Children with executive function disorder (EFD) have neurological weaknesses that make it difficult to stay organized and complete tasks. They can also make it hard to manage emotions or handle transitions easily. EFD is not a stand-alone diagnosis, but a way of describing the various effects of these brain differences on behavior.
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What Are the Primary Types of Executive Function Skills?
As a mom of two boys with combined-type ADHD and rejection-sensitive dysphoria (RSD), one of whom has fairly serious executive dysfunction, I’ve found myself doing a lot of research on the topic of EF over the past several years. What I’ve learned is that executive functioning skills can be divided into two primary types. Each type has different related sub-skills (of which there are 8 in total) for which there may be deficits.
1. Executive Function Regulation Skills
EF regulation skills are really important for children to understand and adapt to their surroundings effectively. If your child finds it challenging to switch tasks, this could be a sign of an EF regulation skill deficit.
Read more: How to Help Kids Develop Executive Functioning Skills at Home
When it comes to EF regulation skills, they involve three key areas:
- Self-control: taking a pause and considering before impulsively reacting to something.
- Emotional control: being able to manage emotions in a way that helps achieve goals or complete tasks.
- Mental flexibility: adapting to different situations and environments with ease, even if they’re not perfect.
2. Executive Function Organization Skills
EF organization skills are what allow kids to gather and retain information in order to make sense of it as a whole and then utilize it for a given purpose.
EF organizational skills include:
- Task planning and organization: Creating steps to reach a goal
- Task initiation: Starting and finishing projects without prompts or procrastination
- Working memory: Holding new information in short-term memory in order to use it to complete a task, project or assignment
- Self-monitoring: Evaluating performance and making adjustments as needed
- Time management: Self-monitoring in order to finish projects when they are due
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What Does Executive Function Disorder Look Like in Kids?
EFD in kids can look a lot like…well…kids being kids. Which is part of the problem. So, you might be thinking, don’t all kids have some difficulty with many of the issues described by EFD? Well, of course, the answer is “yes.” But kids this disorder tend to have a difficult time with various social, emotional and learning situations even when they should have already aged out of the behaviors. For instance:
- While no one should expect a 6-year-old to be able to take good notes on how to complete a math problem. However, if a 5th grader can’t do it without constant monitoring, prompts and reminders, that can be a sign of executive dysfunction.
- If an 8-year-old child consistently melts down when having to leave the playground even after having been given appropriate warnings about the upcoming transition, that may be a sign of EFD.
- If on most mornings, a 7-year-old has a tantrum when asked to get their shoes on in order to get out the door for school, that can also be an EFD symptom.
- A 1st grader may have difficulty remembering to do their homework each night, but if that same problem is occurring in 7th grade — and it’s not simply defiance and/or boundary-testing — there’s a good chance executive dysfunction may be the issue.
Read more: A Guide to Executive Function Skills by Age
Executive Function Disorder vs ADHD
When it comes to executive function disorder (EFD), it can often look a lot like ADHD. However, it’s essential to remember that EFD is not an official psychological diagnosis according to the DSM-5, which is the resource used by psychiatrists and psychologists to diagnose patients. Instead, EFD refers to a group of important skills that children need to organize themselves and manage their emotions.
It’s worth noting that executive functioning deficits are common in children with ADHD and ADHD-RSD. However they are also prevalent in kids with learning differences such as dyslexia or mood disorders like depression and anxiety. Sometimes, kids may even have a combination of these issues. For instance, my youngest child has combined-type ADHD, mild EF, intense RSD, and anxiety. On the other hand, my oldest has combined-type ADHD, intense EF, and a less common presentation of RSD. In contrast, their step-brother has combined-type ADHD and dyslexia, but no prominent signs of EF, with more hyperactive than inattentive ADHD.
Basically, executive function disorder can manifest in many different ways and combinations, and the severity can vary greatly.
Read more: How to Improve Executive Function: The Ultimate Guide
How Are Executive Functioning Deficits Treated in Children?
Treatments for executive dysfunction in children vary depending on the diagnosis of a primary disorder.
Treatments for Kids With ADHD and EFD
Kids diagnosed with ADHD who have executive functioning deficits may be treated with drugs, therapy, and/or coaching. Medications that may help with ADHD-EFD include stimulants like Ritalin or Adderall or non-stimulants such as Strattera, which improve attention and decrease hyperactivity. Cognitive behavioral therapy (CBT), including dialectical behavior therapy for children (DBT-C), can help kids build the skills they need to better regulate their emotions. Finally, EF coaching can teach children organizational skills to help them succeed in school and compensate for their brain’s natural “wiring.”
Treatments for Kids With Learning Differences and EFD
Kids who have EFD and a learning difference may need a different plan of action than those with ADHD. For example, a child with dyslexia and EFD who has difficulty organizing themselves may benefit quite a bit from EF coaching, but may not need CBT or DBT to improve. Instead, dyslexia-specific learning programs, like those based on the Orton Gillingham method, may be a better investment of time and money.
Read more: Executive Dysfunction vs ADHD: What’s the Difference?
Treatments for Kids With Mood Disorders and EFD
Finally, children with EFD and a mood disorder, like anxiety or depression, may benefit from a combination of CBT and psychotherapy, especially in combination with medications like Zoloft or other similar drugs. In cases like these, the EFD can sometimes be eliminated without directly addressing it once the underlying issue is treated and under control.
Goally | Kid’s Tablet for Building Emotional Regulation Skills
Is your child struggling with understanding and managing their emotions? Goally teaches emotional regulation skills in a fun and interactive way!
The Mood Tuner app encourages kids to look inwards and identify their feelings, helping them understand what’s going on inside. Once they’ve recognized their emotions, they can choose from a variety of exercises designed to help them self-regulate and find their balance.
Pinning down this condition in kids isn’t always straightforward. But, the sooner you spot the problems, the simpler they are to handle. If EFD is on the radar for your child, it’s essential to consult with a psychologist or psychiatrist. Seek out professionals well-versed in diagnosing varied mental, behavioral health issues and learning differences. A diagnosis paves the way for your child to receive the aid necessary to do well in school and reach their utmost potential. After all, they’re destined to bloom into truly remarkable adults.
FAQs About Executive Function Disorder
What is executive function disorder (EFD)? EFD is a term used to describe a group of important skills that help individuals manage their behavior, organize themselves, and control their emotions. What causes executive function disorder? The exact cause of EFD is not yet fully understood. However, research suggests that it may be related to factors such as genetics, brain development, and environmental factors. What are the common symptoms of executive function disorder? Common symptoms of EFD include difficulty with planning, organizing, managing time, switching tasks, controlling emotions, and completing tasks. Can executive function disorder be treated? Yes, EFD can be treated. Treatment options include behavioral therapy, medications, and educational interventions. What are some strategies for managing executive function disorder? Strategies for managing EFD include using checklists, breaking tasks down into smaller steps, setting reminders, and practicing mindfulness.
This post was originally published on 03/21/2022. It was updated on 01/04/2024.
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