Ask anyone who’s ever taught kids, and they’ll tell you a story about one student who sticks in their memory. For me, that student is a young man I’ll call Liam. I was his high school English teacher and algebra tutor for a couple of years. I was also his case manager—which meant that because Liam was designated with special education needs, I kept track of all his academic progress, helped his teachers work effectively with him to meet the goals in his Individualized Education Program (IEP), and checked in with him on a regular basis. This was usually during his study hall.
Liam was tall and thin, had a shaggy haircut, wore glasses, and always carried a backpack that was brimming with paper. He drew cartoons with “Star Wars”-like characters who spoke hilarious dialogue. I’d found that if I chatted with Liam about his drawing before we did anything else, he relaxed a little and even began to joke with me. The rapport that we built over a couple of years allowed me to work with him on his academics in a gentle, humorous manner. But whenever he saw me heading towards him in study hall, he’d grin at me, then shake his head and say, “I know why you’re here—it’s the backpack thing. Ms. Bracken, you’re not going to be happy.”
Before I could answer, Liam would pull out his binder and show me one or two graded assignments—but they were never filed in the tabbed section for that course. He filled out his planner every day, but couldn’t find the homework he’d completed. And then there were the sheets and sheets of miscellaneous papers—permission slips, assignments he forgot to turn in, drafts of essays, and science lab reports. “I guess we’ve got plenty of work to do, Ms. Bracken,” Liam would say.
I’d hole-punch all the papers for him, and Liam would dutifully place them in the correct binder section. As we worked, he’d talk about what got in his way and the feelings of overwhelm that plagued him when he had too many papers. We agreed to work together twice a week, and I would do a planner check every day to help keep him on track. “If we can stay on top of the paper monster, Liam,” I’d say, “you probably won’t feel so overwhelmed.”
Besides having some learning challenges, Liam struggled to stay organized and remember his assignments. He could do the work and was actually a good student, but his organizational challenges were holding him back from excelling academically. Liam’s story illustrates how important it is to work with students who have the kind of problems he had—problems that fall into the category called executive function—and what approaches to take that can help.
What kind of challenges do teachers face in a typical classroom?
I wasn’t alone in my experience, as you’ll see from my conversation with a classroom teacher about her experiences helping her students manage their challenges with organizational skills. Here’s what Mrs. N. (pseudonym), a first-grade teacher with twenty-eight years of teaching experience in a suburban Maryland school system, had to say—and I’m quoting her in full, here, because her perspective and her experiences are nearly universal in many ways, from the kids to struggling to focus to the teachers’ lack of professional support and minimal understanding of ADHD drugs:
This year I have twenty-two students in my language arts class (reading, writing, and spelling) and twenty-five students in my math class. Currently, I don’t have any students in my classes with an Individualized Education Program (IEP), but there are a few students in two of the other first-grade classes. In the past when I’ve had students with IEPs, they haven’t had academic goals, and have mainly worked on either speech goals or social-emotional goals like making friends, solving conflicts in a positive way, respecting peers, and understanding classroom rules and expectations.
I don’t have any students identified as having ADHD behaviors this year. [But] I remember one student in the past who had a lot of trouble finishing his work, talking too loudly and at the wrong time, and wasn’t able to stay in his chair. He didn’t seem to like school itself, but he liked to share what he was interested in. When I talk to most parents of my students, they are usually very hesitant to put the child on medication, and doctors seem to feel reluctant as well, especially with first-graders. This particular boy did use some ADHD medication, and I felt like he lost a lot of enthusiasm and excitement about school, lost his personality, and appeared almost zombie-like. The doctor adjusted his medication and he seemed more like himself, and he was able to finish his work in the classroom.
My understanding of what ADHD drugs can do is limited, except that they can stunt a child’s growth. I do remember that my daughter’s college boyfriend took ADHD meds and decided to discontinue them because he didn’t like the way he felt.
