Executive function disorder (EFD) is the term for a trio of behavioral and neurocognitive symptoms that can affect people from childhood through adulthood. Similar to attention deficit hyperactivity disorder (ADHD), the three symptoms of EFD are hyperactivity, inattention, and impulsivity, and it is often mis- or under-diagnosed in children.
Executive functions, which include the ability to pay attention, organize, remember information, and keep track of time, are handled by the frontal lobe of the brain. It also includes the ability to regulate behavior. Kids with ADHD and some with learning disabilities may also have trouble with areas of executive function. ADHD has a clinical medical diagnosis, while EFD is a term that refers to similar issues that exist within this area of the brain’s management system. “EFD can be a reflection of ADHD,” explains Dr. Martha Bridge Denckla, “but it might also indicate an LD [Learning Disability].”
How Executive Function Works in the Brain
Within the brain, the three primary areas of executive function are:
1. Cognitive flexibility (or flexible thinking)
2. Working memory
3. Inhibitory control (which helps govern self-control)
In addition, executive function controls these important brain skills:
• Starting/finishing tasks
• Understanding different viewpoints/having empathy
• Controlling emotions
• Keeping track of activities
• Paying attention
• Planning, organizing, and prioritizing
Typically, these executive skills start developing during early childhood and continue to develop through the mid-twenties. Kids with EFD, however, develop these skills more slowly. Fortunately, many of them catch up during adolescence—and meanwhile, there are educational strategies that can expedite the process.
Signs of Executive Function Disorder
According to Understood.com, the warning signs of EFD include:
• Trouble paying attention
• Trouble managing emotions
• Trouble starting/finishing/switching tasks
• Trouble organizing time/project materials
• Trouble retaining information
• Trouble with self-control
• Difficulty keeping track of activities
• Easily distracted and forgetful
• Doesn’t think before acting
The Effect on Academic Performance
Because of poor retention and being easily distracted, children with EFD often have trouble memorizing and learning lessons. In addition, weaknesses in working memory and flexible thinking can make it difficult to solve multi-step math problems or shift from one math equation to another.
According to educational therapist Dr. Ruth Lee, kids with EFD are more disorganized than other children, and this lack of mental clarity can impact their decision-making skills. In a recent interview, Dr. Lee said, “Often these kids will get so wrapped up in the decision-making process that they never even start the task. Or, if they do begin, they’re constantly starting and restarting because they’ve thought of a better way to do it. In the end, they’re exhausted when the time comes to actually follow through.”
How to Help Kids with Executive Function Disorder
For parents and educators, there are a number of strategies that can help kids overcome the symptoms of EFD. One solution, Dr. Lee suggests, is to make checklists for every activity in the home—from brushing teeth and grabbing backpacks to doing homework.
According to Dr. Matt Cruger, Director of the Child Mind Institute Learning and Development Center, a child with EFD who has to write a book report might fixate on only two elements—writing the report and turning it in—without remembering that the book has to be read as well. That’s why Dr. Cruger recommends teaching kids to break down and organize every element of a homework assignment. Likewise, experts advise that a daily planner can help kids remember and organize tasks, both at home and school.
By offering constant, patient help with organizational skills, and by breaking down tasks to make them more manageable, parents can help their kids manage the frustrating issues cause by EFD. Eventually, the experts say, many of these issues will dissipate as kids get older and start developing more executive skills on their own.
If you suspect your child may be struggling with executive function disorder, he or she may benefit from a more individualized, more structured school environment. Visit K12.com to learn how to bring public school home for your student!