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What Are the Effects of Impaired Executive Functions?

Adah Chung is a fact checker, writer, researcher, and occupational therapist. 

Hero Images / Getty Images

Types of Executive Function

What executive function involves, what happens if your executive function is impaired, other effects of executive function deficits, ways to improve your executive function.

Executive function is a set of cognitive skills that are needed for self-control and managing behaviors.

These skills include self-control, working memory, and mental flexibility. Such functions allow people to do things like follow directions, focus, control emotions, and attain goals. 

The executive functions’ role is similar to a conductor’s role within an orchestra. The conductor manages, directs, organizes, and integrates each member of the orchestra. They cue each musician so they know when to begin to play, and how fast or slow, loud or soft to play, and when to stop playing. Without the conductor, the music would not flow as smoothly or sound as beautiful.

You can think of executive function as the management system of the brain. These mental functions help us organize and manage the many tasks in our daily life.

There are several primary types of executive functions. These functions each play their own important role, but also work in conjunction with one another to monitor and facilitate goal-directed behaviors.

The basic areas of executive function are:

• Attentional control : This involves an individual's ability to focus attention and concentrate on something specific in the environment.
• Cognitive flexibility : Sometimes referred to as mental flexibility , this refers to the ability to switch from one mental task to another or to think about multiple things at the same time.
• Cognitive inhibition : This involves the ability to tune out irrelevant information.
• Inhibitory control : This involves the ability to inhibit impulses or desires in order to engage in more appropriate or beneficial behaviors.
• Working memory : Working memory is a “temporary storage system” in the brain that holds several facts or thoughts in mind while solving a problem or performing a task.

There are also a number of higher-level executive functions that rely on the basic lower-level functions. Some examples of higher-order executive functions include problem-solving , reasoning, fluid intelligence , and planning.

Executive functions play an important role in many different areas of life.

Executive Function's Role in Everyday Life

Some things that you do every day that are dependent on your executive functions include:

• Analyzing information
• Being able to focus on something
• Keeping track of your behaviors
• Making plans
• Managing behavior
• Managing your time
• Paying attention
• Regulating emotions
• Remembering important details
• Seeing things from someone else's perspective
• Self-regulation
• Staying organized

The executive functions play a critical role in a person's ability to function normally. When there are problems with these skills, people may struggle with different areas of life, including school, work, and relationships.

For example, problems with executive function are common when people have ADHD. Declines in executive function are also a feature of dementia and may appear early in its course.

Impairments in executive functions can have a major impact on the ability to perform such tasks as planning, prioritizing, organizing, paying attention to and remembering details, and controlling emotional reactions.

People may experience problems in several key areas, including:

• Organizing, prioritizing, and initiating tasks: People with deficits in this area of executive functioning have difficulty getting materials organized, distinguishing between relevant and non-relevant information, anticipating and planning for future events, estimating the time needed to complete tasks, and simply getting started on a task.
• Focusing, maintaining, and shifting attention: People who are easily distracted miss important information. They are distracted not only by things around them but also by their own thoughts. They have difficulty shifting attention when necessary and can get stuck on a thought, thinking only about that topic.
• Regulating alertness, sustaining effort, and processing speed: People who have a hard time regulating alertness may become drowsy when they have to sit still and be quiet in order to listen or read material that they find boring. It is not that they are over-tired; they simply cannot sustain alertness unless they are actively engaged. In addition, the speed at which they take in and understand information can affect performance.
• Managing frustrations and regulating emotions: People with impairments in this area of executive functioning may have a very low tolerance for frustration, such as when they don’t how to do a task. They can also be extremely sensitive to criticism. Difficult emotions can quickly become overwhelming and emotional reactions may be very intense.
• Using working memory and accessing recall: Working memory helps an individual hold information long enough to use it in the short term, focus on a task, and remember what to do next. If people have impairments in working memory, they may have trouble remembering and following directions, memorizing and recalling facts or spelling words, computing problems in their head, or retrieving information from memory when they need it.
• Monitoring and self-regulating action: When people have deficits in the ability to regulate their behavior, it can significantly impede social relationships . If people have difficulty inhibiting behavior, they may react impulsively without thought to the context of the situation, or they may over-focus on the reactions of others by becoming too inhibited and withdrawn in interactions.

Like an orchestra, each of the executive functions works together in various combinations. When one area is impaired, it affects the others. If a student has deficits in one of these key executive functions, it can obviously interfere with school and  academic performance .

Difficulties with executive functions can affect people in different ways and to differing degrees of severity. Some problems that people may experience if they have executive function deficits include: 

• Anxiety when routines are disrupted
• Always losing belongings
• Always being late due to poor time management
• Difficulty prioritizing things that need to be done
• Difficulty switching between tasks or multitasking
• Problems completing tasks
• Trouble controlling impulsive behaviors

Many people struggle with one or more of these areas, but that does not necessarily mean that they have a mental health condition or learning disability. If problems with these skills are interfering with your ability to function normally or harming your relationships, it is important to talk to your doctor or mental health professional. Your difficulties might be caused by an underlying condition such as ADHD.

People aren't born with executive function skills. They are something that develops as the brain grows. Such skills continue to develop and mature well into a person's teens and twenties.

Many people find it empowering to understand why they are struggling with their relationships, work, or school. Others feel sad or angry that they struggle with tasks that other people seem to do effortlessly.

The good news is there are things that you can do to improve your executive functioning and manage weaknesses that you have. Strategies that can help include:

• Break up large tasks into small steps.
• Create checklists for things you need to do.
• Give yourself time to transition between activities.
• Make a schedule to help you stay on track.
• Use a calendar to help you remember and plan for long-term activities, tasks, and goals.
• Use visual aids to help you process and understand information.
• Write down due dates or important deadlines and put them in a visible location.

Another thing that you can do is find ways to manage your stress levels. Stress can have a detrimental impact on executive functioning, so look for stress relief activities that work for you.

Request Accommodations

If you have a diagnosed condition such as ADHD, you can also request accommodations at school and work that can help. Accommodations are designed to support you in the specific areas where you struggle.

A few examples of accommodations include a reduced amount of homework (e.g., if the class is asked to do 20 math problems, you would be asked to do 10), extra time taking tests, help with reading assignments, permission to record lectures, and help with class notes.

Speak to Your Child's Teacher

To receive help for your child, a good starting point is to speak to their teacher. The school is required by federal law to provide the additional services they need. If you are at college or university, visit the office for student disabilities. They will be able to assist you in setting up accommodations.

