How Occupational Therapy Helps Children’s Executive Functioning

How Occupational Therapy Helps Children’s Executive Functioning

Think about an executive of a company: They have to plan out how resources of the company will be used, decide what the priorities are and in what direction to take them, and make decisions on what to do when there is conflicting information. All of these skills are established through what we call our Executive Functioning

To be able to do these everyday tasks in adult life, we must be able to develop and foster the cognitive skills required for executive functioning as a child.

What are executive functioning skills?

Put simply, they are cognitive skills that are used to execute a task. They help us to plan, organise, make decisions, shift between situations or thoughts, control our emotions and impulsivity, and learn from past mistakes. Kids rely on their executive functions for everything from packing a backpack to handwriting and picking priorities.

Children who have poor executive functioning are more disorganised than other kids. They might take an extremely long time just to get dressed or become overwhelmed while doing simple chores around the house. Their schoolwork can become a nightmare because they regularly lose papers or start week-long assignments the night before they are due. (Sound familiar?!)

How can OTs help?

Executive functioning skills are learned by the child, and some children need more modelling and assistance than others. Occupational Therapists can help by providing the right guidance to allow these skills to emerge along with their developmental milestones. Since executive functioning skills are used across a variety of contexts, it’s important for OTs to collaborate with your child’s teacher so that learning opportunities are able to be maximised through scaffolded and systematic instructional approaches.

Skill areas an OT may work with your child on include:

• Self-regulation: Focusing attention, filtering distractions, controlling impulses, coping and calming skills.
• Problem-solving: Goal setting, making a plan and considering possible scenarios, sequencing steps, and following directions, organisation, recognising errors and correcting them, evaluating self-performance, achieving a goal.
• Multitasking: Prioritising, remembering and working with multiple pieces of information.
• Flexible thinking: Switching approach to a task, considering new ideas or strategies, making choices and decisions, maintaining social interaction

Strategies an OT may use to foster executive functioning skills include:

• Visual tools: Using images or social stories to help foster organisational skills. For example: routine and sticker charts, visual schedules, keeping belongings in the same place everyday.
• Breaking things down: Breaking down tasks into manageable parts to help with task initiation and planning. For example, scaffolding using ‘hamburger paragraph’ and mind maps.
• Memory and matching games to promote working memory.
• Using visual timers and checklists to assist with time management and multitasking/prioritising.
• Providing scaffolds through visual schedules to help sequence tasks and promote attention to the task at hand.
• Using self-regulation strategies through movement breaks and transition activities to maintain focus.
• Goal setting: Teaching kids to sketch out what an assignment will look like when it is completed to help identify where to start, what components are needed, and what the assignment will look like when it is finished.

Of course, it’s important to keep in mind that not one size fits all, and so although one child might have difficulty initiating a task but be a good problem solver, another might find organising their school items quite a challenge. OTs help to pinpoint the skill area(s) that your child has challenges with and develop the relevant strategies during therapy. We provide the structure children need to be successful, but also find the ‘just right challenge’ so that natural learning opportunities can arise.

If you think your child needs help with their executive functioning, please talk to an experienced occupational therapist.

The author, Lisa Hughes, is the Director & Senior Clinician at Occupational Therapy Helping Children – a specialist team of occupational therapists who are dedicated to helping children thrive.