Parenting the Mental Health Generation

What is executive function and how do I help my kid build it at home?

October 18, 2022 CATCH, Community Action Together for Children's Health Season 2 Episode 2
Parenting the Mental Health Generation
What is executive function and how do I help my kid build it at home?
Show Notes Transcript

Have you spent hours arguing with your teen about cleaning their room  or taking out the garbage when they couldn't seem to even start the chore? Wondering why your middle schooler couldn't start their homework?

In this episode of Parenting the Mental Health Generation, Amy and Lisa talk with Stacy Mautner, an ADHD and advocacy coach about these latest buzz words, Executive Functioning (EF). What is it? How do you help your child build these skills? How do you  set realistic expectations for YOURSELF as the parent? And, what is negotiable and non-negotiable when helping your child build their executive functioning skills?


SHOW NOTES:
How to contact Stacy Mautner for ADHD and advocacy coaching
Email podcast@catchiscommunity.org with topic or guest ideas! 

We know this to be true;  it can be lonely and scary when parenting a child struggling with their mental health. Community connection is very important. And, CATCH is community.  Lisa and  Amy will show up in this podcast every month to connect with you. 

Take this 30 minutes for you and join our conversation.

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Amy O. (00:03):

We are about two months into the school year, and you've probably started to notice some patterns forming and how your kids approach their chores, homework, and other daily activities. In the spirit of October being ADHD Awareness month, we will learn some strategies to help your kids with their executive functioning skills. Welcome, I'm Amy.

Lisa (00:25):

And I'm Lisa. And we're the hosts of Parenting the Mental Health Generation. It's difficult to parent a kid struggling with their mental health and it can be really lonely. Here, we lay it all out together and discuss the topics that concern us on our parenting journey.

Amy O. (00:42):

Today we're speaking with Stacy Mautner, founder of Stacy Mautner ADHD coach and Advocate LLC and a CATCH board member.

Lisa (00:54):

Stacy is here to help us break down the buzz term executive functions, provide some signs that our kids might be struggling with their EF skills, and share some tips and tricks to help support your kids at home.

Amy O. (01:07):

So put in your earbuds, take this 30 minutes for you, join our conversation with Stacy Mautner

Lisa (01:16):

Hi Stacy, thanks so much for being here with us today.

Stacy Mautner (01:20):

Hi guys. Thank you so much for having me.

Lisa (01:24):

I don't know about you, Stacy, but I have been getting a lot of inquiries lately and a lot of parents just expressing some questions and concerns about what they're seeing at home in their kids. What might be normal behavior and what might be of concern. You finding that too?

Stacy Mautner (01:41):

Absolutely. I'm actually getting a lot of inquiries right now about concerns about executive function and how it's playing a huge role for them in school and at home as well.

Lisa (01:52):

I think we have so many questions for you about what you're seeing and hearing specifically and of course what parents can do about that. But before we dive in there, do you mind just helping us break down this big buzz term executive functions and help us understand what that really means?

Stacy Mautner (02:12):

Executive function. I love that you said that. It is buzzword. We often as parents are hearing this word from teachers,here teachers are saying your child may be struggling with executive function and then that kind of leaves the parent to figure out what that means. And so there are many different layers and many different ways in which our brain is impacted. And when it's impacted, it's called a deficit. And so what's really important is that with executive function deficits, that we teach explicitly what those skills are. So that is different than a developmental skill that will just develop over time. So some of the areas of executive function are organizing and prioritizing, activating ourselves to work, focus, sustaining attention. Emotion is a huge aspect that I don't think a lot of people are able to recognize as a part of executive function. Working memory is a huge part of it. Metacognition and understanding how we learn and looking at the environment around us and being able to self monitor ourselves and our actions to be able to know what to do.

Amy O. (03:34):

Stacy, can I interrupt you for just a second? Are there metrics by which executive function is measured by age, by grade, or is it the same thing as sort of developmental steps that we look for as parents?

Stacy Mautner (03:52):

Right, so that's a great question. So it's not necessarily age appropriate because we have these expectations and when individuals cannot rise to meet those expectations, that is kind of where we're coming into of what am I missing and how do I look at it a little bit differently than my child can't do it? We have to look at why is your child or why are you as an adult struggling to be able to do something? So a super busy mom who puts the laundry in and then gets busy doing something around the house or goes to run errands and before they know it, it's nine o'clock at night and they've totally forgotten to flip over that laundry. And so what happens is the next morning you might wake up and go, Oh my gosh, I never flipped over the laundry. Now my wet clothes have been sitting in the washer and now I have to rerun this again.