Otterman DL, Koopman-Verhoeff ME, White TJ, Tiemeier H, Bolhuis K, Jansen PW. Executive functioning and neurodevelopmental disorders in early childhood: A prospective population-based study . Child Adolesc Psychiatry Ment Health . 2019;13:38. doi:10.1186/s13034-019-0299-7

Guarino A, Favieri F, Boncompagni I, Agostini F, Cantone M, Casagrande M. Executive functions in Alzheimer disease: A systematic review .  Front Aging Neurosci . 2019;10:437. doi:10.3389/fnagi.2018.00437

Langberg JM, Dvorsky MR, Evans SW. What specific facets of executive function are associated with academic functioning in youth with attention-deficit/hyperactivity disorder ? J Abnorm Child Psychol . 2013;41(7):1145-1159. doi:10.1007/s10802-013-9750-z

Volkow ND, Swanson JM. Adult attention deficit-hyperactivity disorder . N Engl J Med . 2013;369(20):1935-1944. doi:10.1056/NEJMcp1212625

Suades-González E, Forns J, García-Esteban R, et al. A longitudinal study on attention development in primary school children with and without teacher-reported symptoms of ADHD . Front Psychol . 2017;8:655. doi:10.3389/fpsyg.2017.00655

Hirsch O, Chavanon ML, Christiansen H. Emotional dysregulation subgroups in patients with adult Attention-Deficit/Hyperactivity Disorder (ADHD): A cluster analytic approach . Sci Rep . 2019;9(1):5639. doi:10.1038/s41598-019-42018-y

Bunford N, Evans SW, Becker SP, Langberg JM. Attention-deficit/hyperactivity disorder and social skills in youth: A moderated mediation model of emotion dysregulation and depression . J Abnorm Child Psychol . 2015;43(2):283-296. doi:10.1007/s10802-014-9909-2

Shields GS, Sazma MA, Yonelinas AP. The effects of acute stress on core executive functions: A meta-analysis and comparison with cortisol .  Neurosci Biobehav Rev . 2016;68:651-668. doi:10.1016/j.neubiorev.2016.06.038

Brown TE. A New Understanding of ADHD in Children and Adults: Executive Function Impairments . New York: Taylor & Francis; 2013.

Nugent K, Smart W. Attention-deficit/hyperactivity disorder in postsecondary students . Neuropsychiatr Dis Treat . 2014;10:1781-1791. doi:10.2147/NDT.S64136

By Keath Low  Keath Low, MA, is a therapist and clinical scientist with the Carolina Institute for Developmental Disabilities at the University of North Carolina. She specializes in treatment of ADD/ADHD.

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 What is Executive Function and Its Essential Skills?

• January 15, 2024

Understanding executive function (EF) is crucial for navigating life’s challenges and maximizing personal potential. This cognitive powerhouse orchestrates a set of essential skills that enable individuals to plan, organize, and execute tasks effectively. Let’s unravel the intricacies of executive function, explore the seven key executive functions , and shed light on EF disorders.

Defining Executive Function

At its core, executive function refers to a set of mental processes that enable individuals to manage information, plan activities, and regulate behavior. It acts as the brain’s command center, overseeing various cognitive abilities essential for goal-directed behavior. Executive function plays a pivotal role in shaping how individuals approach tasks, solve problems, and adapt to changing situations.

What are Executive Skills?

Executive skills encompass a diverse range of cognitive abilities that collectively contribute to our daily life. These skills include but are not limited to time management, organization, working memory, task initiation, impulse control, flexibility, and emotional regulation. Mastering these skills is crucial for success in education , employment, and interpersonal relationships.

Unveiling the 7 Executive Functions

Working memory.

Working memory allows individuals to actively maintain information in their mind while simultaneously using that information for tasks such as problem-solving, decision-making, and comprehension. Understanding and improving working memory can have a positive impact on various aspects of daily life, academic performance, and professional tasks. Strategies for enhancing working memory often involve techniques to improve focus, reduce distractions, and practice mental rehearsal or visualization. Additionally, staying organized and breaking complex tasks into smaller, more manageable steps can alleviate the demands on working memory.

Inhibition is the ability to control impulsive reactions and resist distractions, allowing individuals to stay focused on their goals. It is a key aspect of executive function and plays a crucial role in various cognitive and social processes. Inhibition allows individuals to regulate their actions, resist distractions, and make decisions that align with their goals. Understanding and enhancing inhibition is essential for effective decision-making, goal attainment, and navigating social interactions successfully. It contributes to the overall executive function, allowing individuals to exhibit greater control and flexibility in their cognitive and behavioral responses.

Task Switching

The capacity to switch attention between different tasks or perspectives, facilitating flexibility in problem-solving and adapting to changing circumstances. Shifting involves the capacity to switch between different tasks efficiently. This may include transitioning from one activity to another, adjusting focus between work assignments, or switching between various aspects of a complex project.

The executive function of initiation involves starting tasks independently, from planning and organizing to taking the first steps towards completion. Difficulties with initiation can be observed in individuals with certain neurological or developmental conditions, such as executive function disorders. Strategies for improving initiation often involve breaking larger tasks into smaller, more manageable steps, setting clear goals, creating routines, and using external cues or reminders when needed. Enhancing initiation skills can lead to increased productivity, goal achievement, and overall success in various aspects of life. It contributes to the effective execution of tasks, projects, and responsibilities, fostering a sense of accomplishment and personal satisfaction.

Planning/Organization

Planning begins with establishing clear and specific goals. This involves defining what needs to be accomplished and articulating the desired outcomes. It involves the ability to anticipate future steps, set priorities, allocate resources, and create a coherent roadmap for the successful execution of a plan. Planning is a crucial executive function that plays a central role in various aspects of daily life, including work, education, and personal pursuits.

Organization of Materials

The ability to organize physical spaces and belongings, reducing clutter and facilitating a more structured environment for optimal functioning.

Emotional Regulation

This plays a pivotal role in managing emotions, helping individuals respond appropriately to different situations and navigate social interactions effectively. Difficulties in emotional regulation can be associated with various mental health conditions, such as anxiety disorders, mood disorders, or conditions that affect executive function. Therapeutic interventions, mindfulness practices, and cognitive-behavioral techniques are often employed to enhance emotional regulation skills. Developing effective emotional regulation is crucial for overall well-being and successful interpersonal relationships. It contributes to mental health, resilience, and the ability to navigate life’s challenges with a sense of balance and composure.

Exploring Executive Function Disorder

While many individuals naturally develop and refine their skills, others may face challenges due to executive function disorder. This condition manifests in difficulties with one or more executive functions, impacting daily life and hindering academic or professional success. Individuals with executive function disorders may struggle with tasks requiring planning, organization, time management, and emotional regulation.

Empowering Through Awareness and Strategies

Empowering individuals with knowledge about executive function and its essential skills is crucial. Recognizing strengths and areas for improvement allows for targeted interventions and the development of coping strategies. For those facing executive function challenges, seeking professional guidance, and utilizing tools like planners, reminders, and organizational aids can significantly enhance your day-to-day life.

Navigating Success with Executive Skills

In conclusion, executive function serves as the linchpin for cognitive abilities that shape how individuals approach life’s complexities. Understanding the seven executive functions provides a roadmap for enhancing these skills and navigating success in various aspects of life. By fostering awareness, embracing strategies, and seeking support when needed, individuals can harness the power of executive function to lead fulfilling and accomplished lives.

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Executive Functioning Skills 101: Problem-Solving

Written by:

  Amy Sippl

Filed under: Problem Solving , Behaviors , EF 101 Series , Executive Functioning

Published:  December 24, 2020

Last Reviewed: February 13, 2024

READING TIME:  ~ minutes

When parents reach out to us about working with a child, we almost always ask about problem solving skills.

• Does your child identify problems?
• When you see a problem in the making, can they see it too?
• If they come to you with a problem, how much effort does it take to generate a solution?
• Can they evaluate the pros and cons of different strategies to solve a problem?
• When your child eventually finds a solution to a problem, can they implement it and stay the course to see the situation through?

For many of the parents and teachers we work with, it quickly becomes clear that the struggles and challenging behaviors they encounter with their child ultimately comes back to challenges with problem solving.

What is problem solving?

Problem solving involves our capacity to identify and describe a problem and generate solutions to fix it .

