Are you a school-based OT who knows executive function is important, but doesn’t know how to address it? Executive function is one of the most important areas we can consider when working with older students. Here’s your crash course on what exactly this means and the strategies you should be implementing with your middle and high schoolers.

What is executive function? 

Executive Function (EF) is an umbrella term that refers to many different cognitive skills that help us complete daily tasks. EF skills include but are not limited to:

• Sustained Attention
  • Focusing on a task until it is done
• Task Initiation
  • Starting a task without procrastinating
• Metacognition
  • Thinking about thinking, reviewing performance
• Planning/Prioritization 
  • Figuring out the steps necessary to complete a task
• Emotional Control
  • Managing emotions to complete tasks 
• Goal-Directed Persistence
  • Continuing to work on a goal in the face of adversity 
• Flexibility
  • Revising plans as needed when conditions change 
• Organization
  • Gathering materials and information and creating ways to access them
• Response Inhibition
  • Thinking before one acts, stopping oneself from impulsive behavior 
• Stress Tolerance
  • Coping with uncertainty, frustration, or change 
• Time Management
  • Estimating how much time a task will take and allocating it
• Working Memory
  • Holding information in one’s mind while addressing other tasks 

If your student has difficulty with executive function, it’s possible that they could struggle with one of these areas but be great at another. It’s also possible that your student may be compensating for weak EF in one area with EF skills that are stronger in another. It’s also very common for students to be of average intelligence or even above-average intelligence and struggle with executive function. Occupational therapy treatment focuses on doing an activity analysis to see what specific component skill a student may be having trouble with. 

Why is executive function important?

EF skills allow us to effectively participate in a variety of activities, from academic work, to self-help tasks, to vocational tasks. Having deficits in this area can make participation in daily tasks difficult. Students with EF difficulties may have messy backpacks/lockers, may procrastinate, or may forget to turn work in. 

What’s the best way to remediate executive function skills?

Executive function is a complex set of skills that can be challenging to remediate. There are very rarely “quick fixes” – most remediation in this area requires consistent practice to be successful. It’s best to incorporate this practice into daily routines as much as possible. 

Important to note: 

Even with remediation, your student’s EF skills might look different from others and that’s okay. Everyone, disability or not, has a pattern of EF strengths and weaknesses. Sometimes if remediation isn’t successful, accommodations may be a good way to support EF weaknesses. 

Further reading: 

• Smart but Scattered
• Executive Functioning Workbook for Teens
• Free Executive Functioning Quiz

Tips for Building Executive Function: 

• Help your student keep consistent routines.
  • This is key to making these skills second nature.  
  • iOS Habit App
  • Google Habit App
• Schedule regular binder/backpack/desk checks.
  •  Use a rubric to help them figure out what components make up an organized binder, backpack, or desk.
• Use timers!
  • Teach your student to practice planning how long a task will take, and then checking against the timer. 
  • Timers can also help sustained attention, i.e. “You only have to work for 10 more minutes.”
  • Timers can also help with initiation of a task – if your student is having trouble getting started with anything, help them set a timer for 5 minutes and tell them they only have to work that long. Once they are in a flow, they will likely continue working. 
  • Pomodoro Timer 

• Teach them how to keep planners, calendars, and checklists (digital or physical).
  • https://ticktick.com/webapp/
• Use assignment tracking logs that delineate assignments and what must be done for them on a weekly basis.
• Help your student proactively build breaks into a schedule.
  • This can help motivate your student to continue pushing through as well as make sure they don’t overwork themselves to the point of being unproductive. 
• Consider minimizing physical materials.
  • Some students are able to manage digital files better than physical papers.
  • Digital textbooks may be easier to manage as well. 
• Help your student break big tasks down into manageable chunks.
  • This could be done verbally or by writing them out.
  • Once broken down, help your student set deadlines for each step of a big task.
• Ask leading questions instead of giving specific instructions.
  • For example, if your student has an assignment due on Friday, instead of telling them “You need to work on this tonight,” you could ask “What day do you plan to set aside time to work on your math project?” 
  • This helps develop independence and planning skills. 
• Teach your student how to use folders and other organizational tools within their Google Drive (or other digital organization systems).
• Provide organization systems for physical materials.
  • A place for everything and everything in its place!
  • Hooks for backpacks and jackets by the door
  • Desk dividers
  • Office supply organizers 
  • An “inbox” or mailbox 
• Teach your student to do a “mental dress rehearsal.” 
  • This simply means having the student practice visualizing a routine they have trouble with, such as remembering to bring homework to school. Help them break down each step, such as opening their backpack, taking out the appropriate paper, putting the paper back in, putting their backpack in the appropriate place, etc. It may sound silly, but it can help your student foresee unexpected roadblocks to completing this task. 
• Give your student support with directions.
  • Give directions in multiple formats (written and verbal). 
  • Check in frequently with your student for understanding.
  • Have them repeat directions back to you. 
  • Use visuals if needed. 
• Consider using color as a visual cue.
  • Use highlighters and teach your student how to use them.
  • Use color-coded folders/binders for each subject. 
  • You can also do this digitally via Google Drive.
• Use a reward system or positive reinforcement.
  • Executive function practice can be really challenging. Consider using a token economy that works for your student.

I hope these strategies are helpful! I would love to hear about any other methods that you’ve found work for your students. Let’s continue the discussion in my online group.

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