Executive Functioning

Anonymous
Our DC (a rising 6th grader) recently completed a battery of tests which suggests an executive functioning deficit. If you have a child in an independent school who has executive functioning deficit, what strategies has the school/teacher used to help your child succeed? Similarly, what strategies do you use at home?
Anonymous
Anonymous wrote:Our DC (a rising 6th grader) recently completed a battery of tests which suggests an executive functioning deficit. If you have a child in an independent school who has executive functioning deficit, what strategies has the school/teacher used to help your child succeed? Similarly, what strategies do you use at home?


Have you talked to a Pysch about stimulant meds? They can be incredibly, strikingly helpful with executive functioning deficits. Having a combo of meds and coping strategies will be the most effective. I would recommend doing meds first and then implementing strategies to avoid unecessary frustration for your child.

Having a written list of daily assignments would be very helpful. That way you can help manage and organize. Time management can be a huge problem for kids and adults with this issue. It's pretty interesting really as they almost perceive time differently almost in a nonlinear way if that makes sense. Helping organize his time with tools like alarm clocks or parent reminders or charts can be helpful.
Anonymous
Anonymous wrote:Our DC (a rising 6th grader) recently completed a battery of tests which suggests an executive functioning deficit. If you have a child in an independent school who has executive functioning deficit, what strategies has the school/teacher used to help your child succeed? Similarly, what strategies do you use at home?


Hi - Just wanted to suggest you cross post this on the special needs site - I think there has been some discussion on this. In fact, you might get some really good suggestions by folks with kids in public school whose kids have IEPs that address exec. functioning issues and the strategies that are implemented to help them. Good luck! Very common problem for middle schoolers!
Anonymous
An "organizational" tutor has been very helpful to us; in combination with meds. My DC meets with the tutor once a week and they go over time management, homework, etc. It totally takes us out of the equation and definitely helped DC.
Anonymous
Wow! So you put your kid on drugs, don't bother to teach them any basic life skills, and they get extra time on tests to boot! What a deal!
Anonymous
Sounds like the same poster who was saying there was no such thing as ADD. Guess she's the opposite: OCD. One note song.
Anonymous
I would recommend strategies before drugs. Drugs can be helpful, but less intensive interventions should be attempted first. Visual schedules, timers, breaking down a 'plan of attack' before engaging an assignment, checklists, outlines... all are helpful. I'm sure a teacher or learning specialist should be very helpful with this. It is a fairly common diagnosis and, generally speaking, organizational skills are a huge part of teaching, especially for students at that age.
Anonymous
OP here. Thanks for all your posts. I posted this on the special needs board as well. But I just want to clarify that the psychologist who did the testing did not diagnose DC with ADHD. From what I understand from the psychologist, ADHD and executive functioning deficit are two different things. Many (a little more than 50%) who have ADHD also demonstrate executive functioning deficit, and certainly ADHD combined with executive functioning deficit can be complicated. However executive functioning deficit impacts about 12-15% of the population. We were told there is not much research on how medication affects children with executive functioning deficit. Inattention and hyperactivity respond well to ADHD medication, but executive functioning deficits often don’t. At this time we are not considering medications but wanted to know if anyone had success with other strategies, CogMed for example or other brain exercises.

PP 18:15, can you recommend the organizational tutor that you are using?
Anonymous
I'm a psychologist, and in my experience almost all children with ADHD have executive dysfunction of some sort (closer to 98% than to 50%). But, there certainly are children who have executive dysfunction but don't meet the criteria for diagnosis with ADHD.

Just wanted to clarify.
Anonymous
Thanks 20:21. Are you familiar with CogMed. Is it something you would recommend for a child with working memory and organization challenges? What strategies have you seen used successfully in a school environment (specifically independent school environment) and at home? Are there schools of which you are aware that are particularly supportive of children with executive functioning deficit? A concern now is that the current school will become increasingly more academically challenging over time, and we wonder whether DC can be successful there. We need to talk with the school, and we will. Thanks for any info you can offer.
Anonymous
Anonymous wrote:Thanks 20:21. Are you familiar with CogMed. Is it something you would recommend for a child with working memory and organization challenges? What strategies have you seen used successfully in a school environment (specifically independent school environment) and at home? Are there schools of which you are aware that are particularly supportive of children with executive functioning deficit? A concern now is that the current school will become increasingly more academically challenging over time, and we wonder whether DC can be successful there. We need to talk with the school, and we will. Thanks for any info you can offer.


I have heard very positive things about CogMed from a number of parents - increased working memory, better auditory processing, better focus. I haven't heard about a direct effect on organization, but if you can remember the directions there's a higher chance you will follow them! I have heard from two or three parents that they saw no effect. The research says that about 80% benefit, and this is consistent with what I've seen. To some extent I think the difference was in how much the kid "bought in" to doing the program - it's a substantial investment of time and money, and if the child is just going through the motions it won't really help.

