The answer may be an underlying deficit of executive functions. ‘Executive functions’ is an umbrella term that covers a wide range of difficulties some of which include:
- Working memory – ability to hold information in memory needed to complete a task. Eg- writing to dictation, answering questions
- Controlling impulses – unable to wait for a turn or the child may answer questions without thinking first.
- Understanding and following the rules of a game
- Regulating emotions – excessive crying, bursts of anger
- Transition skills – moving from one activity / object / person to another.
Deficit in executive functioning is treated through a multi-disciplinary approach by a team of professionals which include the speech language pathologist, psychologist, occupational therapist and special educator. Significant difficulty in the above mentioned areas can impact an individual’s quality of life and also have consequences on their social life, relationships, academics, money management and daily life activities- like following a sleep schedule, cooking, shopping, planning or hosting an event etc. Executive function deficits may be observed in individuals with Autism, ADHD, learning disability, traumatic brain injury, seizure disorder, intellectual deficits.
Other neurological factors which may cause deficits in executive functioning are delayed development of Pre- frontier cortex in the brain. The pre-frontal cortex plays a major role in transition skills ( moving from one activity to another), emotional regulation, working memory and inhibitory control. Any lesion or failure of this brain area to develop would result in impulsive reactions,rather than planned choices and responses. The child may respond impulsively or fail to regulate emotions.
Shifting mental gears between tasks (eg- chopping, sauting, adding ingredients in a cooking activity) requires cognitive flexibility that many learners find overwhelming. This happens because the working memory holds on to old task information while the new task competes for attention resources. It can often be very frustrating. An executive function deficit can also be seen in children with a history of malnutrition, emotional trauma or parental neglect.
Professionals can help an individual with executive functioning deficit through sessions targeted towards:
- Identifying patterns (through caregiver or personal interview and observation)
- Adjusting systems
- Specific training in the area of difficulty (working memory, transition, emotional regulation, planning, group interaction etc)
- Microchoice integration
- Developing compensatory strategies
- Establishing routines
- Using co-regulation language that soon becomes the individual’s inner voice
- Providing recovery windows