According to Newell & Simon (1972) , “a person is confronted with a problem when he wants something and does not know immediately what series of actions he can perform to get it” (p.72). We engage in problem solving behaviors when we evaluate possible steps forward and then take action to obtain an outcome.

Problem solving involves many other executive functioning behaviors, including attentional control, planning , and task initiation . We need to pay attention to our environment to notice a problem, outline different strategies, and then attempt one of those solutions. Depending on the issue, we might also need to use time management , emotional control , or organization skills. Over time, if we can observe our behavior and understanding of the environment through working memory and self-monitoring behaviors, it can also influence our problem solving skills.

Developing Problem Solving Behaviors

Problem solving skills develop early through play behaviors as infants and toddlers. At these early stages of development, much of a child’s play consists of cause and effect activities or ‘figuring out how things work.’ As children move into early learning years, problem solving includes learning decision making and turn-taking. Children learn to brainstorm solutions to simple problems and learn to notice issues when others point them out.

As children reach adolescence, they begin to independently identify problems in many settings, including home, school, work, and friends. They sort out conflicts and decide what steps to take but may seek adult feedback and support to evaluate the potential advantages and disadvantages. Developing good problem solving skills as adults involves generating unique solutions to complex problems and persisting through multiple solutions until a problem resolves.

Examples of Problem Solving

How we problem solve might look different depending on the situation. Here are several examples of skills we need to know to problem solve effectively:

• Complete puzzles and games to accomplish a goal.
• Use language and body movements to achieve an outcome.
• Identify and define a problem, including where the problem originated and why.
• Break apart a problem into smaller parts.
• Identify problems in different social contexts, including work, school, home, and friends.
• Sort out conflicts and what to do in social situations.
• Seek guidance from others about what to do.
• Persist in developing new strategies when previous attempts fail.

Problem Solving and Challenging Behavior

Not all teens and young adults develop strong problem solving behaviors like those listed above. Barriers related to diagnosis, learning history, and motivation can impact how a child or student handles problems when they arise.

Learners with a history of behavioral and learning challenges may not always use good problem solving skills to manage stressful situations. We all know students who use challenging behaviors like talking back, arguing, property destruction, and aggression when presented with challenging tasks. We also know students who shut down, check out, or struggle to follow directions when encountering new or unknown situations. Without a step-by-step model for problem solving, including identifying a problem and choosing a replacement behavior to solve it, many of our children and students use challenging behaviors instead. Over time, learners written off as ‘defiant,’ ‘lazy,’ or ‘helpless’ may just need better problem solving tools.

How to Evaluate Problem Solving Issues

Some of the negative consequences of when a child or student struggles with problem solving skills might be obvious. Still, it may be more difficult to evaluate where there are underlying areas of concern. Here are some strategies to consider if it’s time to intervene:

• Conduct a behavioral observation. Using the list of behaviors above, observe your child or student when they encounter a problem. Jot down strengths and areas where the process stumbles. Notice what they solve independently and the types of issues that consistently require support.
• Conduct a skills assessment. There are many different tools, checklists, and workbooks (get 20% off our executive functioning workbook with coupon code LSA20 ) available to evaluate and create goals around executive functioning skills like organization . Many of these assessments and evaluation tools can also help develop SMART goals to target down the road. Download our problem solving skills pre-assessment below and complete it with your child.
• Meet with your child’s care team. Chances are if you’re noticing issues with problem solving skills, your child’s caregivers, teachers, coaches, and family members are also observing similar things. Gather the other stakeholders involved to coordinate and learn more about where problems arise.
• Contact a professional or life skills coach. Not every parent or teacher comes equipped to address problem solving skills. Working with a trained professional with experience in helping children develop and enhance problem solving can help teach new skills more efficiently and effectively.

Further Reading

• Bransford, J. D., and Stein, B. S., “The Ideal Problem Solver” (1993). Centers for Teaching and Technology – Book Library . 46.
• Kern, L., George, M. P., & Weist, M. D. (2016). Supporting students with emotional and behavioral problems.  Baltimore, MD: Paul H. Brookes .
• Life Skills Advocate Blog: Executive Function Skills by Age: What to Look For
• Life Skills Advocate Blog: How Teaching Executive Functioning Skills Can Reduce Challenging Behaviors
• Life Skills Advocate Blog: SMART Goal Setting
• Newell, A., & Simon, H. A. (1972).  Human problem solving  (Vol. 104, No. 9). Englewood Cliffs, NJ: Prentice-Hall.

About The Author

Amy Sippl is a Minnesota-based Board Certified Behavior Analyst (BCBA) and freelance content developer specializing in helping individuals with autism and their families reach their best possible outcomes. Amy earned her Master's Degree in Applied Behavior Analysis from St. Cloud State University and also holds undergraduate degrees in Psychology and Family Social Science from University of Minnesota – Twin Cities. Amy has worked with children with autism and related developmental disabilities for over a decade in both in-home and clinical settings. Her content focuses on parents, educators, and professionals in the world of autism—emphasizing simple strategies and tips to maximize success. To see more of her work visit amysippl.com .

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Life Skills Advocate is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com. Some of the links in this post may be Amazon.com affiliate links, which means if you make a purchase, Life Skills Advocate will earn a commission. However, we only promote products we actually use or those which have been vetted by the greater community of families and professionals who support individuals with diverse learning needs.

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Frontal Lobe: What It Is, Function, Location & Damage

Olivia Guy-Evans, MSc

Associate Editor for Simply Psychology

BSc (Hons) Psychology, MSc Psychology of Education

Olivia Guy-Evans is a writer and associate editor for Simply Psychology. She has previously worked in healthcare and educational sectors.

Learn about our Editorial Process

Saul Mcleod, PhD

Editor-in-Chief for Simply Psychology

BSc (Hons) Psychology, MRes, PhD, University of Manchester

Saul Mcleod, PhD., is a qualified psychology teacher with over 18 years of experience in further and higher education. He has been published in peer-reviewed journals, including the Journal of Clinical Psychology.

On This Page:

The frontal lobe is the brain’s largest region, located behind the forehead, at the front of the brain. These lobes are part of the cerebral cortex and are the largest brain structure.

The frontal lobe’s main functions are typically associated with ‘higher’ cognitive functions, including decision-making, problem-solving, thought, and attention .

It contains the motor cortex , which is involved in planning and coordinating movement; the prefrontal cortex, which is responsible for higher-level cognitive functioning; and Broca’s Area , which is essential for language production.

Frontal Lobe Functions

Below is a list of some of the associated functions of the frontal lobe:

Executive processes (capacity to plan, organize, initiate, and self-monitor) Voluntary behavior Problem-solving Voluntary motor control Intelligence Language processing Language comprehension Self-control Emotional control

The frontal lobes are believed to be our behavior and emotional control centers, meaning that this area is activated when needing to control our behaviors to be socially appropriate and to control our emotional responses, especially in social situations.

Moreover, the frontal lobes are thought to be the home of our personalities.

Alike to most lobes in the brain, there are two frontal lobes located in the left and right hemispheres.

Each lobe controls the operations on opposite sides of the body: the left hemisphere controls the right side of the body and vice versa.

It is believed the left frontal lobe is the most dominant lobe and works predominantly with language, logical thinking, and analytical reasoning.

The right frontal lobe, on the other hand, is most associated with non-verbal abilities, creativity, imagination, and musical and art skills.

The frontal lobe, like other structures of the brain, does not always work in isolation from each other. The frontal lobes work alongside other brain regions in order to control a variety of functions.