Amy O. (04:47):

That has absolutely never happened to me. <Laugh>

Lisa (04:50):

Oh my gosh, me either.

Stacy Mautner (04:51):

That happens to me all the time.

Amy O. (04:53):

Often why I smell like a wet rag

Stacy Mautner (04:56):

<Laugh>. Good thing there's good detergents for that, that we could pull those smells right out. Working memory is a huge, is a huge part of our executive function, so I wouldn't necessarily say it's age appropriate or that you're missing certain skills younger and you know, you have certain skills when you're older. It really is identifying the lagging skill set and plugging in that hole to meet you where you're at right now with whatever age you're at.

Lisa (05:25):

I would add to that, you know, I do think there are certain expectations that that we have of people in different age groups and different age ranges, right? If we tell a three year old to clean up, that might not even be a developmentally appropriate ask because it's way too broad. And instead we could maybe say, can you go pick up those specific toys and put them in the bin? Whereas perhaps with a teenager when we say, go clean your room, there's an expectation that they're able to break down that task on their own and understand all the different elements that they need to do in order to complete that. And then when somebody isn't able to do that, perhaps they do have that lagging skill in terms of their organization, their task initiation or completion, their breakdown. That certainly relates to a lot of the work that I do as a neuropsychologist where when people come to my office and we're testing for these executive functioning skills, we are always comparing them to other children or adolescents their age. Yeah. To say, you know, is this developmentally appropriate and expected it at this age level or are you not yet able to do the things that most typically developing same aged peers are able to do?

Stacy Mautner (06:42):

You brought up so many great points in that scenario that you just talked about that I would love to reflect back on. So what you are suggesting in that last part of your comment was that bell curve, when you're doing that neuro evaluation, you're comparing that child's scores to that of the similar age group of peers. And what would be interesting to know about are those neurotypical kids or are they neurodiverse? So if there is neurodiversity, it's a lens of adhd. So I don't want to combine ADHD and executive function, but we know with the way that the brain has developed with those who are identified with ADHD have a 30% developmental delay compared to their peers. So when we're looking at those bell curve results, it would almost be interesting to actually break down the kids who were tested beyond the knowledge of they just fit that age group.

Stacy Mautner (07:43):

To circle back to your initial comment, I love what you said about the three year old, so let's start there for a second. When you're working with a toddler, you are exactly right to say clean up. What does that mean? Like that is such a broad statement for a three year old. So you have to be very explicit to say, clean up the crayons. Where do the crayons go? So you're walking them through the step, you're telling them what to clean up, but you're also scaffolding that support to them. So they know, okay, once I clean up the markers, now where do they go? You're explicitly teaching that skill for that three year old to grab onto, so then they could transfer that knowledge and apply it to something else. Now going back to that high schooler who you're saying, clean up your room, your room's a mess.

Stacy Mautner (08:38):

If we are in an environment that is so overwhelmingly messy, a person with executive function is going to feel overwhelmed within that environment and then they're not going to know where to start. So what might be helpful for parents in that situation is even just having a warm body in that room and just saying, Okay Lisa, you've got a lot of clothes on the floor, I'm asking to clean up your room, so what does that mean? What does that look like? And so hopefully your teenager would be able to say, I need to put my clothes in the hamper. Awesome, let's start with that. Then you might look at your desk and say, You've got a lot going on or any of these materials, something that needs to go back to school. If so, what do we need to do with those materials so we make sure that we don't leave for school tomorrow morning without those items?

Stacy Mautner (09:35):

So just kind of walking them through what is going on in their room and how do we clean it up or where does it go? You're walking them through step by step and you're scaffolding that for them, but you also want to make sure that you're doing it in a calm tone. We all feel as parents that our kids should be able to clean their room, but there is something going on with them or they might feel so overwhelmed and so they can't start with their task initiation, which is a part of executive function. And so if it's something that doesn't excite them, interest them, motivate them, we struggle to get started.