My students primarily need help with organization. A lot of them don’t clean up after themselves, don’t finish their work, and stuff papers in their desks. To help them, I make sure they have folders for finished work, a color-coded journal for each subject, and a school box for their supplies; I recommend that they keep them in the desk in a certain order. Every few weeks, if I notice the desks getting messy, we’ll spend some time as a class in getting things tidy again. I emphasize the importance of always keeping things in the same place and following a predictable routine to help students thrive. Parents rarely ask me about organizational skills at home; instead, they are much more concerned about academics. One thing I do tell parents is to be sure the child has a place for everything school-related at home—a designated space or a desk. I’ve also told them to make a visual list (pictures paired with words on a chart) for their child if the child has trouble following multi-step directions.
As far as professional development (PD) goes, it’s usually pretty specific to our work on each grade level. I haven’t had much if any PD on how to teach special education students; although I have had some help with co-teaching (working in the same classroom with a special educator) Most of the time, I rely on the special educator to help me meet a specific student’s needs.
What Should Teachers and Parents Know?
Top of the List: Executive Function (EF).
Given all such challenges faced by teachers in the classroom, the burning question is how to address them—and what information would help. A good starting point is the term “executive function.” Harvard University’s Center on the Developing Child offers this definition of EF skills:
“Executive function and self-regulation skills are the mental processes that enable us to plan, focus attention, remember instructions, and juggle multiple tasks successfully. Just as an air traffic control system at a busy airport safely manages the arrivals and departures of many aircraft on multiple runways, the brain needs this skill set to filter distractions, prioritize tasks, set and achieve goals, and control impulses.”
The three aspects of brain function that help us to master EF skills are working memory, which allows us to hold several pieces of information in mind at once; mental flexibility, which helps us to shift our attention to different demands and apply different rules in a new setting; and self-control, which allows us to manage our impulses and set priorities.
The American Psychological Association (APA) offers this more formal definition:
“Executive Functions are higher level cognitive processes of planning, decision making, problem solving, action sequencing, task assignment and organization, effortful and persistent goal pursuit, inhibition of competing impulses, flexibility in goal selection, and goal-conflict resolution. These often involve the use of language, judgment, abstraction and concept formation, and logic and reasoning. They are frequently associated with neural networks that include the frontal lobe, particularly the prefrontal cortex.”
Many of us face EF challenges on a regular basis, and as adults we refer to having problems with poor time-management, struggling with a lack of planning, or underestimating time or effort needed to complete something. Some common examples include double-booking because we forget to write an appointment in our calendar, putting off large projects until the last minute and then rushing to complete them, and squeezing in too many commitments in a short period of time. In looking into the literature specifically focused on the term executive function, I found that the emphasis is placed on people with special education needs and learning disabilities, ADHD behaviors, schizophrenia, and Alzheimer’s. For the purposes of this article, we’ll be looking at ways to help children and adolescents with ADHD behaviors develop and strengthen their EF skills both at home and in the school setting.
When do we begin to develop EF skills?
You may be surprised to discover that the kinds of games we play with babies and young children have an important role in developing EF skills, especially in the areas of working memory, flexible thinking, and controlling impulses. Here are a few examples and the ages at which babies begin to develop these skills through play from The Harvard Center on the Developing Child.
- 6-18 months old: Activities focus on games like peek-a-boo and hiding objects for the child to find (working memory); imitation and copying games and conversations and role-plays (attention, working memory, and self-control)
- 18-36 months: Activities that fuse language and physical skills like imitation games and games incorporating following directions like “Simon Says” or “Freeze” (working memory, sustained attention and controlling impulses); and talking about feelings related to daily activities, reading, or play (emotional regulation); puzzles and sorting games(working memory, selective attention, reflection, and planning).
- 3-5 years old: Language and physical skills developing quickly now, so activities like putting on a play or sifting a plot in a story help children blend a lot of skills together (working memory, self-control, and sustained attention); cooking requires children to wait for instructions, exercise working memory while holding complicated directions in mind, and focus attention when measuring and counting.