Substructures

The frontal lobe contains the motor cortex , which is involved in planning and coordinating movement; the prefrontal cortex, which is responsible for higher-level cognitive functioning; and Broca’s area, which is essential for language production.

Prefrontal Cortex

The prefrontal cortex is primarily responsible for the ‘higher’ brain functions of the frontal lobes, including decision-making, problem-solving, intelligence, and emotion regulation.

This area has also been found to be associated with the social skills and personality of humans.

This idea is supported by the famous case study of Phineas Gage , whose personality changed after losing a part of his prefrontal cortex after an iron rod impaled his head.

The frontal cortex has also been shown to be activated when an experience becomes conscious. Different ideas and perceptions are bound together in this region, both of which are necessary for conscious experience.  Concluding that this area may be especially important for consciousness.

Cognitive disorders that have been shown to be linked to this region are attention deficit hyperactivity disorder ( ADHD ), Autism, bipolar disorder, depression , and schizophrenia.

The prefrontal cortex can be further divided into the dorsolateral prefrontal cortex and the orbitofrontal cortex.

Motor and Premotor Cortex

The motor cortex is critical for initiating motor movements, as well as coordinating motor movements, hence why it is called the motor cortex.

Each area of the motor cortex corresponds precisely with specific body parts. For instance, there is an area that controls the left and the right foot.

The premotor cortex is associated with planning and executing motor movements. Within this area, voluntary movement is rehearsed, distinguishing these movements from unconscious reactions.

The premotor cortex has also been shown to be important for imitation learning through the use of mirror neurons.  These neurons essentially allow us to reflect the body language, facial expressions, and emotions of others.

Furthermore, the prefrontal cortex can support cognitive functions of a social kind, such as showing empathy.

Broca’s Area

Another region of the frontal lobes worth mentioning is Broca’s area . This region is located in the dominant hemisphere of the frontal lobes, which is the left side for around 97% of humans.

This region is associated with the production of speech and written language, as well as with the processing and comprehension of language.

The name is taken from the French scientist Paul Broca, whose work with language-impaired patients led him to conclude that we speak with our left brains.

Language differences in those with Autism may be correlated to differences in the structure and function of Broca’s area (Bauman & Kemper, 2005).

As the frontal lobes are situated at the front of the brain and are large in size, this makes them more susceptible to damage. This area is the most common for traumatic brain injuries, with damage to this region causing a variety of symptoms.

Below is a list of symptoms that may occur if an individual has experienced damage within their frontal lobe:

• Changes in mood
• Attention deficits
• Atypical social skills
• Difficulty problem-solving
• Lack of impulse control/ risk-taking
• Loss of spontaneity in social interactions
• Reduced motivation
• Impaired judgment
• Reduced creativity

Damage to Broca’s area, in particular, has been shown to affect the ability to speak, understand language, and produce coherent sentences.

One of the most famous case studies associated with frontal lobe damage is the case of Phineas Gage . He was a railway construction worker who suffered an unfortunate accident when a metal rod impaled his brain in the frontal region.

Gage survived this accident but was said to have experienced some personality changes because of the trauma. Before the accident, Gage was described as a ‘well-balanced’ and smart, energetic person.

After his accident, he was described as being childlike in his intellectual capacities and had a loss of social inhibition (behaving in ways that were considered socially inappropriate).

This case study implies that the frontal lobes are essential to our personalities, intelligence, and social skills. As well as trauma to the head is a cause of damage to the frontal lobes, there are many other causes that can lead to damage.

For instance, a brain tumor, stroke, or infection can cause deficits in this lobe. Similarly, conditions such as cerebral palsy, Huntington’s disease, dementia, or other neurodegenerative diseases can lead to associated damage.

If someone is suspected of having frontal lobe damage, there are methods to diagnose this. Magnetic resonance imaging (MRI) and computerized tomography (CT) scans can detect some differences in the frontal lobes after suffering a stroke or infection, as well as be able to detect dementia.

Also, neuropsychological evaluations can be completed to test for areas such as speech comprehension, social behavior, memory, problem-solving, and impulse control, among others.

One common test to establish frontal lobe damage is the Wisconsin Card Sorting task. Within this task, individuals will be shown cards of varying sorts, such as some having symbols, numbers, different shapes, and colors on them.

They will then be asked to sort the cards by a certain criterion, which will then change throughout the test. Those who have damage to a certain part of the frontal lobes may struggle with this task and will not adjust to new sorting criteria. They will stick with the original criteria (this is called perseveration).

Other tests worth noting as finger tapping tests, to test for motor skill ability, and the Token Test, which tests for language skills.

To be able to treat frontal lobe damage, occupational, speech, and physical therapy can be helpful for rehabilitating these lost or damaged skills.

Finally, a talking therapy called cognitive behavioral therapy (CBT) is common for working on regulating emotions and aiding impulse behaviors.

CBT may not fully treat physical damage to the frontal lobes, but it can help those with impairments cope and manage their symptoms.

Research Studies

• Semmes, Weinstein, Ghent & Teuber (1963) suggested that the frontal lobes played a part in spatial orientation, particularly our body’s orientation in space.
• Eslinger & Grattan (1993) investigated damage to the prefrontal cortex. They suggested that people with damage to this area may not have problems with word comprehension or identifying objects by their names, but if asked to say or write as many words as possible or describe as many uses of an object, they would find this task difficult. This shows that damage to one area associated with language does not impair all aspects of language.
• Kolb & Milner (1981) discussed the involvement of the frontal lobes in facial expressions. They found that patients with frontal lobe damage had difficulty expressing spontaneous facial expressions and would also show fewer facial movements spontaneously.
• Kaufman, Geyer & Milstein (2017) reported that patients who suffered damage to their frontal lobes had changes to their personalities.
• It was found that these patients developed an abrupt, suspicious, and sometimes even argumentative manner.
• Some patients were reported to have displayed ‘emotional incontinence,’ whereby they would have bouts of pathological laughing or crying.
• Walker & Blummer (1975) found that damage to the frontal lobes resulted in displays of abnormal sexual behavior in the orbital region and reduced sexual interest if the dorsolateral region was damaged.
• Stuss et al. (1992) found that damage to certain areas of the frontal lobes resulted in ‘bland’ personalities. These patients also displayed fewer signs of distress in emotionally heightened situations.
• Catani et al. (2016) investigated the brains of people with Autism and found support for the hypothesis that Autism is associated with different connectivity in the frontal lobe region compared with neurotypical individuals.
• Mubarik & Tohid (2016) conducted a literature review of studies that investigated the frontal lobes of those with schizophrenia.
• They found that many people with schizophrenia have differences in the structure of white matter , grey matter , and functional activity in their frontal lobes compared to those without the condition.

Bauman, M. L., & Kemper, T. L. (2005). Neuroanatomic observations of the brain in autism: a review and future directions. International Journal of Developmental Neuroscience, 23 (2-3), 183-187.

Catani, M., Dell’Acqua, F., Budisavljevic, S., Howells, H., Thiebaut de Schotten, M., Froudist-Walsh, S., … & Murphy, D. G. (2016). Frontal networks in adults with autism spectrum disorder. Brain, 139 (2), 616-630.

Eslinger, P. J., & Grattan, L. M. (1993). Frontal lobe and frontal-striatal substrates for different forms of human cognitive flexibility. Neuropsychologia, 31 (1), 17-28.