Amy O. (10:16):

So Stacy having raised two kids, both of whom were teenagers at one point, neither of whom ever cleaned their room. Yeah. Are you suggesting in that scenario with the teen that the family has identified executive functioning deficits in their child? Or are you suggesting that parents of teens who want to help their kids improve their executive functioning skills regardless of diagnosis, that kind of scaffolding and is it is a, an important way to parent?

Stacy Mautner (10:48):

Right. So that's a great question. So based off of that scenario, I am not identifying that that child has executive function deficits. What I'm identifying is that child needs some support. And so that's what is super important is that as parents we're offering these scaffolds for them not to minimize what they can do, but also to help lower our own expectations saying, have I set my child up with the skills that they need to be able to clean their room? How can I come in and support my child and let's just practice it and not say you're struggling with task initiation, let me help you. We want to show our kids, we are there to support them and we're not there to get angry because their room is a mess. But we're there to be able to teach them how to clean their room in a very safe, comfortable way. So our kids know that they're getting the support from you without feeling shamed for not being able to do something on their own.

Lisa (11:53):

And I would add to that, you know, to your question Amy, that when we are trying to tease apart, okay, what of this is teenager <laugh> and what of this is an actual, you know, deficit or area of weakness that we need to address differently? Yes. The thing that that we as clinicians always go back to is this idea of functional impact. And that's a conversation I'm having with my clients and their families a lot of the time. So if we take a different example, let's say of homework, Yeah. You know, you might be hard pressed to find kids or teens that are gung-ho about, you know, getting home from school and grabbing that snack and sitting at the kitchen counter and immediately opening up their books to do their work. But just because it's a drag doesn't necessarily mean there's, you know, a problem per se. The question becomes, is homework completion turning into a screaming match every night?

Lisa (12:47):

Are assignments getting turned in or are assignments getting completed I should say? But then the student is forgetting to turn them in? Is the student not able to actually complete their homework because they've forgotten what work they have to do or they've left the materials they need at school. Those are signs that are going to create that impact that perhaps there's something more going on as opposed to the child that's maybe a little bit resistant and wines a little bit, but once you get them sitting down, they are in fact equipped with the materials they need and able to get that work done. Yeah.

Amy O. (13:21):

So just to clarify, as part of what you guys do, I mean I know Stacy's a coach and you're a diagnostician Lisa,. But as part of what you guys do, is try to help a family determine whether or not this sort of impact that you're describing functional impact is diagnosable or is just normal. In other words, are you always trying to sort of understand how, help me understand the difference between someone who needs to be treated mm-hmm <affirmative> for ADHD or executive functioning deficits and someone who, and some child who just sort of normally struggles with the things as they're growing and developing. Does that question make sense?

Lisa (14:05):

Yeah, it, it does. And I can take that one because I do it all day every day. Yes.

Speaker 4 (14:09):

I would love for you to take that one

Lisa (14:12):

<Laugh>. It it is, it is really sort of very much what what I just described there in terms of thinking about the impact. But I think it's important to tease apart here the fact that executive functioning challenges are in fact a symptom of a lot of different things. One of which is normal development <laugh> and to some capacity. Yes. One of which is certainlyADHD and then many of which are other things like anxiety or depression or autism spectrum or just, you know, trauma. Many other things that could create executive functioning challenges. And so that is my day to day job is trying to figure out this, what we are seeing. Is that part of typical development, does that seem to span outside of what we would expect for typical development? And if it does seem to span outside of that, what are the underlying mechanisms making it hard for that student to achieve success in those ways, which of course helps to guide the intervention. What I will also say though is that even without a diagnosis or a label, if anyone is struggling with these skills, there is always room for support. And that's where I'm going to throw it back over to Stacy.

Stacy Mautner (15:25):

Yes. Yeah.

Lisa (15:26):

In terms of how, how we can help.

Stacy Mautner (15:28):

I love

Amy O. (15:28):

It. So you know, past task initiation, which you kind of went through with the teenager cleaning his room. Yes. Or her, what are there, what other supports at home are crucial for parents to understand when kids are struggling with their EF?

Stacy Mautner (15:45):

Let me just piggyback off of what Lisa was saying to get started. So I love like the diagnostic work is really where Lisa comes in. That's that neuro valuation. The individual, whether it's a child or an adult, doesn't have to be identified with ADHD per se, but what they're noticing is those lagging skills and how it's affecting their day to day and their ability to feel success. Right? So my goal as a coach is to set up the student with some strategies at home and some strategies at school that can support the success of these lagging skills by identifying these common patterns. So when we look at task initiation with homework, there's a lot of these executive function skills that overlap each other. So let's just start with your child comes home no matter what the age is and let's just say they have homework in math, in reading, and then they have science and again this is where we need to scaffold and support our skill set because often when kids come home with multiple tasks, they don't know where to get started or how to get started.