As for in-school interventions, keep in mind that a lot will depend on the individual teacher, school, and learning specialist. Most schools have a statement somewhere (web page, handbook) about what they will/won't do - it isn't always strictly accurate but gives an idea of the climate. That said, I have seen the following implemented successfully at one or more schools:
teacher checks assignment book and backpack before kid leaves for the day (for lower grades when you have one main teacher)
teacher asks directly for homework
teacher breaks long-term assignments into parts, and checks for completion along the way
teacher checks for understanding at least some of the time
child works with learning specialist on a weekly basis on organization (e.g., clean out the backpack!)
reminder list of classroom routines or assignment rubrics taped on child's desk
teacher reads drafts of longer assignments and gives feedback before final draft is due

Notice that these are all aimed at organization of materials, tracking assignments, or time management. For things like problem solving strategies I think a one-on-one tutor is more effective.


Anonymous
Went through something similar to OP's situation last year with our DS, 7th-grader who a teacher in the fall suggested might have ADD and should see an expert. In the first quarter DS had gotten 4 A's and 2 B's, and this teacher said that DS was capable of better grades but was hurting his grades by forgetting to turn in homework that he had done meticulously and on time and that he had brought to school in his binder, or forgetting to write down homework assignments or extra-credit problems that were on the whiteboard every day, etc. His grades were suffering especially in a math class in which the teacher required homework to be placed in a bin as one crossed the threshold -- if one turns around after class had started, the homework is docked points for being late.

We took DS to two pediatricians, one recommended by the school. One (the one not recommended by the school) said that DS's grades were just fine and that she thought the school (and we as the parents?) was just trying to get DS medicated to improve his performance and make the school look good. The other recommended a battery of tests.

We couldn't get an appointment for the tests within the next two months, so in the meantime we took DS to a school-affiliated psychiatrist, who after two sessions with DS and two separate sessions with DH and me determined that DS did not have ADD but had challenges with executive functioning. He recommended not medication but behavioral strategies for dealing with the all-important transitional points in DS's day, e.g., when he switches classes, or when he gets in our car to go home. We had to organize his binders with a special place where his homeworks would go. When he got in the car to go home, he had to open his backpack and visually check, with me, that he had the required items for homework on each subject. At the end of doing his homework, he had to check in with me and show me where he put each item of homework. I know it sounds exhausting, and it was and is. DS and I have been doing this "mindfulness" routine for almost two years now, but it has paid off. DS gets straight A's.

I thought what we were doing was extreme, but then I found by talking to other moms that just about everyone does the car routine, checking the backpack for items subject by subject.

I did e-mail DS's math teacher about DS's challenges with executive functioning, just to thank him for letting me know of the missed homeworks and to tell him that we were seeking help for the problem, and he wrote back sympathetically, but I didn't ask him to make an exception for DS on homework policy and he didn't offer. DS's school is not the type that would cut a kid some slack.

We're still working on it every day. I hope these routines will become second nature to DS. Probably DS will have these challenges for the rest of his life. We're told that there's a genetic component, and DH is definitely a lifer when it comes to problems with executive functioning! DH married an organized woman like his mother, and I fear that DS will have to do the same. I pity the woman DH marries if he is still this forgetful and disorganized when he grows up!
Anonymous
I am not the OP, but wondering if some privates handle this better than others--any school suggestions for elementary school aged kids with executive functioning dysfunction? She is a very bright child, but will need a lot of extra support. thanks.
Anonymous
OP here. PP 11:01 and 13:18, thank you for the suggestions! They do sound like quite a lot of work, but we need to try them. This morning, I participated in the Cogmed webinar. It sounds promising, though as you pointed out 11:01 there is an 80% success rate among the 90% of individuals who actually complete the training. In addition regarding retention and long term benefits, Cogmed has only conducted research through 6 months after training. But we are are seriously considering it.
Anonymous
Anonymous wrote:I am not the OP, but wondering if some privates handle this better than others--any school suggestions for elementary school aged kids with executive functioning dysfunction? She is a very bright child, but will need a lot of extra support. thanks.


FWIW, GDS seems to do a number of the executive functioning suggestions previously mentioned with all their kids (e.g. assignment book checks, asking for homework, time set aside for organization, longer assignments broken down into smaller chunks with set check-in points to verify that work is on track, reading drafts). I've seen this in the second half of LS and in MS. In HS, I've heard that the learning specialists work with kids as needed. I think that the goal is to lay down good study/organizational habits school-wide from a relatively early age and there's a recognition both that these are learned behaviors and that kids learn at different speeds and in different ways.
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