Kaufman, D. M., Geyer, H. L., & Milstein, M. J. (2017). Chapter 21-neurotransmitters and drug abuse. Kaufman’s Clinical Neurology for Psychiatrists . 8th ed. Amsterdam: Elsevier, 495-517.

Kolb, B., & Milner, B. (1981). Performance of complex arm and facial movements after focal brain lesions. Neuropsychologia, 19( 4), 491-503.

Mubarik, A., & Tohid, H. (2016). Frontal lobe alterations in schizophrenia: a review. Trends in Psychiatry and Psychotherapy , 38(4), 198-206.

Semmes, J., Weinstein, S., GHENT, G., Meyer, J. S., & Teuber, H. L. (1963). Correlates of impaired orientation in personal and extrapersonal space. Brain, 86 (4), 747-772.

Stuss, D. T., Ely, P., Hugenholtz, H., Richard, M. T., LaRochelle, S., Poirier, C. A., & Bell, I. (1985). Subtle neuropsychological deficits in patients with good recovery after closed head injury. Neurosurgery, 17 (1), 41-47.

Walker, A. E., & Blumer, D. (1975). The localization of sex in the brain. In Cerebral localization (pp. 184-199). Springer, Berlin, Heidelberg.

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Executive Function Deficits

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The umbrella term executive function (EF) refers to a group of interrelated cognitive processes, including but not limited to controlling initiation and inhibition; sustaining and shifting attention; organization; goal setting, and completion; and determining plans for the future. Taken together, these skills allow individuals to plan and execute tasks as well as to interact and communicate successfully with others. Early EF skills begin to develop in infancy, continue to grow throughout adolescence, and may continue to develop during adulthood.

EF was once considered to be specific to frontal lobe development (prefrontal cortex); however, it is now known that EF involves diffuse brain circuitry, with multiple areas working together (Fiske & Holmboe, 2019).

EF comprises many skills, and there is some disagreement on which skills are housed under this umbrella term (Fahy, 2014; Jacob & Parkinson, 2015; Nyongesa et al., 2019). However, many researchers and clinical experts suggest the following core cognitive dimensions (Nyongesa et al., 2019):

• working memory
• inhibitory control
• cognitive flexibility

Other higher order EF cognitive skills include, but are not limited to,

• metacognition—the ability to consider one’s own thought process, including self-awareness and self-monitoring;
• fluid/abstract reasoning skills;
• multifactorial problem solving (i.e., complex problem solving); and
• advanced Theory of Mind skills (e.g., perspective-taking).

EF depends on foundational cognitive functions working together. Such cognitive functions include, but are not limited to,

• processing speed, and

EF deficits are a breakdown of any of these skills at any level. Such a breakdown can impact an individual’s ability to complete functional tasks, such as following a sleep schedule, completing assignments, meeting deadlines, planning for activities, navigating social situations, and managing medications. Difficulties in any of these areas may impact life participation and quality of life.

Speech-language pathologists (SLPs), among other professionals (e.g., neuropsychologists, psychologists, occupational therapists, and physicians), play a critical role in identifying and treating EF deficits in children and adults. Please see ASHA’s resource, Populations Often Impacted by Executive Function Deficits .

Incidence and Prevalence

EF deficit is a common sequela across various neurologic, psychologic, and behavioral diagnoses. However, research pertaining to the incidence rates (i.e., the number of new cases identified in a specified time) and prevalence rates (i.e., the number of people who are living with EF deficits in a given time) varies across research studies due to differences in participant characteristics (e.g., age, severity), methodology (e.g., different outcomes measured), and diagnostic classification criteria used. Estimates of EF deficit in some populations, listed alphabetically, are as follows:

Amyotrophic lateral sclerosis (ALS) —22% to 70% (Crockford et al., 2018; Kasper et al., 2015)

Attention-deficit/hyperactivity disorder —50% to 83% of children (Lambek et al., 2011)

Autism spectrum disorder —41% to 78% (Lynch et al., 2017)

Dementia and Alzheimer’s disease —84% of patients with Alzheimer’s disease and 77% of individuals with vascular dementia (D’Onofrio et al., 2018)

Huntington’s disease —71% (Julayanont et al., 2020)

Parkinson’s disease —10% to 65% (Aarsland et al., 2010; Kalbe et al., 2016)

Preterm infants —6% to 18% of adolescents born very prematurely (i.e., with an average gestational age of 28 weeks or birth weight lower than 1,250 g; Luu et al., 2011)

Stroke —19% to 47% (Hayes et al., 2016; Pohjasvaara et al., 2002; Tang et al., 2019)

Traumatic brain injury (TBI) —18% to 38% of children and adolescents with mild-to-severe TBI (Sesma et al., 2008; Williams et al., 2022), 48% of adults with moderate-to-severe TBI in the subacute phase (Tsai et al., 2021), 38% of adults with moderate-to-severe TBI in the chronic phase (Tsai et al., 2021), and 55% of individuals with severe TBI in the chronic phase (Azouvi et al., 2016)

Signs and Symptoms

Preschool and school-age children.

EF deficits can have a significant impact on the well-being and academic progress of preschool and school-age children. Preschoolers with EF deficits may have trouble with home and class routines, including completing steps for grooming and dressing. Children may become easily frustrated or behave impulsively due to difficulties with emotional regulation and inhibition. They may lack the ability to organize their thoughts to communicate what they are struggling with, especially in the case of a comorbid communication disorder (e.g., speech sound disorder, language disorder).

As academic, developmental, and social demands increase, children may begin to display EF deficits that were not apparent when academic demands were less complex. Older children may have difficulty developing social skills, completing school assignments, engaging with peers, staying organized, keeping up to date with homework and testing schedules, navigating the school environment, and following class schedules. EF skills can be affected by environmental factors, including adverse childhood experiences (e.g., trauma and malnutrition), family structure, and availability of educational opportunities. For further information regarding EF development in young children, see McCormack and Atance (2011).

Adolescents and Young Adults

Adolescents with EF deficits may have similar difficulties to preschool and school-age children. EF skills develop over the course of adolescence, with the prolonged development of the prefrontal cortex. Therefore, higher expectations regarding EF skills occur with increasing age during this stage of development. It should not be expected that full EF development is complete until a person is in their 20’s.

For instance, there is a significant increase in the difficulty of schoolwork as a child moves into middle school, and this becomes more challenging in higher education. A child with EF deficits who was able to do well in elementary school may begin to experience difficulty as the demands of schoolwork and complex social interactions increase. Successful transition of young adults into adulthood depends on functional EF skills. Young adults with EF deficits may struggle as decision making and responsibilities of adulthood become increasingly complex as they age (e.g., paying bills, saving money, reading contracts) and as they transition to higher education and/or the workforce.

EF deficits may potentially be associated with youth incarceration. Young males with a history of being involved with the juvenile justice system and those with a history of committing violent crimes may demonstrate reduced EF skills when compared to the general population (Syngelaki et al., 2009; Zou et al., 2013).

The experiences of adults with EF deficits are impacted by the severity of other diagnoses, the nature of their EF deficits, the cognitive demands of their environment (e.g., home or work), and environmental supports available to them. For example, some adults with EF deficits who have jobs with fewer EF demands may be able to easily complete work tasks but may have trouble managing complex life skills, such as paying bills, managing medications, or engaging appropriately in social situations. Such challenges may place these individuals at risk of losing financial security (e.g., losing consistent employment). A person with even mild EF challenges who works a cognitively complex job may have significant difficulty completing work tasks but may be able to function independently in basic home tasks/activities. Additionally, adults with EF deficits may experience reduced quality of life and increased risk of marital discord, social problems, and physical health disparities (e.g., obesity, overeating, and substance abuse; Diamond, 2013). This may be, at least in part, due to associations between EF deficits and impulsivity and risky behaviors (Reynolds et al., 2019). EF deficits and incarceration in adults may be related (Meijers et al., 2015). Adults with a history of incarceration and EF deficits may also be at greater risk for recidivism (Hancock et al., 2010).