What I liked about this guide is that most of the activities included are things that parents and teachers routinely do and, most importantly, they are all play-focused. If you see your child struggling in certain areas, you can simply add more games or activities that help to develop that skill. The guide maintains its focus on game-oriented approaches up to adolescence, where it then switches to activities that are more real-world and self-reflection-oriented, such as involvement in social concerns, setting and achieving goals, and monitoring time and behavior.
What about stimulant drugs? Why are they so popular, and what are the risks?
While many doctors recommend stimulant drugs (such as Ritalin, Adderall, and Concerta) for children with ADHD behaviors, the research on the effectiveness is mixed at best. A 2012 article published by the National Library of Medicine reported a variety of results from several studies. They found that although stimulants enhance classroom manageability, increase attention, and help improve skills like note-taking and homework completion, they do not increase one’s IQ or normalize a child’s ability to learn and apply knowledge, nor do they improve academic achievement. The authors conclude on a very sober note, warning about the long-term effects of chronic stimulant use, including addiction, tolerance, cardiovascular effects, and in some cases, psychosis.
A 2022 Australian study on stimulant effects on adolescents raises very serious concerns. The study compared two groups of adolescents with the same symptoms—those who had received and ADHD diagnosis and those who had not. The researchers found that kids who were labeled as having ADHD had worse quality-of-life outcomes and were more likely to engage in self-harm. “Those who received the diagnosis scored worse on feeling that they belonged at school and could succeed academically, having a sense of self-efficacy, and demonstrating negative social behaviors. Most concerningly, kids who received the diagnosis of ADHD were 2.53 times more likely to harm themselves than kids who had the same level of ADHD symptoms but did not receive the diagnosis.”
Some parents choose to try stimulants for their child on a temporary basis to help the child experience some success in the classroom and build more positive interactions with teachers and peers. But many psychologists and ADHD coaches caution that “pills don’t teach skills” and emphasize the need to focus on helping the child with EF skills both at home and in school.
Many children, especially those with ADHD behaviors, struggle with organization and executive function skills, especially when they start school. What can a parent do to help their child at home?
A book called Learning to Plan and Be Organized: Executive Function Skills for Kids with ADHD by Kathleen Nadeau, PhD, addresses this need. Designed for both parent and child, it has a workbook-like format with charts, checklists, and fun ways to take a break. The author includes a simple, encouraging, step-by-step guide for everything in a child’s day, from morning routines to organizing things, planning, and remembering. The author focuses on helping the child to develop habits and stay organized at home—skills which will then be easier for the child to adopt in a school setting, since they will be used to working within a structure.
Nadeau begins the book with a section for parents that explains how EF skills develop over a lifetime and usually improve with maturity; describes early skills a child needs to master; and outlines the five keys to success: “Make the exercises enjoyable, set reachable, age-appropriate goals, encourage the child if he or she struggles, reward the child with recognition and praise, and reward with privileges and tangible rewards if your child needs more motivation.” Nadeau also reiterates the need for parents to be patient and encouraging while working with their child.
In an extensive first chapter for children, she talks about planning and organizing as being necessary life-skills that many kids with ADHD behaviors find challenging—and uses upbeat language to help kids see their gifts and recognize their challenges. “Kids with ADHD can be very smart and creative…and think up cool ideas other kids might never think of,” Nadeau writes. “Sometimes when you have a great imagination and have ADHD, it’s hard to keep your mind on what you’re doing because your brain is always thinking of lots of interesting things.”
She encourages them to face up to their need for planning and organizing, adding that those skills don’t just help with what you don’t want to do; they can also help with things you love, like baking some brownies or getting ready for a camping trip. To help kids consider the areas where they most need to focus, Nadeau has created a self-assessment questionnaire that invites a child look to at the following areas: habits; morning, after-school, and bedtime routines; organizing stuff; getting things done; managing time; planning projects; remembering things; and “what I wish people knew about me.” Once the child completes the checklist, she advises them to talk to their parents and decide which areas they need to pay the most attention to so that their lives run more smoothly. She congratulates them for completing the task and then offers a break-activity before they move on.
