Definition, symptoms, testing and treatment


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    What is Executive Function?

    1. What Most People Know About Executive Function

    When we ask parents what they know about Executive Function, we get similar answers.

    Here are some real life examples of Executive Functioning as understood by parents:

    • The ability to follow instructions step-by-step
    • To complete tasks such as chores without getting distracted
    • To get ready for school or appointments in a timely manner
    • To remember to pack their school materials and lunch


    These very common examples seem simple, but they rely on complex cognitive processes in the brain such as working memory, sequential processing, and time orientation.

    2. A Formal Definition of Executive Function

    According to Harvard University’s Center on the Developing Child:

    “Executive function and self-regulation skills are the mental processes that enable us to plan, focus attention, remember instructions, and juggle multiple tasks successfully.”


    According to UCSF Weill Institute for Neurosciences:

    “The term executive functions refers to the higher-level cognitive skills you use to control and coordinate your other cognitive abilities and behaviors.”


    According to ADDitude Magazine:

    "People with EFD often experience time blindness, or an inability to plan for and keep in mind future events. They also have difficulty stringing together actions to meet long-term goals. This is not an attention problem in the present tense, but rather a sustained attention problem."

    3. Executive Function According to Stowell Learning Center

    Executive Function skills are higher-level mental skills that allow us to self-monitor and manage our own attention and behavior.

    These are real life problem-solving, planning, executing, and decision-making skills that are dependent on having a strong foundation of supporting cognitive skills.

    As the ladder image suggests, a student needs to have strong cognitive skills at the lower rungs (core learning skills and processing skills) in order to support the more advanced cognitive skills on the higher rungs.

    For example, if a student is having issues with eye-hand coordination (Core Learning Skills) and isn’t able to process information quickly (Processing Skills), then they’ll have trouble with a "simple" task such as writing out their schedule on a calendar.

    We develop more than 15 Executive Function skills through our comprehensive programming:

    1. Visual inner language
    2. Verbal inner language
    3. Working memory and verbal working memory
    4. Organization
    5. Time orientation
    6. Patterns and relationships
    7. Problem solving
    8. Reasoning
    9. Strategizing
    10. Using information
    11. Making connections
    12. Logic and reasoning
    13. Relevance vs non-relevance
    14. Planning
    15. Study skills
    16. Test-taking strategies
    17. Self-monitoring and management of attention and behavior (self-control, self-regulation, attentional control, emotional regulation, cognitive flexibility)
    18. Social awareness / tact

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    4. Common Myths About Executive Functioning Skills

    • Executive Function cannot be developed
    • Poor Executive Function is due to laziness or lack of motivation
    • Students will grow out of it when they get older

    Most people assume that Executive Function skills are automatically in place for everyone by early childhood, but in reality, these skills are tied to brain development and supported by many underlying neurodevelopmental/processing skills. 

    Both the supporting and executive functioning skills can be developed through targeted training, practice, and repetition just like learning how to throw a baseball.

    5. Causes and Factors that Affect Executive Function

    • Chronic stress and anxiety
    • Sickness such as the flu and Covid-19
    • Injuries to the prefrontal cortex
    • Attention Deficit Hyperactivity Disorder
    • Weak underlying neurodevelopmental or cognitive skills

    Executive dysfunction is a result of an underdeveloped or injured prefrontal cortex. However, the neuroplasticity research and decades of clinical evidence show us that with intensive and targeted training, the brain can develop new, more effective neuropathways, or connections for thinking and learning.

    6. What Most People Miss About Executive Function

    The major growth in Executive Functioning does not begin until about 11 - 12 years of age and continues until about age 25.

    The part of the brain responsible for Executive Function tasks, the prefrontal cortex, is the very last part of the brain to fully develop. 

    This is why car insurance companies charge higher premiums for drivers under 25 years old and why drivers under 25 years old are statistically more likely to get into an accident .

    Age-Appropriate Expectations

    Most people don't realize that Executive Functioning develops as you age. What is appropriate for a college-aged student is not appropriate for a middle school-aged student.