Older Adults

As they age, older adults’ EF skills may decline due to age-related atrophy of the cerebral cortex. Older adults may have difficulty completing tasks such as problem solving through home repairs and managing finances. EF deficits in older adults may contribute to higher risk of falls in older adults—particularly those with balance and gait impairments who may rely on cognitive skills to compensate for physical problems (Kearney et al., 2013; Springer et al., 2006).

EF deficits occur in both children and adults and may present differently depending on the age group they impact, the particular EF skill(s) impacted, and the cause of the deficits (i.e., acquired or developmental). EF deficits in children (e.g., difficulties with task planning or completion due to attention-deficit/hyperactivity disorder) are likely to continue into adulthood. Please see ASHA’s Practice Portal resource on Populations Often Impacted by Executive Function Deficits . Any of the conditions listed on this resource may coexist, which may complicate the identification and treatment of EF deficits.

Roles and Responsibilities

SLPs play a central role in the screening, assessment, and treatment of persons with EF deficits and are uniquely qualified to identify EF deficits among other related comorbidities. The professional roles and activities in speech-language pathology include clinical/educational services (diagnosis, assessment, planning, and treatment); prevention and advocacy; and education, administration, and research. See ASHA’s Scope of Practice in Speech-Language Pathology (ASHA, 2016).

SLPs with competency in the identification of EF deficits can look to their state licensure scope of practice and legislation related to diagnosis. Reimbursement entities may limit reimbursement of services to individuals with this diagnosis.

Appropriate roles for SLPs include, but are not limited to, the following:

• Identifying risk factors for EF deficits and understanding a variety of medical diagnoses and their potential impact on EFs.
• Identifying signs and symptoms of EF deficits.
• Being aware of typical development and age-related changes regarding cognition and EF skills.
• Screening and assessment for EF deficits, including the use of both informal and formal tools.
• Providing treatment for EF deficits, documenting progress, adapting and adjusting treatment plans based on patient performance, and determining appropriate discharge criteria.
• Identifying and using appropriate functional outcome measures while determining the impact of EF deficits on the overall quality of life.
• Including patients and caregivers in the development of a treatment plan.
• Providing education and counseling to individuals and caregivers.
• Practicing interprofessional collaboration, including educating and consulting with other professionals. See ASHA’s resource on interprofessional education/interprofessional practice (IPE/IPP).
• Advocating for services for individuals with EF deficits.
• Performing research to advance the clinical knowledge base.

See the Assessment section of the Executive Function Evidence Map for pertinent scientific evidence, expert opinion, and client/caregiver perspective.

EF deficits can be clinically assessed using formal or informal approaches. Dynamic assessment is critical, as EF deficits are complex and the extent of EF deficits may not be clear at the time of the initial evaluation. Assessment can also be complicated by co-occurring issues or diagnoses. For example, assessment and treatment of EF skills in an adult with intellectual disability and a recent traumatic brain injury may be complex, as dynamic recovery from traumatic brain injury may make understanding baseline EF challenges difficult. Such comorbidities may also make it difficult for an SLP to provide an accurate prognosis. The individual’s care partner should be educated on assessment challenges related to comorbidities. Careful monitoring of individuals’ progress as well as ongoing communication with the patient and their care partner may clarify the extent of any new EF deficits and prognosis during treatment.

Although many assessment materials are based in language, nonverbal assessments are also considered. Nonverbal assessments are especially useful in the case of an accompanying language deficit.

Individuals rarely present with a chief complaint of EF deficits and may use general terms such as “memory loss,” “brain fog,” or “being scattered” to describe cognitive deficits. SLPs may ask specific questions about the individual’s EF during tasks (e.g., difficulties in planning, organization, multitasking attention; Rabinovici et al., 2015) to better understand the patient’s functional EF performance. Patient/caregiver/family/teacher interviews and discussion may help to further describe the nature of these deficits and clarify if, and how, they differ from the individual’s baseline. In many cases, a neuropsychologist may perform a comprehensive evaluation to determine the extent and the likely etiology of cognitive symptoms.

The interconnectivity of EF skills makes it challenging to assess different EF skills separately. It is difficult to isolate specific EFs and assess them in a way that does not involve a different EF skill (e.g., multifactorial problem solving cannot be assessed without considering the influence of attention). Therefore, when assessing the subcomponents of EF (e.g., attention), SLPs should be mindful of how these interconnect with other skills in the EF framework.

Additionally, the cognitive tasks that individuals face may change from day to day, and it is challenging to replicate functional situations in an assessment setting or a therapy room. Assessment in relevant contexts is therefore suggested when possible. Contextually relevant evaluations allow the SLP to dynamically assess the individual’s EF in real-life activities (e.g., classroom, noisy waiting room, workplace). There is also natural variation in any individual’s EF capacity due to factors such as fatigue, stress, sleep, nutrition, and interest in the activity. Ongoing assessment throughout the course of treatment is important for these reasons, although SLPs should also be aware of the likelihood of practice effects for the various measures they use to reassess. 

See the Screening section of the Executive Function Evidence Map for pertinent scientific evidence, expert opinion, and client/caregiver perspective.

Screening tools are used to determine the need for further assessment if EF deficits are suspected. Many factors may impact performance on screening measures, and poor performance may not indicate true impairment. Some screening tools designed to assess foundational cognitive skills (e.g., attention, processing speed, memory) may assist in identifying individuals with EF deficits, whereas other screening tools may directly measure EF skills. They may include written or verbally presented tasks, rating scales to be completed by the patient and/or caregiver, parent and teacher checklists, and informal observations.

Many cognitive screenings are administrated verbally and depend on language skills, but some individuals with EF deficits may also have language deficits. Nonverbal screening tools are considered and used when appropriate.

Comprehensive Assessment

Assessment may also include the administration of formal tests (please see ASHA’s Executive Function Evidence Map for further information). SLPs collaborate with other professionals (e.g., neuropsychologists, occupational therapists, psychologists) when possible. EF skills assessed may include inhibition, flexibility, working memory, and planning, among others (Follmer, 2018). If the individual is also working with a psychologist or neuropsychologist, they may already have been administered a battery of tests. SLPs can gain valuable information about EF skills from the neuropsychological/psychoeducational evaluation and ensure that assessment materials that SLPs use are not duplicates of those already completed. The SLP can also provide valuable insights into how EF deficits identified on standardized batteries might impact a person in everyday activities. Additionally, they can explain how an individual’s functional complaints might not be observed on standardized testing. For example, when testing occurs without time pressures and in a quiet, one-on-one setting, a person may not exhibit breakdowns in selective attention or working memory.

Informal assessment tools, such as observations in real-life situations, patient/client interviews, care partner interviews, checklists, informal rating scales, and questionnaires, can help gather information about the subjective functional impact of EF deficits on a person’s day-to-day activities. Results may differ between informal, report-based assessment and formal, performance-based assessment due to differences in measure sensitivity or construct measured (i.e., behavioral observations vs. accuracy and time performance; Ten Eycke & Dewey, 2016; Toplak et al., 2008; Vriezen & Pigott, 2002). As such, informal assessment tools are often used in conjunction with standardized or formal assessments to gain a more complete understanding of the functional impact of each individual’s EF deficits at home, at school, and in the community.

