Difficulty Accepting Alternative Options

Develop Flexibility Skills

Practice Low-Stress “Either-Or” Situations

You may notice that your child gets upset when the thing he wants is not an option to him. At school he got put on the red school spirit team, and is very upset that he’s not on the blue team with his close friends. Or, you get to the shoe store and he doesn’t find the sneakers he wants in black. He melts down and badgers you to go to another shoe store rather than settle for the gray sneakers in front of him. He gets upset and refuses to accept changes in plans or to adjust his expectations. As a result, he doesn’t learn to adapt to changing circumstances, risks social problems, and experiences undue stress. 

Most elementary-school children get upset when forced to shift gears in a situation where their heart is set on something they’re not going to get. But when your child is consistently distraught when things don’t go the way he hoped, this may indicate he is struggling to develop flexibility skills.

Flexibility is one of our executive functions: the set of skills that let us effectively execute daily tasks.

Solution: Practice Responses to Either-Or Situations

Identify in advance situations that have two possible outcomes. Ask him to practice how he’ll respond if he needs to accept the undesirable alternative. Repeatedly practice with these lower stress, predictable situations. Success (managing responses) in these low-demand situations lays the groundwork for increased adaptability in higher stress situations.

Don’t do this: When he asks her friend to come over after school, and has a meltdown when the friend is not available, tell him, “deal with it.”

Try this instead: Before your child calls a friend to ask if they can come over and play, have him imagine the two possible outcomes — yes or no. Now have him practice how he’ll respond if the friend can come, and if the friend can’t. Repeat this in other situations where there are two predictable outcomes. When he faces an unpredicted change in plans — like a thunderstorm hitting on your way to the neighborhood pool or finding out the pizza restaurant is closed on Monday, leaving you to go another night — remind him of what he practiced when he managed his response in the controlled scenario.

Remember: If your child falls apart with a change in plans, teaching flexibility may help reduce the anxiety associated with the unknown, and prepare him to respond in a way that makes him proud of herself.

It is perfectly normal for children to experience some degree of difficulty and frustration as they learn to execute new tasks. Toddlers can tantrum, school-aged children can yell and argue, and teenagers can ignore instructions. When deciding if executive function weaknesses require intervention, ask yourself: “How frequently is this occurring? How intense is the experience/significant the impact?” If your answer to these questions is “too much,” “too often,” “I don’t know what to do to change this,” or “it’s only getting worse,” you may benefit from a face-to-face conversation to help problem-solve your concern. Effective problem solving will help you clearly identify the problem, goal, steps it will take to achieve your goal, possible barriers, and available supports.

What to Expect

You and your child or adolescent will meet with a pediatric neuropsychologist for approximately one hour. 

Executive Function Interventions

These interventions aim to create new habits that can sidestep or override a child’s cognitive challenges.


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