Stacy Mautner (16:59):

So now we're looking at more pieces of executive function. The organization and planning organization doesn't necessarily mean the physical in like the physical being and environmental it also means organizing your thoughts and being able to organize the structure of how to break things down into task one, test two, test three. So it's organizing and planning go hand in hand with that. And then prioritizing is another executive function and procrastination. So all of these things are working together against a child who is struggling to get started. So it's really about finding out what feels hard about getting started on homework. Is it just I am uninterest in this homework assignment, therefore I'm procrastinating and pushing it off? Is it class was super hard and I don't really understand the material, therefore I don't want to get started. And maybe how I'm showing that is I'm going to now have an emotional breakdown and start fighting with mom and dad and with a brother or sister that's in the house.

Stacy Mautner (18:18):

So we have to look at that behavior. That's the sign that's your child's way of communicating. It's not the problem. The problem is what is causing that dysregulation. So if something feels too hard, we want our kids to know what part of this homework feels too hard and if it feels too hard, how can we solve that problem? So there's really all of these executive function skill sets that are so important to be cognizant of and why it's impacting your child and how it's impacting your child. So we want to get ahead of it, we want to be proactive. So if your child is coming home with three homework assignments, we want to think about well how do we prioritize in itself? Right?

Amy O. (19:06):

So Stacy, what I hear you saying I is,

Stacy Mautner (19:09):

Yeah,

Amy O. (19:10):

You could see your kids sitting at the kitchen counter refusing to do his homework, you know, slamming the backpack down and pouting and, and that's what you see.

Stacy Mautner (19:20):

That's the behavior.

Amy O. (19:21):

And that's the interaction that you're having. But what's really happening behind the scenes could very well be this whole list of executive functioning skills that are overwhelming him and with some scaffolding, with some supports, with some understanding of that you can allow him to feel safe to start the task to be in the task because they know then that they're going to have those supports moving forward to get through it.

Stacy Mautner (19:46):

Yeah, exactly. And so really like the non-negotiable is that the homework has to get done, The negotiable is how it gets done.

Amy O. (19:55):

Mm-Hmm <affirmative>. Yeah. Yeah,

Lisa (19:56):

I was just going to say, you know

Amy O. (19:59):

It's really helpful.

Lisa (19:59):

It's fascinating how truly opposite strategies work best for different people. Like with the simple example of do we start with the easiest assignment first to kind of get the ball rolling and then once you've initiated your homework, then you can tackle the harder things. Or are you the kind of student that needs to tackle the hardest thing first so that mentally it's out of the way and then you're like, oh okay the rest is easy, I can just get that done. And until you do the digging that you're describing, you don't really know how that student is going to best respond to that work. I find it even as an adult, as I write my reports, I'm the kind of person that gets the hardest section that requires the most thinking done first because then the rest feels like a breeze. And my business partner sometimes likes to just get her feet wet with the easier parts and then work her way up to the, to the harder ones.

Stacy Mautner (20:50):

I love that you're saying that. Yeah.

Amy O. (20:52):

When you guys are dealing with families, do you run across parents who are either confused or challenged by, But wait a minute, isn't my kids supposed to be able to do this on his or her own? Like I'm not going to help with the homework or taking out the garbage or walking the dog because I'm supposed to be teaching them independence and you know, self-confidence and reliability on their own skills. Yeah. Like how do you balance that sort of challenge within your brain as a parent?

Stacy Mautner (21:23):

Again, our expectation is my child is 15 years old, they should be able to take out the garbage. But now let's break that down. Is taking out the garbage, interesting, motivating, rewarding, Those are the things that we need to get ourselves typically to do something. So now going back to that mindset, the difference between neurotypical and neurodiverse. If you're neurotypical you can easily do something. Actually, let me say that again. Not easily do something, you can do something even though you are not motivated, not interested, don't feel a reward from it because you're able to have that skill set and and the brain function to just know if I just get it over with, it's done. But not for the neurodiverse brain. That's not how our brain works. And so again, the non-negotiable is you have to take out the garbage. The negotiable is when you take out the garbage and making that task into a an, and I'm not saying a monetary reward here, but making it into some way that your child feels an internal reward for doing something good.