Environmental assessment may be useful in determining the presence and extent of EF deficits, because the environment can serve as a barrier to or facilitator of the demonstration of EF skills, and standardized tests may have limited ecological validity. For example, in the school setting, an environmental assessment may include observation of a student’s navigation of their daily schedule, interactions with peers, and participation in their classroom. Environmental assessment for adults may be more challenging, as it may require an SLP to accompany an individual to their worksite or home, which may not be possible. In a clinical setting, environmental and/or task modifications may be made when informally assessing EF skills to better replicate an individual’s typical environment (e.g., introducing two tasks simultaneously, adding of interruptions, or presenting auditory and/or visual distractors).

The advent of telemedicine may make these sorts of observations more feasible for SLPs, although environmental assessment may occur more in the context of vocational rehabilitation than in SLP services for adult populations.

School-Based Assessment and Eligibility

Assessment and treatment of EF deficits in children is important, because EFs are foundational for school readiness and success. Children with developed EF skills make larger gains on tests of math, language, and literacy development than peers with EF deficits during their preschool years (Center on the Developing Child at Harvard University, 2011). There is an association between EF skills and academic achievement, although SLPs should remain aware that the causality of this relationship is yet to be determined (Jacob & Parkinson, 2015).

School-based assessment follows the same tenets of comprehensive assessment. However, the wide array of available tools for assessing EF in adolescence may make selection of the appropriate measurement tool(s) complicated for clinicians. See Nyongesa et al. (2019) for further discussion.

Eligibility for school-based services in public schools falls under the Individuals with Disabilities Education Improvement Act of 2004 (IDEA, 2004). IDEA (2004) requires that a student have the presence of a disability falling under seven educational categories that adversely affect academic achievement and functional performance, requiring specialized instruction. The student is determined to be eligible based on educational, functional, and/or social impact. Definitions for eligibility vary between different states and different districts (please see ASHA’s resource on eligibility and dismissal in schools for further information). IDEA (2004) also requires that an evaluation be comprehensive and assess all areas of suspected disability. Please see ASHA’s Practice Portal page on Documentation in Schools for further information.

Students may be determined to be eligible for an individualized education program (IEP) and/or a 504 plan . An IEP is a legal document used to ensure that a student eligible for special education has measurable and achievable goals and objectives. When attending a public school, a student with EF deficits may qualify for SLP services as part of an IEP.

504 plans outline accommodations a student may need to access the general education curriculum. 504 plans require a physical or mental impairment limiting one or more life activities. Some examples of accommodations for EF difficulties may include preferential seating close to the front of the class, frequent breaks, or written transcripts of lectures.

For more information on IEPs and 504 plans, see Individualized Education Programs (IEPs), Individualized Family Service Plans (IFSPs), and Section 504 Plans .

There are many approaches for treating EF deficits, some of which are more appropriate for children whereas others are better suited for adults. As always, the most evidence-based treatments available, focusing on the specific areas of difficulty an individual experiences, and preferences should be used. Treatment approaches include, but are not limited to, the following:

• Dual-task training
• Environmental modifications
• Explicit verbal reasoning training
• High-tech aids (e.g., smartphones, computers, smart pens, recording devices)
• Low-tech aids (e.g., written notes, pictorial checklists/schedules, reminders, calendars, alarms)
• Cognitive orientation to occupational performance intervention (Missiuna et al., 2001)
• Goal management training
• Goal-oriented attentional self-regulation (GOALS; Novakovic-Agopian et al., 2011)
• Goal–plan–do–review (GPDR; Ylvisaker et al., 1998)
• Metacognitive strategy instruction
• Metacognitive contextual approach
• Short-Term Executive Plus (STEP; Cantor et al., 2014)
• Strategic Memory and Reasoning Training (SMART; Chapman & Gamino, 2008)
• Time pressure management (TPM; Winkens et al., 2009)
• Video and verbal feedback
• Verbal self-instruction

Client/patient input is important when determining treatment needs. Additionally, parents/care partners/teachers may provide a clinician with a deeper understanding of the issues that individuals with EF deficits experience in day-to-day life, particularly given that people with EF deficits may inherently lack awareness of their deficits. It is essential to work with family or other related persons (e.g., parents, care partners, teachers) to promote the generalization of EF strategies or interventions into real-life activities.

Treatment may be provided in a variety of settings, including one-on-one and group treatment. Both school and work atmospheres often include some element of teamwork. Therefore, group therapy may help some students/patients address functional goals. “Life skills” outings in the community give a practical way for individuals to use strategies and improve skills. See the Service Delivery section of the Executive Function Evidence Map for pertinent scientific evidence, expert opinion, and client/caregiver perspective.

Telepractice is also an option for treatment. However, as with any therapy, clinicians may need to make modifications to how they deliver services (e.g., access to resources). Please see ASHA’s Practice Portal page on Telepractice for further information.

Functional goals for both pediatric and adult populations are tailored to the individual’s unique needs. However, some potential examples of items for goal consideration may include

• maintaining a schedule to arrive on time to therapy/work/class,
• using a clock or timer to increase the awareness of the passage of time and appropriate time allotment for task completion (this is particularly useful when working with children),
• taking notes during therapy and following through on expectations,
• using computer programs related to job function or school-based activities,
• evaluating an attempt to solve a problem and recommending changes to try next time to improve success,
• prioritizing and completing multiple tasks given a time frame, or
• completing tasks with the assistance of a trained care partner or peer.

The SMART goal (Specific, Measurable, Actionable, Reasonable, and Time bound) framework can assist in appropriate EF treatment goal setting.

SLPs working on an individualized education program (IEP) team in the schools may prioritize collaborative goal writing when addressing EF deficits. Please see ASHA’s resource, How To: Writing Collaborative Goals for IEPs.

School-Based Intervention

Many of the treatment techniques described below are applicable to multiple age groups.

Developing Skills

• developing EF skills through direct treatment/instruction
• training/supporting teachers in the use of classroom management strategies
• training teachers to assist in the development of social–emotional skills by modeling and coaching pro-social behavior, social problem-solving skills, comprehension and expression of emotions, impulse control, and organizational skills
• learning chunking strategies to break up and better organize tasks
• requesting repetition of complex verbal material and/or
• requesting additional time to complete tasks
• learning to review work for errors before submission

Using Classroom Strategies

• recording classroom lectures and discussions for further review
• using visual schedules, using clocks, estimating elapsed time, and estimating expected time to complete a task
• completing prewriting tasks (e.g., flowcharts, web charts, storyboarding)
• listening for key words in class/lectures
• using a calendar app to track assignments,
• setting an alarm as a reminder for tasks, or
• organizing school binders to hold materials in an easy-to-navigate fashion

Environmental Accommodations and Modifications

• a dedicated note-taker
• removing clutter and visual distractions
• additional time to complete tests or homework
• reduced amount of work (i.e., grading quality, not quantity)
• the option to work or test in a distraction-free environment, separate from peers
• additional assistance with complex assignments (e.g., providing steps for breaking down assignments into manageable components)

For additional strategies and information regarding EF interventions for children aged 4–12 years, see Diamond and Lee (2011).

