What is executive functioning?

Executive functioning is a relatively common term used in the world of health care and neuropsychology which refers to the mental capacity to focus attention, to process information while completing other tasks, and to plan and remember instructions (1). This skill allows children to control impulses, filter out distractions, and prioritize action goals (1).

The development of EF emerges in infancy and continues developing throughout adolescence until early adulthood (2). EF is controlled by the prefrontal cortex and parietal cortex regions of the brain (3), and may also present as underdeveloped in certain developmental disorders, in Autism Spectrum Disorder (ASD), Sensory Processing Disorder (SPD), as well as in Attention Deficit Hyperactivity Disorder (ADHD) (3). During infancy, EF develops as a self regulatory function through regulation of behavior. As children grow older, higher order skills begin to develop, such as problem solving, self correction, and multi-tasking (4). It is important to remember that no one child is alike and that these are only developmental milestones which may vary from person to person!

EF is not a skill that children are born with, but develop through supportive environments and social systems. These include positive relationships with parents and peers. Through such support, the three main components of executive functioning may develop. These include mental flexibility, self-control and working memory (5). Mental flexibility allows children to respond to different demands in the environment while responding and shifting attention appropriately. Self-control allows children to regulate impulsive reactions, while working memory allows children to manipulate information presented to them.

When the management of everyday life tasks becomes a struggle for children, EF difficulties may manifest themselves through difficulties with self-regulation, task initiation, impulse and emotional control, planning, and flexible thinking. A few examples of how these may come about include:

  • Struggling to remember the steps required to tie shoes
  • Difficulty beginning a series of homework assignments
  • Trouble with transitions between activities
  • Struggles around following instructions
  • Completing weekly chores
  • Presenting with a messy desk and/or locker
  • Struggling to remember location of belongings

Areas of focus from an occupational perspective will primarily revolve around academic performance and social competence. What do these goals look like?

School participation (6):

  • School work is completed in a timely manner
  • Transitions in the classroom are made smoothly
  • Daily classroom behavior is cooperative

Social competence (6):

  • Development of collaboration with peers
  • Initiation of peer interactions
  • Classroom rules and expectations are adhered to
  • Communication is encouraged
  • Responsibility is assumed for individual actions

What are a few approaches suggested by occupational therapists? For concerns surrounding:

  • Working memory:

-Using images or social stories may help by providing organizing input. For example: routine and sticker charts, visual schedules

-Keep belongings in the same place everyday

  • Initiation of tasks: Breaking down the task into manageable parts
  • Cognitive flexibility: Providing structure through visual schedules to help ease transition
  • Self-regulation:

-Use first/then statements. For example: First we work on printing, then we can paint

-Provide 5-10 minutes of alone/quiet time for the child, such as coloring or playing quietly with toys of preference

-Provide time for self-reflection and expression of daily feelings

-Encourage physically and cognitively challenging activities, such as aerobic exercise during recess

-Deep breathing activities

-Include movement breaks and heavy muscle work: many children with sensory processing difficulties find heavy muscle work such as proprioceptive and vestibular input self regulating.

While implementing these strategies, it will be important to keep in mind that what works for one child may not work for another. EF is an important part of the developmental trajectory for all children, which enables them to function through activities which promote purpose, goal achievement, as well as initiation and regulation of behavior. Don’t forget to be creative! Helping your child with EF struggles holds great potential to help them become the best they can be when faced with life’s challenges!


  1. Center on the Developing Child [Internet]. Cambridge MA: CDC; c2017. Executive Function & Self-Regulation; [cited 2017 July 24]. 
  2. Lehto JE, Kooistra L, Juuiarvi P, Pulkkinen L. Dimension of executive functioning: Evidence from children. Br J Dev Psychol. (2003) December; 21(1): 59-80
  3. Lee K, Bull R, Ho RM. Developmental changes in executive functioning. Child Dev. (2013) November/December; 84(6): 1933-1953
  4. Growing Hands-On Kids [Internet]. c2017. What Therapists Need to Know About Executive Function Skills; 2016 Apr 7 [cited 2017 July 24].  
  1. Ringo M, Ho H. Developmental Changes in Executive Functioning. (2013). Child Dev. December; 84(6): 1933-1953
  2. North Shore Pediatric Therapy [Internet]. United States; c2017. Executive Functioning Skills: How Can I Help My Child? 2016 Dec 2 [cited 2017 July 24]. 


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