    For example: 

    Ages 6 - 11 / Elementary School

    • Increasing independence with self-care (bathing, dressing)
    • Becoming more flexible with changes in routine; fewer tantrums
    • Learning to keep track of their own things
    • Learning to manage their time with school tasks and estimate how long things will take.
    • Completing multi-step tasks such as setting the table, yardwork, cleaning their room
    • Collecting materials/equipment for own events (i.e. sports practice) and projects
    • Using a calendar or planner and execute long-term projects with guidance from parent


    Ages 12 - 18 / Middle School / High School

    • Learning to manage their time and multiple activities
    • Learning to see different perspectives
    • Increased independence with schoolwork and projects, but please note that some teens will still need some guidance with long-term planning as they do not see more than 2 - 3 days in advance.
    • Increasing problem-solving and critical thinking skills
    • Developing own beliefs and world views
    • Starting to see bigger picture but still do not perceive long-term consequences in the way adults do

    Overlapping or Closely Related Symptoms

    Executive Function weaknesses may be a symptom of another learning disability.

    For example:

    • Poor organization, use of planner, planning, and management of materials can be related to visual processing delays
    • Auditory processing disorder can cause difficulties with memory, note-taking, listening, and attention.
    • Core Learning Skills challenges such as retained reflexes and poor bilateral integration will impact working memory, attention, and distractibility, and regulation.
    • Weak language processing, comprehension, working memory, visualization, or processing speed can  impact following directions, planning, organizing, reasoning, time management, and follow through. 

    Executive function skills are higher level thinking and self-management skills that are supported by many underlying skills such as auditory, visual, and language processing, and bilateral integration.

    Executive Function Impacts on Learning and Adult Life

    1. How do Executive Function Issues Affect Learning?

    • Missing homework
    • Difficulty remembering instructions
    • Doesn’t notice or forget to do parts of instructions, test questions, assignments
    • Impulsive in class, lack control in school setting
    • Trouble getting started or finishing tasks
    • Lack of time management and follow-through
    • Difficulty planning and executing long term assignments
    • Poor note taking
    • Doesn’t know how to study for tests
    • Waits until last minute to start tasks

    2. How do Executive Function Issues Affect Quality of Life?

    • Forgetfulness
    • Losing things
    • Overbook, forget, or late to appointments/events
    • Difficulty managing family needs and commitments
    • Poor planning, organization, and time management
    • Difficulty regulating emotions
    • Trouble finishing things
    • Lack of tact may affect social interactions
    • Feel scattered and overwhelmed

    Executive Function Profiles

    Learn about the four Executive Function profiles, their characteristics and specific strategies to help your child based on his/her profile.

    Subscribe to our weekly newsletter to download this guide and gain access to more Executive Function resources.

    Testing Executive Function

    1. When To Get Tested For Executive Function Issues?

    When your child or teen does not seem to be growing in independence and needs more support than expected due to difficulties with:

    • Managing their time
    • Organizing their space or materials
    • Trouble reasoning
    • Waiting until the last minute to start a long term project
    • Can’t plan and organize projects
    • Lacks tact
    • Poor follow-through
    • Trouble getting started
    • Losing or forgetting things
    • Impulse control
    • Overly emotional
    • Being on time
    • Needs you right there in order to get homework/non-preferred tasks done
    • Can’t get started on tasks or homework on own
    • Starts things but doesn’t finish
    • Regularly brings unfinished schoolwork home for you to do with them 

    2. Where To Get Tested For Executive Function

    Stowell Learning Center - Functional Academic and Learning Skills Evaluation

    Here is what you can expect when getting assessed at SLC:

    1. Identify weak or inefficient underlying neurodevelopmental and cognitive processing skills at the root of the problem 
    2. Create a plan for eliminating the challenges

    The assessment and individualized Cognitive Learning Plan is very comprehensive. The Cognitive Learning Plan builds the underlying cognitive skills needed to support Executive Functioning, and includes training and coaching on specific Executive function tasks for increased independence and long-term success.

    What about getting tested by a neuropsychologist?

    A neuropsychologist will look for a root cause and may provide an official diagnosis. They may test for ADHD which is often considered a developmental impairment of Executive Function.

    They do not provide intervention, but will often refer you to a specialist such as Stowell Learning Center.

    What about getting tested by an Executive Function/ADHD Coach?

    An Executive Function/ADHD Coach will conduct an informal evaluation of Executive Functioning for the purpose of developing a coaching program.

    It can be very effective, but keep in mind that you may come up against roadblocks to Executive Function development due to untreated weak underlying neurodevelopmental and cognitive processing skills.

    Working with an Executive Function Coach is most effective after the weak underlying skills have been resolved, and the student is ready for more advanced Executive Function strategies such as creating a system to organize their digital files and maintain the organization.

