What is executive function?

Executive function is a set of skills that guides how people manage daily life. These skills include things like attention, working memory, planning, staying organized, time management, problem solving, managing emotions and adjusting to change. Executive function is how you set goals, take action and follow through — even when something feels hard or frustrating. Together, these skills make it easier for children and adolescents to follow routines, complete schoolwork and build healthy relationships with others. When a child or teen can manage tasks and emotions more independently, daily life feels less overwhelming for them and their family.

What are the signs of executive function impairment?

When executive function skills are impaired, everyday tasks like getting ready, following directions or finishing homework can feel challenging. Executive function impairment can affect how children and teens perform in school, connect with friends and take part in family routines. Over time, ongoing struggles with executive function can lower your child’s self-confidence and motivation and can increase stress for the entire family.

Children, teens and families can experience executive impairment in the following ways:

Attention

• Has trouble staying focused in class or during homework
• Easily distracted by sounds, people or thoughts
• Misses key instructions or details

Initiation

• Struggles to start homework or chores without reminders
• Avoids unfamiliar tasks, even if they’re important
• Needs frequent encouragement to begin multi-step assignments

Inhibition control

• Blurts out answers or interrupts conversations
• Acts without thinking about the consequences
• Has difficulty stopping themselves from doing something they know they shouldn’t

Working memory

• Forgets multi-step directions
• Loses track of what they’re doing during a task
• Can’t remember what to bring to class or what was just explained

Processing speed

• Takes much longer than peers to complete homework or tests
• Struggles to keep up in fast-paced conversations or group activities
• Needs extra time to think through questions or respond in class

Planning and prioritization

• Has trouble figuring out the steps needed to complete a project
• Jumps into tasks without a clear plan
• Overlooks important details or deadlines

Organization

• Backpack, locker or bedroom is often messy or cluttered
• Frequently loses items like notebooks, assignments or sports gear
• Difficulty keeping track of what needs to be done and when

Time management

• Underestimates how long tasks will take
• Runs late for school, practice or other activities
• Struggles to prioritize tasks and meet deadlines

Cognitive flexibility

• Gets upset when routines change or plans don’t go as expected
• Has trouble seeing other ways to solve a problem
• Becomes stuck on one idea and can’t easily shift to another

Self-monitoring

• Doesn’t notice mistakes in work until someone points them out
• Has trouble recognizing how their actions affect others
• May think they’re doing fine even when they’re off track

Emotional regulation

• Overreacts to small problems or changes
• Has difficulty calming down when upset or frustrated
• Mood swings can be frequent and intense

What are the causes of executive function issues?

Genetic conditions or medical treatment can impact how the brain develops executive function skills. 

• NF1 is a genetic condition that can affect brain development, leading to challenges with attention and broader executive functions.
• Tumor location can affect areas of the brain that are important for the development of executive function skills.
• Surgery can impact parts of the brain that play key roles in the development of executive function skills.
• Chemotherapy can affect brain cells and slow the development of executive function abilities.
• Radiation therapy can change brain structure and connectivity, which slows the development of executive function skills.

How to improve executive functioning skills in kids

When children and teens struggle with executive function, there are many formal and informal supports that can help them succeed. 

Formal school supports include special education services, 504 plans, individualized education programs (IEPs) and tutoring to provide tailored academic assistance. 

Informal supports can include classroom accommodations like extra time on tests or using organizational tools. 

Therapeutic services provided by behavioral health clinicians can teach skills to improve focus, flexibility, organization and emotional regulation. 

In some cases, medication may be recommended to help manage impulsivity, inattention or mood challenges. 

Family education or intervention programs can also help parents develop strategies to help their child develop routines and increase independence, as well as advocate for their child’s needs.

Cognitive behavioral therapy (CBT), including problem-solving and solution-focused approaches, can help children and teens develop better self-control, planning and task-completion abilities. 

Working memory training programs, such as computerized exercises, can improve short-term memory and attention, though these are often difficult to complete. 

Organizational skills training, including teaching children to use planners, break down tasks, manage their materials (including backpacks) and develop time management, can have positive effects on academic performance and daily functioning. 

Mindfulness practices also show promise for increasing executive functioning skills for kids and teens by improving attention and emotional regulation. 

Combining these approaches with school supports, family coaching and, when appropriate, medication management can provide a comprehensive way to support executive function skill development and overall well-being and quality of life.