Executive Thinking Dysfunction



Executive Function Skills are Associated with Reading and Parent-Rated Child Function in Children Born Prematurely
Irene M. Loe, MD,* Eliana S. Lee, BS,* Beatriz Luna, PhD,# and Heidi M. Feldman, MD PhD*

“Preterm children are at risk for executive function (EF) problems, which have been linked to behaviour and learning problems in full term children.”


Some people describe executive function as “the CEO of the brain.” These skills allow us to set goals, plan, and get things done. When kids struggle with executive skills, it affects them in school and in everyday life. Trouble with executive skills isn’t a diagnosis or a learning disability on its own. But it’s a common problem for kids who learn and think differently. Kids with ADHD have difficulties with executive function.

The three main areas of executive function are:

Executive function is responsible for a number of skills, including:

  • Paying attention, focusing
  • Organizing, planning, and prioritizing
  • Starting tasks and staying focused and finishing them
  • Understanding different points of view
  • Emotional regulation
  • Self-monitoring (keeping track of what you’re doing)
  • Working memory (Short term Memory)
  • Flexible thinking
  • Self-control

Challenges with Executive Function in Kindergarten:

  • Struggles with basic tasks like finding things in a cubby or packing up at the end of the day
  • Raises hand but doesn’t remember what to say when asked or called on
  • Has trouble following directions and often forgets what to do next Might ask for help a lot
  • Difficulty expressing feelings
  • Answers questions with an off-topic answer
  • Has tantrums over things little things
  • Is very stubborn can get ‘stuck’ on one way to do things
  • Gets frustrated easily, might throw things instead of asking for help

Trouble with Executive Function in Primary School:

  • Starts a working and gets distracted, cannot finish
  • Can solve a maths problem one way but gets ‘stuck’ when asked to solve it a different way
  • Focuses on the least important part of conversation
  • Mixes up assignments, can’t explain it either and doesn’t bring home the right books and handouts needed
  • Has a messy desk and backpack
  • Doesn’t cope with rules or routines changes
  • Can only see one way to do things


Executive skills usually develop quickly in early childhood and into adolescence. But they keep developing into the mid-twenties some say up to 25 years old. As they get older, though, they may have fewer challenges as teens and young adults.
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“Being Flexible is a part of the Executive Thinking Dysfunction, one way in which it interferes with my son is when he needs to stop doing something that he likes to do and change focus. If he is playing on his computer game and I say stop and come to dinner. It will be World War 3 if I demanded this. For my son, understanding someone else’s point of view can be totally missed. We understand coming to dinner when I say so is a sign of respect and he would need to be able to put himself in the other person’s shoes to see how this makes me mad! This skill is missing by him and looks disrespectful.   But I understand now that he needs to finish this game first, I can accept this and will continue to review the idea that the world won’t always wait like I do and he understands this. But He told me that this is how his mind works, It’s similar to me cooking dinner, ‘can I walk away from the stove while cooking at a critical time.’ Flexibility is negotiable and has changed over time as he has gotten older. So, when that song on his computer is done, he comes or when he finishes that final stage of a computer game he comes. As he gets older this has improved! Some skills are learned over a longer period of time. But showing my flexibility as he gets older is also a teaching point with him.” - Andrea, Mum to Aiden

Speaking with your GP about your concerns is a great starting place. You may be referred to a Paediatrician or Psychologist for further assessment. Be kind to yourself and try to not judge yourself or your situation.

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Disclaimer: This publication by Miracle Babies Foundation is intended solely for general education and assistance and it is it is not medical advice or a healthcare recommendation. It should not be used for the purpose of medical diagnosis or treatment for any individual condition. This publication has been developed by our Parent Advisory Team (all who are parents of premature and sick babies) and has been reviewed and approved by a Clinical Advisory Team. This publication is not a substitute for professional medical advice. Miracle Babies Foundation recommends that professional medical advice and services be sought out from a qualified healthcare provider familiar with your personal circumstances.To the extent permitted by law, Miracle Babies Foundation excludes and disclaims any liability of any kind (directly or indirectly arising) to any reader of this publication who acts or does not act in reliance wholly or partly on the content of this general publication. If you would like to provide any feedback on the information please email [email protected].