    3. How Does Stowell Learning Center Test For Executive Function Deficits?

    Overview of testing

    1. Parent (and student) interviews and questionnaires help provide a picture of what the challenges look like and when they occur, as well as the student’s strengths and coping mechanisms
    2. Testing observations, continuous performance testing (IVA), perceptual attention testing (PATH), and reflex testing provide insights about attention and regulation. 
    3. Processing skills testing looks at the impact of memory, attention, auditory and visual processing,  processing speed, and reasoning on performance
    4. Basic academic testing uncovers challenges with reading, writing, spelling, math, or comprehension that may be impacting the student’s ability to pay attention and perform as expected in school.
    5. Behavior Rating Inventory of Executive Function (BRIEF) Parent Report and Self-Report version (as appropriate) may be used for ages 11 - adult.    
    6. This comprehensive approach identifies underdeveloped processing skills, specific areas of challenge with executive function, and strengths and challenges with various aspects of attention control.

    What to expect when coming in for testing

    • Testing takes approximately 3-hours with breaks whenever needed
    • Testing is one-to-one in a comfortable, engaging, nurturing environment
    • Parents will submit intake questionnaires in advance to help the evaluator get a more complete picture of the student
    • Testing activities are varied and the test battery is individualized to each student
    • Testing observations of behavior, approach to tasks, emotional and attention regulation, analysis of errors, and use of strategies as well as student input help create an overall picture of the student’s learning, Executive Function, and needs.
    Two Irvine clinicians holding a notepad and discussing treatment plans.
    Irvine center clinicians discussing treatment plans.

    Treating Executive Dysfunction

    1. What Does A Treatment Plan Look Like?

    Here’s what a treatment plan for Executive Function might look like.

    Take note that each student’s plan will be a little different because each student comes to us with a different combination of strengths and challenges.

    Cognitive Learning Plan Objectives

    • Increase auditory and visual processing, working memory, concentration, and processing speed
    • Increase listening and reading comprehension, attention to detail, and reasoning
    • Increase study skills
    • Increase executive functioning and application to home and school
    Signature Program - Step 1

    Programming Recommendations:

    • The Listening Program - Level 1  (TLP-Online)
    • AMPS - Metacognition  (Attention, Memory, and Processing Skills with an emphasis in planning, goal-setting, and thinking about one’s own thinking, or meta-cognition)

    Recommended number of hours per week: 4 hours (1 hour sessions 4 days per week)

    Recommended home follow-up: Daily home listening

    Based on the recommended 4  hours per week, it is estimated that Step 1 programming will take approximately 5 months to complete. 


    Programming Recommendations: 

    • The Listening Program- Level One (TLP-Online)
    • Auditory Stimulation and Training- Comprehension and Study Skills
    • Executive Function Training

    Recommended number of hours per week: 4.5 hours (1.5 hours per day 3 times per week)

    Recommended home follow-up: Daily home listening; application of skills into school and homework

    Based on the recommended 4.5 hours per week, it is estimated that Step 2 programming will take approximately 5 months to complete.

    Stowell Learning Center student smiling and wearing headphones for a listening therapy session.
    Stowell Learning Center student wearing headphones for a listening therapy session.

    Results of Executive Function Treatment

    1. Why Do Treatments and Strategies Fail?

    Has your child been treated for Executive Function weaknesses, but you haven’t seen results? Or have you tried multiple strategies to coach your child but nothing has changed?

    There are several reasons, but these are the most common ones we find:

    • Several unidentified weak underlying cognitive skills are blocking progress
    • Jumping into Executive Function strategies without developing the weak underlying cognitive skills
    • Lack of practice because parents or teachers micromanage
    • Lack of persistence and partnership with parents


    • Trying to use a planner when poor visual processing makes copying difficult and the organization of the planner pages confusing.
    • Learning note taking strategies when poor auditory processing causes the student to have to put all their mental effort into listening and trying to lip read.
    • Applying time management strategies when retained reflexes and underdeveloped core learning skills cause impulsivity, a general lack of awareness, and poor sense of time passing.
    • Planning a project or assignment without a solid ability to visualize in order to predict, remember, and sequence steps and “see” what the end will look like.
    • Applying problem solving strategies when the student lacks the ability of inner language to visualize and reason through multiple solutions.

    2. How Soon Can I See Results?

    Most of our students attend 3 - 4.5 hours per week and are with us somewhere between 9 and 24 months. However, students with severe executive function issues or more weak underlying skills that need to be developed may require a longer course of treatment.

    Doing an Intensive Program (10 - 20 hours a week for 6 - 8 weeks) is highly effective for our Executive Function students and can condense six to nine months of therapy into six to eight weeks.

    Case Study

    View the details of a high school student's treatment plan at Stowell Learning Center, and his measurable improvements.

    Executive Function Resources


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