Stacy Mautner (22:44):

This reward pathway then brings out the motivation that we can keep doing and doing good. Like when you're younger you might have a sticker chart. When you're older you might want to create some sort of system like to gamify something, some sort of a chart that might represent a game. And like every time they take the garbage out, they move forward on this game board. Well what happens when they get to the finish line? Do they get their weekly allowance? If they don't take out the garbage, maybe their weekly allowance isn't as much money. That is just something to consider. The more that we could as parents scaffold what feels hard and teach them the skill set of what feels hard, the more support we're giving, but we don't want to do it. So there's a difference between doing and scaffolding

Lisa (23:39):

And Amy I would add that the ultimate goal is independence and self sufficiency. That is what we want for our kids. There's no doubt about that. But in order to do that, the child has to feel like they can be successful and we have to truly be setting them up for success. And so if we are kind of leaving them hanging to dry without the skills to do those things in the spirit of hoping they'll build their independence, it may inadvertently have the adverse impact. Right? They may end up feeling shame and guilt and sadness and depression and all these other things that are going to make it that much harder. And so yeah, if we start by providing a lot of support than the idea is that slowly over time we can provide less and less and less support and have them move to that place where they can function more independently.

Amy O. (24:32):

I like how Stacy uses the non-negotiable and the negotiable. Yes. I think that's a really good message for parents to remember. You know, the non-negotiable is you've got to get it done. The negotiable is how we're going to get there

Stacy Mautner (24:43):

Or what time

Amy O. (24:45):

Or what time or when. Mm-Hmm. <affirmative>, We could probably talk to you for the rest of the morning Stacy, but we are going to have to wrap up shortly. Is there anything else that you want to share with our audience along the lines of the conversation that we've had thus far before we sign off? And maybe we'll invite you back to continue this conversation again another time.

Lisa (25:09):

Any other tips or tricks that you find yourself giving over and over again to families these days that just seem to be so helpful?

Stacy Mautner (25:17):

Yeah, so I have so many things that I would love to share and I agree with you Amy. I could talk to you not just all morning, I could talk to you all week long about this <laugh>.

Stacy Mautner (25:28):

What I really want to say is really think about the expectations we set for our children. And if our children are not able to rise to that expectation, we have to think about the why. And then we have to be able to meet our kids where they're at. So if they're not able to do something but they're 15 years old and you know, a 15 year old has no problem doing this, we have to look at why are they struggling, what do they need help with? Is it uninteresting or do they not know how? Is it overwhelming? Can we break something down into parts? So we want to understand why they aren't able to reach our expectations. And then we need to as parents lower our expectations and provide them with the scaffolded support to teach them explicitly the skills that they need. And then after time and practice, we then back away and hope that they can rise to our expectations.

Stacy Mautner (26:29):

And if they don't rise then we have to go back again. So it's kind of like repeating those steps. And so we always want to talk to them in a way that doesn't allow our kids to feel shamed and just to like talk to them about what is feeling hard about what I'm asking you. Is it because you would prefer to play on technology? Well I get that that's a preferred task. This is a non-preferred task. But we have to, again, as I keep saying the non-negotiables, our homework, our chores, our responsibilities are non-negotiables. But the when the how those are negotiable. So then we have to be open to being flexible with our thinking because it might not match our timeline, but at least it's getting done. So we just want our kids to feel success.

Amy O. (27:17):

Gotta let go of some of that control. Oh. Spaghetti's. <laugh>.

Stacy Mautner (27:22):

It's so hard. I know. We all struggle with that. Yeah.

Lisa (27:26):

Yeah. Stacey, thank you. Thank you for your time, your wisdom, your humor, and your commitment to our community's mental health. We have loved this conversation.

Stacy Mautner (27:36):

Thank you.

Amy O. (27:37):

Yeah, it was great.

Stacy Mautner (27:38):

Aww. Thank you so much for having me.

Lisa (27:40):

And thank you to our listeners for tuning into another episode of Parenting the Mental Health Generation.

Amy (27:47):

We'll see you again next month.

Lisa (27:49):

Stay current on our all of our CATCH programming by liking us on Facebook @catchiscommunity or by visiting our website www.catchiscommunity.org.