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With the January 2009 update, it is now a decade since I first created this section of the web site and over 15 years since I first started trying to educate educators and parents about the importance of this topic in children's development and functioning. We have made a lot of progress in that time, but we still have a long way to go to increase awareness and understanding, and we need much more research on effective interventions and treatments. Executive Dysfunction (EDF) continues to be one of the most overlooked contributors to academic, behavioral, and social problems for both youth and adults.
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The foundations for
learning are attention, memory, and executive
function. While most parents would immediately have
some sense of what "attention" and "memory" mean,
they may never have heard of executive functions.
And yet without these functions, so many aspects of
our functioning would be impossible or
significantly impaired.
Executive functions
(EF) are central processes that are most intimately
involved in giving organization and order to our
actions and behavior. They have been compared to
the "maestro" who conducts the orchestra. You could have talented musicians, but without a conductor to tell them when to show up, what to play, and how to play it, you'd have cacophony, at best. The comparison to a maestro or conductor is somewhat misleading, however, unless you recognize that a maestro is not "higher" than or "the boss" of other functions. In that sense, the image of a conductor or CEO fails. Executive functions have a unique role that they play in influencing the use of our other functions, but they are not more important than other functions. Neurologist Martha Denckla, M.D. talks about the executive functions in terms of our ability to "get our act together." I think that's a great description, because without executive functions, we would not be able to plan behavior to reach a goal.
So what
are the executive functions? Although there is no one agreed-upon definition and there is currently no diagnosis called "Executive Dysfunction," there seems to be a consensus
that executive functions involve (at the very
least):
- planning for the
future
- the ability to
inhibit or delay responding
- initiating
behavior, and
- shifting between
activities flexibly
If we break down the
skills or functions into subfunctions, we might say
that executive functions tap into the following
abilities or skills:
- Goal
- Plan
- Sequence
- Prioritize
- Organize
- Initiate
- Inhibit
- Pace
- Shift
- Self-monitor
- Emotional
control
- Completing
We will consider
these skills in more detail later in this article,
but for now, it should also be noted that in
considering executive functions, we will also be
talking about "working memory," which is not purely
an executive function but overlaps executive
functions, attention, and memory. Also, although
"emotional control" is included in this list, it is
not a purely executive function.
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Because there is no uniform
agreement on what the executive functions are,
there has been no agreement on how to assess them.
If we talk about particular subfunctions, however,
it is possible to answer the question.
Executive functions are
generally assessed via neuropsychological tests and
assessments. For any one function or subfunction,
there may be a variety of tasks or tests that tap
into components. There are also several batteries of tests that can be used.
If you suspect that you, your
child, your spouse, or your student has executive
dysfunction (EDF), the appropriate referral would
be to a board-certified neuropsychologist.
Neuropsychologists are psychologists who specialize
in the relationship between brain and
behavior.2 In school settings, school psychologists may wish to use B.R.I.E.F. if they have been trained to use it. Although it has limitations, it frequently provides parents and school personnel with a better understanding of the child's functioning and need for accommodations or services.
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1 Some of the material in this section represents the influence of Sheryl K. Pruitt, M.Ed., as we have discussed and presented these issues together many times over the years. I am deeply indebted to her for her input. All statements and any errors are solely my responsibility, however.
2 To find out more about
neuropsychological assessment and its use in
assessing individuals wtih ADHD, see the
neuropsychologycentral.com
web site's resources and links.
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