By: Alissa Talamo, PhD
Clinical Neuropsychologist, NESCA
Cody is a 17-year-old young man participating in 11th grade. He is a talented runner with a good sense of humor and he has achieved mostly Bs in his college preparatory and advanced college preparatory high school classes. However, Cody’s mother describes him as the kind of kid whose “head would fall off if it was not attached.” Cody has an English tutor who has helped him to organize his thoughts and writing throughout high school. He seems to run out of time with everything—homework, tests, showers, video games—unless his parents and teachers provide him with several reminders. He also has trouble starting and finishing tasks, even things that are important to him. For example, he wanted to apply for a job at Market Basket. His mother has emailed him the online application link three times, but he still had not completed it after two months. Cody wants to go to college and is hoping to be recruited by a men’s cross country team. So, his parents took him to see a neuropsychologist to see if he could qualify for extra time on the SAT. They had heard the term executive functioning and knew that this was an area where Cody struggled, but they did not realize how significant his challenges were until the neuropsychologist shared his test results. Cody and his parents were grateful to have a better understanding of Cody’s learning strengths and challenges and also to learn that executive functioning skills can be remediated throughout the lifespan.
What is executive functioning?
Part 1 of this blog defined executive functioning as the “conductor” of all cognitive skills and identified three main components:
- Working memory (the ability to hold and manipulate information in your mind),
- Inhibitory control (inhibiting impulsivity, to pause and think before reacting),
- Cognitive flexibility (the ability to adjust to changing demands).
Part 2 of this blog post highlights activities suggested to enhance the development of executive functioning and self-regulation skills during adolescence (taken from developingchild.harvard.edu booklet titled “Enhancing and Practicing Executive Function Skills with Children from Infancy to Adolescence.”). The full guide is available for download and describes many additional activities and games that provide ways for adults to support various aspects of executive functioning and self-regulation in adolescents (Center on the Developing Child at Harvard University, 2014). While neuropsychological evaluation can be extremely important for understanding an adolescent’s executive functioning profile and planning for postsecondary education, there are a number of activities that young people can work on at home in order to build their executive functioning skills.
Here are some examples of activities suggested for adolescents:
- Goal setting, planning and monitoring
- Help the adolescent identify short and long-term goals and think about what has to be done to achieve them.
- Help adolescents be mindful of interruptions (particularly from electronic communication such as email and cell phones).
- Sports — The focused attention and skill development inherent in competitive sports improve the ability to monitor one’s own and others’ actions, make quick decisions, and respond flexibly.
- Yoga and meditation — Activities that support a state of mindfulness may help teens develop sustained attention, reduce stress, and promote less reactive, more reflective decision-making and behavior.
- Strategy games and logic puzzles — Classic games like chess exercise aspects of working memory, planning, and attention.
- Study skills
- Break a project down into manageable pieces.
- Identify reasonable plans (with timelines) for completing each piece.
- Self-monitor while working
- When you don’t understand, what might be the problem? Do you know what the directions are? Is there someone you can ask for help?
- Think about what was learned from an assignment that was not completed well. Was this due to a lack of information, a need to improve certain skills, bad time management, etc.?
- Keep a calendar of project deadlines and steps needed to complete along the way
- Identify ways to reduce distractions (e.g., turn off electronics, find a quiet room).
Are you concerned your adolescent’s trouble with getting organized, starting tasks, or keeping his/her emotions in check could be related to executive functioning issues?
There are many things you can do to get the answers you need to best help your adolescent. The most comprehensive way to assess a child’s executive functioning difficulties and determine a cause is a neuropsychological evaluation. A comprehensive neuropsychological evaluation is made up of a set of tests, questionnaires, interviews, and observations that a clinician will use to gain a good understanding of a young person’s strengths and weaknesses, along with learning how the individual processes information and completes tasks. At NESCA, we offer comprehensive evaluations that can look for potential learning disabilities, attentional difficulties, and other challenges that can negatively impact a child’s executive functioning development. In addition, a NESCA evaluation will include explicit recommendations to address challenges that have been identified.
Also, if you want to learn strategies for helping a teenager or young adult develop executive functioning skills, read Part 1 of this blog!
About the Author:
To book a neuropsychological evaluation or consultation with Dr. Talamo or one of our many other expert neuropsychologists, complete NESCA’s online intake form. Indicate that you would like to see “Dr. Talamo” in the referral line.
Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email firstname.lastname@example.org or call 617-658-9800.