I’ve always believed that it’s essential for kids to feel like they are in charge of something in their lives, and that they can take control and succeed. I think this book does a great job of looking at many areas of a child’s life and offering concrete activities that the child can do to “strengthen the muscles” of organizing and planning. Nadeau emphasizes the need for self-reflection on both problems and successes and teaches kids to aim for progress instead of perfection when looking at how far they’ve come.
What can teachers do in the classroom to help kids with EF skills?
A classroom full of active, inquisitive kids will present many challenges for any teacher. Most teachers that I know, like my friend Mrs. N., have systems in place in their classrooms that are meant to help everyone stay on track with accessing materials, handing in work, and keeping track of class projects. Joyce Cooper-Kahn and Margaret Foster have written a thoughtful and complete guide for teachers entitled Boosting Executive Skills in the Classroom: A Practical Guide for Educators. I have to confess that when I was teaching in the 2000s, I knew many ways to help kids organize and stay on track, but I did not have a complete picture of the role of EF skills and how they develop. I would have found this book very valuable and think other teachers will as well.
The authors first give an overview of what kinds of things can disrupt and imped the smooth development of EF skills, such as developmental challenges (including ADHD and behaviors associated with Autism Spectrum Disorders), acute and chronic stress (problems in the family like drinking, drug use, and abuse), and problems with feeling depressed or anxious. They liken EF skills to learning to ride a bicycle, where you have to coordinate balance, pedaling, blocking distractions, and watching the path in front of you. They caution teachers to be mindful that children “have a finite ability to exert effortless attention” and more importantly, stress that “cognitive control and behavioral control draw on the same resources.”
The most efficient way for teachers to help kids with EF skills in the classroom is to look at implementing routines and strategies for all kids to follow. For about 80% of students, classroom design is sufficient, and the remaining 20% of the students may require more support, especially more frequent check-ins. Cooper-Kahn and Foster talk about four elements that a teacher can incorporate to help kids with EF skills:
- Classroom culture: creating an atmosphere of acceptance and a classroom geared to success for all by providing opportunities of safe practice and safe failure, assessment that considers both practice and performance, and feedback that offers positive words and ways to improve.
- Planning: planning assignments and providing appropriate structures for success, managing timeframes by breaking down large assignments into small chunks and noting due dates in the planner, and providing appropriate strategies to assist students (graphic organizers, Venn diagrams, SQ4R-survey, question, read, recite, and review).
- Classroom routines: providing guidelines for students to follow about entering the classroom, transitioning from one activity to another, following the same format for instruction (warm-up, introduce new material, provide opportunities for practice, application, and review), and providing routines for studying and long-term projects.
- Classroom Design: providing furniture arrangements that support both individual and group work, decorating the room so that it’s attractive but not over-stimulating, as well as providing reinforcement for important concepts kids need to master.
The authors provide detailed ideas and rationales for each section as well as self-reflection questions, review tips, and even some charts to keep track of progress. I think the guidance in this book would be helpful to all teachers who want to create a structured, smooth-running, and supportive environment for their students as well as help them function well in a school environment.
What can teens do to take control of their learning and assignments and manage some of the negative thinking habits that plague them and sometimes stop them from trying?
Due to the challenges and changes of adolescence, teens have unique struggles which can be greatly exacerbated for kids who struggle with ADHD symptoms. They’ve worked diligently through the lower grades to be organized, turn things in on time, and stay focused. But now in high school, they are faced with more demanding assignments, pressure to do well and go to college, and on top of it they’re navigating the rocky world of peer relationships. Self- image can take a particular beating for kids challenged by ADHD, so I was thrilled to find Mindfulness and Self-Compassion for Teen ADHD: Build Executive Functioning Skills, Increase Motivation, and Inspire Self-Confidence, co-authored by Mark Bertin, MD, and Karen Bluth, PhD.
