Executive dysfunction is a buzzword phrase these days. This is great, because lots more parents are aware of this specific set of struggles and recognize that it can be observed in children (and adults) with a variety of needs. Executive functions are essentially the constellation of skill sets needed to be human. They separate us from animals. These are functions like inhibiting automatic responses to stimuli around us, using flexibility to switch gears on the fly, using our brain’s proverbial “gas” and “brake” pedals, fluently coming up with solutions to problems, using advanced reasoning skills to connect the dots we see around us, and regulating our attentional and emotional centers. I work with lots and lots of children who are delayed in the development of these skills. Executive dysfunction can be linked to ADHD, learning differences, mood disorders, autism spectrum disorders, or acquired injuries like a head injury or brain tumor (among many other diagnoses). It’s easy to see when these skills don’t work properly, leading to struggles with planning, organization, emotional and behavioral control, and the ability to prioritize. The “fixing it” part is much harder. There are lots of options for building executive functions, including interventions led by a psychologist, group or individual academic organization training, parent training to support household functions, and even computerized programs that cite their ability to rewire the brain. My background is in cognitive rehabilitation, so I am very familiar with direct intervention for executive dysfunction and know firsthand that children can learn these skills with direct practice. The computerized programs that tout revolutionary and drastic changes make me more wary. Executive functions are a complex set of skills and simply “hooking in” to a computer program is unlikely to create the kind of change that generalizes easily into the real world. However, I do believe that every parent and household has the ability to support development of executive function in their children.
Building executive functioning skills can happen organically through real world exposure and simple maturation. The frontal lobes, which manage many of your executive functions, are not fully developed until around 25 years old. However, a “wait and see” method is unlikely to work for children and adolescents with true executive dysfunction. These skill sets can also be developed through deliberate practice. Making progress often feels slow and practice can be difficult and boring. Many of the programs that are readily available, if you can find the right provider, are rather dry and work to build behavioral strategies to support functions. I provide this type of service and I know that it can help. It’s just not that exciting most of the time. However, you can work on lots of executive functions through simple activities and without having to buy anything.
With COVID restrictions, my extended family has not been able to get together as a group as much as is generally the case. At those “shindigs,” which usually happen every other month or so, we always include some degree of gameplay. I am a game enthusiast. Maybe I just like to win (ahem). We play board games, card games, domino games, dice games, quiz games, and strategy games, and it is some of the most fun that I have. In my own immediate family, we also spend regular “family game nights” playing cards or board games. This simple act of getting together for fun can be a prime opportunity to build and practice executive functions. It also helps parents and kids interact around fun activities, not just the drudgery of daily home, work, and school.
Games that delay rewards are especially useful. This requires the child to practice sustained attention, planning, working memory, and inhibition. Board games such as Monopoly, Chess, or Clue can help build these skills. My family leans toward strategy games like Catan, Tsuro, Pandemic, which require you to plan, adjust flexibly, and execute a long-term strategy that plays out over time. My very favorite (which no one will play with me anymore) is Dark Tower, a cult classic electronic board game from the 80’s. Even games for small children like Candy Land and Chutes and Ladders offer a chance to work on counting and color recognition, but also lend themselves to lessons needed to develop social skills like turn taking, sportsmanship, and inhibitory control. Although most parents try their hardest to limit and control video game play, problem-solving video games can provide this type of practice as well. For example, The Legend of Zelda requires a sustained effort over time, without immediate gratification and real-time wait periods that keep sessions to a reasonable time each day but build increasing strategy over weeks. SimCity, and other organization-based games, require bursts of short-term attention, delayed rewards, and strategy skills for achieving long-term objectives. Managing a fantasy sports team is a great example of bringing executive skills to real-world problems as it requires a coordinated, long-term effort, regular check-ins (pacing), and a reward that is delayed for months.
There are also tech companies building gaming platforms specifically to address executive functioning deficits. This is not an endorsement, as I don’t have the personal experience to speak to this one directly. EndeavorRX received FDA approval as a prescription-only gaming system to improve attention. Mightier.com uses a tablet and smart-watch (to monitor heart rate) to help students practice self-regulation and emotional regulation. I have had a chance to play with this one (I forced my kids to guinea pig it for me). Although they think the graphics are less than ideal, I love the integrated lessons and cues to use self-calming strategies that are usually taught in counseling.
It might not seem like it (because they are fun and kids usually willingly participate), but these games improve executive functioning skills in ways that can carry over to other more mundane uses like managing and multi-tasking homework, completing big projects (with long-term efforts and delayed rewards), and even studying for exams. Take some time out of your day or week to gather your crew together and play. Pick a game, any game. Almost all will require some degree of executive function and can be dusted off and brought out for some fun brain work.
