Compensating for Executive Functioning Issues People with executive functioning issues usually have difficulties in the areas of attention, impulse control, working memory, planning and organizing, monitoring one’s own actions, and multi-tasking. Neuroscience is in the infancy stage in the area of brain plasticity, and strengthening the wiring in the areas of the brain that have weak connections. So, for individuals with ADD and ASD, most strategies have focused on finding ways to compensate for those weaknesses; building in strategies to work around the issues. These usually include, (1) changing the physical environment to make the skill easier, (2) making modification in the task itself, and (3) teaching the individual coping skills to help them compensate for the given weakness. For example, in the area of attention/concentration these three areas may consist of: 1) Physical environment: Making modifications to the classroom to minimize distractions, sitting the child to face away from activity that may distract, using partition if needed to do work, taking the child out of the classroom for tests, etc. 2) Tasks modifications: Breaking the task down into smaller parts, presenting only one portion at a time, presenting page rulers/templates, written outlines to highlight important information, etc. 3) Individual coping skills: Sitting on exercise ball, chewing gum, and listening to MP3 player to facilitate attention; using visual schedules, to do lists, and task sequence lists to keep the person oriented to what to do and when to do it; setting auditory cues (alarms) on watches and smart phones to cue people into what and when to do something, and problem solving/task completion worksheets to outline the steps to complete. To compensate for weak executive skills, we usually need to provide the function “externally” to substitute for what the brain cannot do “internally”, until we can teach a “automatic routine” (habit) to take its place. The habitual routine takes the place of the need for the cognitive “thinking” skill they lack. When someone has good executive functioning, we assume they have the ability to inhibit their impulsive response long enough to use there “thinking skills” to appraise, evaluate, and execute what is needed. When the brain does not do that naturally, we have to provide that function externally (e.g. above strategies) until we establish a set routine that becomes automatic (habit). For example: 1) We may use a picture routine to cue someone into doing their morning routine, until it is repeated enough to become “habit”. Once the routine becomes “automatic”, the picture routine can be faded out. However, for every new routine, we may need to always start off with a visual schedule until the routine becomes habit. As the person becomes older he learns to always set up a visual list (check list, written steps) when starting new routines, until they become automatic habits. We use a habitual routine to by-pass the executive functioning (think it through) process. 2) A child who impulsively blurts out comments while the teacher is talking can be taught (prompted and practice) raising his hand before talking. The teacher has to prompt, practice and reinforce until it becomes habit. We might also place a visual cue card for raising hand (no talk, raise hand) on his desk to visually remind him. Once this behavior becomes habit, we can remove the cue card. 3) A child who has difficulty rushing through tasks and doing a sloppy job may be given a visual model, or photo, of the finish product to match his work to. He matches what he does to the visual model. Once he can complete the product accurately, we can fade out the visual cue card. As you can see, in all of these examples, we are not necessarily improving the executive functioning skills, but providing the missing function “externally” until it becomes a habit, which by-passes the need for the cognitive (thinking) mediation. Just like all of us, we need to develop strategies to compensate for our weaknesses. By focusing on developing our strengths, and compensating for our weaknesses, we grow stronger! This series on executive functioning can be found in the blue book, Autism Discussion Page on the Core Challenges of Autism.
Posted on: Sun, 30 Nov 2014 13:09:15 +0000
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