Executive function in children: Why it matters and how to help

Executive function in children: Why it matters and how to help

Executive function refers to skills that help us focus, plan, prioritize, work toward goals, self-regulate behaviors and emotions, adapt to new and unexpected situations, and ultimately engage in abstract thinking and planning. Just as a principal conductor would do for an orchestra, executive functions supervise and coordinate a multitude of cognitive, behavioral, and emotional tasks.

Executive functions in childhood are, by default, challenging. That’s because, although our executive function skills begin to develop in the first year of life, they are not fully developed until early adulthood.

Executive function in children

As with other developmental milestones, there is some normal variability in the time at which children reach executive function milestones. But some children experience greater-than-normal challenges or delays related to their executive function skills.

In some children, executive function issues present as trouble with impulse control, tantrums, and difficulty in self-regulating emotions. For others, challenges with school organization, time management, and remembering instructions are more visible. Adolescents who struggle with executive function often have a very difficult time reaching independence and making plans for the future.

Contrary to what we tend to think, executive functioning does not refer to a single ability, and executive functioning skills do not develop in a linear progression. The major components of executive functions include inhibitory control (the ability to control impulses); working memory (a type of short-term memory that involves temporarily storing and manipulating information); and cognitive flexibility, or shifting (the ability to switch between thinking about different topics). Each of these skills develops at different rates, with windows of growth and opportunity for intervention.

Executive function skills can be substantially fostered or hindered by environmental factors including early childhood stress, family structure, and educational opportunities. Fortunately, this means these skills are extremely malleable and amenable to improvement. Evidence-based interventions have been rigorously studied and have shown that children’s executive functions can be boosted following structured educational, neuropsychological, and socioemotional programs.

Promising interventions: Cognitive training, neurofeedback, and physical activity

Interventions targeting executive functions in children have exponentially increased in the last years. There is evidence of some benefit, which can vary depending on the child’s cognitive characteristics (such as language, memory, or intellectual functioning), family functioning, and underlying medical or psychological conditions.

Perhaps the most widely known interventions are those using computerized programs, such as Cogmed cognitive training, or neurofeedback, such as Mightier. These child-friendly interventions consist of relatively intensive training (for example, several sessions per week for five to 15 weeks) of specific executive functions, such as working memory or impulse control. There are consistent data backing up the use of these interventions. But critics question whether these improvements generalize to support improved executive functions in daily life.

There is strong evidence that certain school curriculums improve executive function in young children, particularly those using a Tools of the Mind approach. This educational approach involves a focus on teaching self-regulatory and socioemotional skills through dramatic play and cooperative learning. In these classrooms, children learn skills such as taking turns, active listening, and developing creative ways of problem-solving.

Interventions involving physical activity (such as aerobic exercise or yoga practice), as well as organized sports activities (such as soccer or basketball) and martial arts benefit the development of executive skills, as they require children to hold rules and strategies in mind, adapt flexibly to others’ actions, and monitor their own performance and behavior. Physical activity is also critical for getting blood (and therefore oxygen) flowing to the brain and for emotional well-being, which are in turn essential for children’s executive function development.

Promising intervention: Mindfulness

As we learn more about what improves executive functions, we also realize that stress is one thing that “freezes” children’s ability to apply executive functions appropriately. Chronic stress and anxiety, often due to family, school, or health issues, is one of the biggest risk factors for executive dysfunction throughout the life span, particularly in children, for whom the executive functions that help us to manage stress have not yet matured.

To tackle both stress reduction and executive function improvement at once, mindfulness training seems like an ideal candidate. Mindfulness training involves the practice of bringing one’s attention to the present moment, to what we are doing and what we are feeling, without judgement. Mindfulness interventions have been increasingly adapted to children of all ages via simple exercises of breathing, body scanning, gratitude, and kindness towards oneself and others. The emerging data are promising, showing that children who participate in mindfulness programs show less anxiety, greater concentration and memory skills, and handle difficult emotions better.

The take-home message

There is certainly not a one-size-fits-all intervention to improve executive functions in children. Typically developing children, and children with neurodevelopmental disorders such as ADHD, autism spectrum disorder, or learning disabilities, may respond very differently to each one of these interventions. Not all of them may be feasible or even appropriate for some children and families.

The best approach is one that considers each child’s strengths and vulnerabilities, as well as each individual family’s needs and functioning. For example, offering an overly intense computerized training to an already anxious and stressed child may not be the most appropriate option, as it would reduce the time they could have to unwind, exercise, and potentially practice emotional resilience.

Finally, regardless of the intervention, parent-child relationships are key. It is the parents’ and the family’s constant support, shared experiences, and time spent together enjoying everyday activities like reading books, cooking, or dancing that help scaffold children’s self-regulatory skills. These are, undoubtedly, the most effective and lasting executive function foundations.

References

Executive function skills

Interventions shown to aid executive function development in children 4 to 12 years old. Science, August 19, 2011.

Randomized Controlled Trial of Working Memory Intervention in Congenital Heart Disease. The Journal of Pediatrics, December 2020.

Cognitive training/neurofeedback

Adaptive training leads to sustained enhancement of poor working memory in children. Developmental Science, July 2009.

Computerized training of working memory in children with ADHD—a randomized, controlled trial. Journal of the American Academy of Child and Adolescent Psychiatry, February 2005.

Improving neurodevelopmental outcomes in children with congenital heart disease: protocol for a randomised controlled trial of working memory training. BMJ Open, February 19, 2019.

“RAGE-Control”: A Game to Build Emotional Strength. Games for Health Journal, February 2013.

Mindfulness

Mindfulness-Based Program Embedded Within the Existing Curriculum Improves Executive Functioning and Behavior in Young Children: A Waitlist Controlled Trial. Frontiers in Psychology, September 10, 2019.

Relating mindfulness and executive function in children. Clinical Child Psychology and Psychiatry, April 2020.

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