Parent's guide to children with Executive function disorder

Rebecca Branstetter, book, The Everything Parent's Guide to Children with Executive Functioning Disorder, is an easy to read book that focuses on presenting strategies to help children who struggle with executive functioning to learn skills and become more successful. The book has four main sections:

• introduction- what is executive functioning (EF), how does it develop and what disorders are commonly associated with it
• discussion of each area- 10 chapters focusing on different skill sets and strategies to help develop them
• home life- what can you do at home- routines, advocacy, parenting and self-assessment
• appendix- checklists of strategies for each skill area.

Branstetter divides executive functioning into ten areas: task initiation, response inhibition, focus, time management, working memory, flexibility, self-regulation, emotional self-control, task completion, and organization. She discusses two important issues. One, while some specific disabilities are often characterized as having some executive function issues, not all EF occurs with a disability. We all know someone who is chronically late, or whose room/office/desk is always a mess or who frequently puts his foot in his mouth, who has no disability. It is important to normalize these concerns. That being said, they are skills that can be improved through instruction or compensated for through actions. Two, EF skills are highly heritable and environment can reinforce good or bad EF skills. Often parents struggle with the same skills that their children struggle with and parents who are working to improve problem areas are modeling self-improvement and development in a healthy manner.

Another key idea of Branstetter is to limit focus. We cannot solve the problems of the world in a day, nor can we take a child whose life is a chaotic mess an expect to improve every aspect in an afternoon. Select one thing at a time and expect to spend some quality time on it. Do not get frustrated because initial attempts are not successful. Not all strategies work for all people. My daughter's method for getting homework home, completed and back to school would make me nuts, but it works for her. Some people respond well to word based checklists, but others need more detailed picture cues. Some need a break from school before they start in on homework while others need to keep going in the academic vein. Know your child. Children with EF concerns need to find the methods of support that work for them, not ones that work for the adult. That being said, it takes longer for these kids to learn and internalize these skills. You can collect data on progress- number of late homework assignments per week, number of prompts needed to get a room picked up, or number of tantrums per week. If a strategy is showing improvement, then stay with it, if not, modify it. We need to provide support for learning these skills as if for a much younger child. Reducing support too early will result in a backslide. Other authors suggest it takes children with EF weaknesses perhaps three times as long to learn the skills as other people. That means you are in it for the long haul.

One thing Branstetter comments upon is taking care of you. As the supportive adult to a child with EF challenges, you are in it for the duration. This is especially wearing. Find time for yourself. Enlist family members or friends to take over for child care for a while, hire tutors to take over homework monitoring or academic support, take a walk, find someone to help with housework. You may not need to do these things on a regular basis, but once in a while they are essential for maintaining sanity. Further, the self-care you do today may be very different from that you do tomorrow or that which you did last year. Just remember to recharge your batteries so you can be the best parent you can be.