Executive Thinking Dysfunction

Evidence

Executive Function Outcomes at School Age in Children Born Moderate-to-Late Preterm

https://www.jpeds.com/article/S0022-3476(25)00174-X/fulltext

Lauren Rossetti, Leona Pascoe, Rheanna M. Mainzer, Rachel Ellis, Joy E. Olsen, Alicia J. Spittle, Lex W. Doyle, Jeanie L.Y. Cheong, Peter J. Anderson.

Research surrounding outcomes of preterm birth has historically focused on children born “extremely preterm” (<28 weeks of gestation) or “very preterm” (<32 weeks of gestation). However, children born moderate-to-late preterm (MLP; 32-to-36 weeks of gestation) account for approximately 85% of preterm births and are increasingly reported to experience poorer neurodevelopmental outcomes compared with children born at term (≥37 weeks' gestation). Studies of individuals born MLP have typically focused on outcomes in infancy and preschool age. More recently, poorer general cognitive ability at school-age has been reported in children born MLP compared with those born at term. However, significant gaps in knowledge of performance on specific cognitive domains in this population remain. Such knowledge is necessary to determine the underlying neuropathologic mechanisms, and to structure surveillance and intervention programs.

Education

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:

• Cognitive flexibility (also called flexible thinking)
• Working memory
• Inhibitory control (which includes self-control)

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

Empowerment

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.

CLICK HERE to read article. 

“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.

Useful Links:

• Mindfulness Meditation: https://www.headspace.com/meditation/parents
• For further information contact: https://www.adhdaustralia.org.au/

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