The authors refer to EF skills as the “brain manager” that’s responsible for directing school work, social life, emotions, driving, and overall planning. As the authors put it, the brain manager is like an orchestra conductor and needs to be a strong leader. They then go on to define and give examples of how using mindfulness and self-compassion can help with integrating all of a teen’s responsibilities, making life easier and more rewarding instead of frustrating.
The authors point out how often we engage in negative self-talk when we mess something up—an assignment, a missed play, or an awkward end to a conversation or date. Mindfulness can help you stop, reflect, and notice what’s going on inside so that you don’t get swamped and even paralyzed by your emotions. Self-compassion consists of using mindfulness to be aware of your thoughts and feelings, recognizing that all humans struggle at times, and being as kind to yourself as you would be to a good friend. Several examples of mindfulness and self-compassion exercises are offered in the book to help start a practice.
The rest of the book is devoted to understanding how your “brain manager” works in a variety of situations and how to apply mindfulness and self-compassion, along with other tools, to accomplish what you want for yourself. The areas covered include the following:
- Management of Attention: how to focus and use your attention well.
- Management of Behavior: recognizing when it’s appropriate to speak or act; managing your impulses and developing an awareness of what you want to avoid.
- Management of Tasks: organizing, planning, and keeping track of time.
- Management of Information: Using lists to help retain information and search out study aids that work for you.
- Management of Effort: developing skills to manage the tasks that are “sprints” (homework, studying for a test, reading a chapter) as well as “marathons” (reading a novel or a play, writing a paper).
- Management of Emotions: learning how to avoid being swamped and paralyzed by emotions and maintain equilibrium.
I found the ideas and practices contained in this book to be very thoughtful and practical. I think that all teens would find the book helpful, not just teens identified as having ADHD behaviors. Teens need to feel like they are taking control of their lives and decisions, and I think the exercises in this book could help any teen successfully navigate the many social, emotional, and intellectual challenges they face.
For the teachers and parents who may have read this article, I hope that the information I’ve presented has been helpful. Like any skill or set of habits, EF skills develop over time and, hopefully, strengthen with guided practice and encouragement.
And remember, any time there’s a set-back along this journey, you can always begin again.
Bertin, M. MD and Bluth, K. PhD (2021). Mindfulness & Self-Compassion for Teen ADHD: Build Executive Functioning Skills, Increase Motivation & Improve Self-Confidence. Instant Help Books, Oakland. Oakland, CA: New Harbinger Publications
Cooper-Kahn, J.and Foster, M. (2013). Boosting Executive Skills in the Classroom: A Practical Guide for Educators. Jossey-Boss, San Francisco, CA: A Wiley Imprint
Center of the Developing Child, Harvard University. (2023). Enhancing and Practicing Executive Function Skills with Children from Infancy to Adolescence https://developingchild.harvard.edu/resources/activities-guide-enhancing-and-practicing-executive-function-skills-with-children-from-infancy-to-adolescence/
Lakhan, S. E. and Kirchgessner, A. (2012) Prescription Stimulants in individuals with and without attention deficit hyperactivity disorder; misuse, cognitive impact, and adverse effects. Brain and Behavior. 5(661-677). doi: 10.1002/brb3.78
Nadeau, K. (2016) .Learning to Plan and Be Organized: Executive Function Skills for Kids with ADHD. Washington, DC: Magination Press, American Psychological Association
Perler, S. https://sethperler.com/pills-dont-teach-skills-executive-function/ Executive Function and ADHD Coach
Simons, P. (2023) “ADHD Diagnosis Leads to Worse Qualtiy of Life, Increased Self Harm in Kids.” Mad in America. https://www.madinamerica.com/2022/10/adhd-diagnosis-leads-worse-quality-life-increased-self-harm-kids/
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