certain tasks, it is also true that if their attention is too aroused they can find themselves becoming “over-focused” and getting stuck in a particular activity or step of a task at the cost of everything else. Just as they can be sidetracked by pleasurable feedback, clients can also be sidetracked by negative feedback such as those “voices in the head” that continually remind one of one’s inadequacies. Clients with AD/HD are also very adept at self-deception and forgetting the pain of past procrastination and other self- defeating behaviors.
The coach compensates for these deficits by providing daily reminders and helping the client sequence out the details of needed actions. By pressing clients to process and evaluate outcomes and consequences, the coach allows clients to develop the ability to make more proactive choices and be less reactive to the environment. Coaches also help clients develop the ability to estimate the time it takes to complete tasks by having on-going discussions, reviewing plans for timelines and processing out the details and sequences of tasks. The coach helps clients to, in effect, observe themselves in action, by processing out events, asking question sand providing feedback.
Please check back often as I will continue to post noteworthy tidbits of information as well as helpful resources, products and links that I think are valuable.
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