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You are listening to Supporting Supporters, a ChangetoChill podcast. This is a free mental well-being resource offered by Allina Health. My name is Tonya Freeman. I’m a licensed psychologist and regional lead psychologist with Allina Health.  

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Hello, and thank you so much for the warm welcome. My name is Jaime Zander, and I am a primary care psychologist with Allina Health, and I primarily work with children, adolescents, and families. Before we even get started, I want to say thank you so much for the important work you all do to provide a safe and supportive learning environment for your students. You have been asked to do some challenging and incredible work over the last few years, and I continue to be both impressed and grateful for ongoing collaboration and the amazing work you all do.

In this episode, I’m going to talk about executive functions and the essential role they play in self-regulation. Executive functions are important and essential self-regulating skills that help us all plan, organize, make decisions, shift between situations, and manage impulses. They also allow us to make in the moment assessments of our situations and adapt our behaviors accordingly. Throughout elementary school and well into adolescence and even young adulthood, these frontal lobe skills are being developed as children's brains grow and make important connections. These skills help kids accomplish everyday tasks from organizing their backpack to completing their morning routine. As these are developing skills, when requesting a child complete a task, it is first and foremost important to ask ourselves:

1.       Is what I am asking this child to do developmentally appropriate? 

2.       Is this specific child capable of doing this task that I’m asking them to do?

First, it is important to ask ourselves whether the skill or task we are requiring the child to do is developmentally appropriate for their age and developmental ability.

Second, there are many reasons why children may exhibit executive functioning deficits. I think executive functioning deficits are more commonly understood in the context of children who have previous ADHD diagnoses. However, executive functioning and other frontal lobe skills can be impacted for a variety of different reasons including trauma, mood and anxiety disorders, developmental delays, and even other neurocognitive deficits. Therefore, it is important to consider developmental history or what we know of a child's developmental history when considering a child's ability to self-regulate.

As there are so many different executive functioning skills, it would be difficult to discuss all of them today within the confines of this podcast episode. Therefore, I am going to be focusing on 3 different executive functioning tools that can be useful to help children who may be struggling in these areas and to further develop the skills independently. My hope is that utilizing these tools may help promote self-regulation and executive functioning skill development in addition to helping teachers and parents manage transitions and decrease frustration for the student.

1.       Planning

The necessary steps for completing a task are not always obvious for children who experience executive dysfunction. That is why adults who clearly define the separate steps to achieve the tasks can be significantly helpful in achieving the task. Often, children with executive dysfunction and planning deficits can get bogged down by decision-making fatigue or need to start and restart tasks due to challenges with distractibility. With each achievement, children can build self-efficacy and strengthen confidence in their ability to complete individual tasks. To help children establish basic routines or to accomplish a larger project, I always recommend the use of a checklist or schedule. Although this can sound simple, the use of a checklist or schedule can minimize decision fatigue and can set clear expectations for the task at hand. In particular, I am a big fan of the use of visual checklists or visual schedules. For younger children, this can be used for a morning or night routine such as pictures depicting waking up, getting dressed, brushing teeth, eating breakfast, and organizing backpack.  In the school setting, visual schedules can help with transitions, minimize surprises throughout the day, or setting expectations for group participation. For example, a school visual schedule may include cleaning up, washing hands, and getting in line.

2.       Time Limits

Time management is an executive functioning skill the combines both need for attention and focus, in addition to planning and organization. Therefore, those with executive dysfunction may have a difficult time grasping how long it may take to complete a task or feel overwhelmed by a large amount of small tasks. To help develop the skill of time management, it is often helpful for adults to regulate time for children by setting a specific time limit. This can be done in a variety of ways, but I particularly like the use of a visual timer. Visual timers allow children and adolescents to visually see how much time they have to complete a task or how much time is left during a certain task. This is particularly useful for younger children who have difficulty grasping and understanding the concept of time. Additionally, it can be very useful to allow for small, short breaks after a certain amount of time of focused attention.  For example, for children who may struggle with attention, it can be useful to set a timer for 15-20 minutes of focused attention, while allowing 10 minutes of a break for movement and/or rest. What is most important to remember, these breaks should not be used for time scrolling on the phone, video games, or other activities that require focused attention. These breaks are most useful when they involve movement, fresh air, or social connection.

3.       Positive Reinforcement 

Another way to foster the growth of many different executive functioning's is use of positive reinforcement, which can sometimes be known as praise or reward. The idea behind positive reinforcement in behaviorism is to encourage the behavior we would like to see. Children with executive dysfunctions are frequently redirected by the adults in their life and told what not to do for behaviors that are often difficult for them to manage such as regulating body movement and impulsivity. Therefore, it can be so helpful for both the growth of self-esteem and for executive function growth to provide immediate praise and affirmation for focused, on task behaviors. This can also look like instructing kids what to do instead of what not to do. For example, instead of saying “stop talking to your friend in class," instruct the child or adolescent on what the expectation is for the classroom environment. This may sound like "The expectation is that you talk to your friend during break or during free period," or "The expectation right now is that your attention is on the speaker."

I hope this information provided you with some tools or things to reflect on about encouraging the growth of executive skills. Here are, again, three things I would suggest trying out in the next few weeks just to see how they feel: 

1)      Help promote planning by organizing visual checklists or visual schedules for children or helping them break larger tasks down into smaller, more manageable goals. 

2)      Use time limits or visual timers to help promote time management skills. 

3)      Use positive reinforcement to promote self-esteem and encourage focused, on-task behavior. 

Thank you so much for your time! I appreciate you taking the time to listen.

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On behalf of Allina Health and Change to Chill, we thank you for taking the time to listen to our podcast. We do hope you enjoyed this episode and we hope that you join us in other episodes covering even more interesting topics with mental health providers. As always, you can find the show notes and any accompanying research and tools at the change to chill website at www.changetochill.org. In health and wellness, take care and see you next time!