Treatment may vary across settings. For instance, an SLP in private practice or in a clinical setting may not have the opportunity to observe the student in a classroom setting. The ability to interact with and observe a student in functional settings can be key to therapy provision. SLPs treating in either private practice or clinical settings may consider contacting (with appropriate consent) the client’s school-based SLP or teacher, to determine if strategies taught in the clinic are effective in the classroom. If a child is being seen by both a school and an outpatient SLP, both parties may collaborate to ensure that they are targeting similar and appropriate goals.

SLPs may consider the use of restorative therapy, compensatory strategies, or a combination of the two when treating adults with EF deficits. Any course of treatment is tailored to the specific individual being treated and the specific areas of deficits observed. A combination of approaches allows SLPs to directly treat EF dysfunction and provide strategies and approaches that will be useful to the individual in each environment (i.e., home, workplace, or the community).

Therapy incorporating internal strategies for improving EF skills may include

• visualization exercises;
• self-talk exercises;
• determining the steps/sequence as part of breaking down a task;
• prioritizing tasks for completion within a specific time frame;
• estimating elapsed time and expected time to complete a task;
• self-evaluating performance;
• identifying and monitoring for the driving factors behind breakdowns in EF skills, with the generation of potential solutions to remediate them;
• proactively selecting strategies for improved performance and judging the success of selected strategies;
• identifying barriers to safety awareness secondary to EF deficit (e.g., fall prevention) and potential strategies for increased safety; and
• identifying and reducing the impact of internal (e.g., hunger, fatigue, anxiety) and external (e.g., auditory, visual, temperature) distractions when completing complex tasks.

SLPs may work with adults on developing external strategies to assist them in functional tasks, including

• prewriting when engaged in a writing activity (e.g., work e-mails);
• setting alarms to remind the patient to take their medication or complete tasks;
• developing routines and structure;
• using a planner, a calendar, or other organizational tools; and
• engaging care partners, when appropriate, to provide external structure and cueing and promote generalization of EF strategies into everyday routines.

Treatment goals, activities, and compensatory strategies differ across settings. In an outpatient setting, treatment may involve a lot of patient/caregiver report on the effectiveness of different strategies, as well as what new situations may be challenging for the patient. Therapists who visit patients in their homes/workplace can observe and assess the patient in their typical setting and may be able to develop treatment plans and goals that are specific to the individual’s environment.

Please see Brown et al. (2022) and Jeffay et al. (2023) for further information.

Audiology Treatment

Children and adults who have both EF deficits and hearing loss may benefit from additional considerations regarding hearing loss treatment and management. Patients may differ in age of onset of hearing loss, age of identification of hearing loss and intervention, degree of hearing loss, mode(s) of communication (i.e., oral/aural, manual, total communication), and severity of EF deficits.

People with hearing loss may benefit from the use of an assistive listening device (e.g., FM system, remote microphone). People who use hearing aids, bone-conduction devices, or cochlear implants may also use assistive listening devices to increase the effectiveness of their technology. The use of an assistive listening device improves the ratio between the signal of importance (often a person who is speaking) and noise. These technologies support auditory access in the classroom, in the workplace, and in other challenging listening environments. These systems may be useful for people with EF deficits (e.g., attentional difficulties) even when they have normal hearing thresholds. For more information on the evaluation and treatment considerations of children who are deaf or hard of hearing in schools, refer to Students Who are Deaf or Hard of Hearing in the School Setting and ASHA’s Practice Portal page on Language and Communication of Deaf and Hard of Hearing Children . Assistive listening devices can be used in isolation, in addition to another hearing technology, and/or in conjunction with another accommodation.

Cognitive decline, increased likelihood of dementia, and resulting deficits in EF skills are related to age-related hearing loss. However, it is unclear if hearing loss causes cognitive decline (Slade et al., 2020). Audiologists may help identify patients who are exhibiting signs of mild cognitive impairment or EF deficits and make appropriate referrals to a physician for assessment. Some early signs an audiologist may notice are reduced electrophysiological responses, poor auditory processing, memory impairment, receptive/expressive language difficulties, and confusion (Lister et al., 2019). Some adults with hearing loss may have improved functional cognition with hearing aid use (Sanders et al., 2021). Hearing loss management and treatment is considered one of the greatest modifiable risk factors for age-related cognitive decline (Livingston et al., 2020). Audiologists may counsel patients on the consequences of untreated hearing loss when hearing loss is identified. See Untreated Hearing Loss in Adults .

Augmentative and Alternative Communication (AAC) Users

EF skills may impact decisions about the format (e.g., digital vs. analog) and complexity of a chosen AAC system. Generally, less complex systems require less advanced EF skills. More complex (e.g., digital) devices that include menu navigation may require more advanced EF skills. Regardless of the complexity of the AAC system, modifications to the AAC device (i.e., symbol type and color, organization, array size, background color, and layout) can be made to decrease EF demands on users (Thistle & Wilkinson, 2012).

Special considerations may need to be made for individuals with acquired brain injury (ABI) who use an AAC device, especially those who had reading challenges before injury and those with severe language and/or cognitive deficits. Individuals with ABI may also need separate devices for different stages of recovery (e.g., a low-tech “yes/no” selection in the acute stage of recovery and use of a dynamic display as the patient’s recovery stabilizes into the chronic stage of injury; Wallace, 2010). Please see ASHA’s Practice Portal page on Augmentative and Alternative Communication and ASHA’s Augmentative and Alternative Communication (AAC) Evidence Map for further information.

Other Effects on Treatment

There may be factors that impact the EF abilities of an individual that fall outside of the SLP’s scope of practice, such as

• pharmacological status,
• physical health status (e.g., pain), and
• psychological status.

Although SLPs do not directly target these factors, they may consider working with an individual on metacognitive skills to help them recognize the effects of these factors on overall EF. Clinicians may consider providing tracking sheets to assist the patient in monitoring such factors. Clinicians consult with and/or refer individuals to other providers, as appropriate.

Patient-Centered Care

Viewpoints on cognitive differences such as EF deficits vary among cultures. SLPs collaborate with patients, students, and their families to treat EF deficits in a culturally sensitive manner. Cultural considerations are a key component of assessment and ongoing treatment. Cultural background may influence performance on EF tasks (Kelkar et al., 2013; Lan et al., 2011).

Perceptions of appropriate EF behaviors vary across cultures (e.g., judgments about which behaviors are considered impulsive, what is an appropriate solution to a problem, how to best organize and prioritize information). These expectations vary not only between different cultures but also within a culture across settings, languages, and communicative exchanges (e.g., at school vs. at home, when speaking with peers vs. adults). Clinicians use collaborative goal setting —considering the needs of the individual across contexts and languages spoken—when working with individuals and their care partners.

Lack of familiarity with formal assessment methods may decrease an individual’s participation or performance in assessment. The clinician considers EF in the context of each person’s experience and background, rather than judging everyone according to the standards of the clinician’s cultural background. Gathering information using a variety of sources and techniques can help provide a more complete picture of the functional impact of EF deficits.

During assessment, documentation should include a description of any modifications and/or accommodations made to the testing process to reconcile cultural and linguistic variations, hearing and/or visual deficits, or other factors that may impact screening or comprehensive assessment. Any modifications and/or accommodations should also be considered when reporting assessment results. It is not appropriate to report standardized scores if the individual is not represented in the norming sample or if modifications are made that are not included in the standardized procedures.

Cultural stigmas related to disability may prevent individuals from advocating for themselves, requesting supports or accommodations, or using external aids. Different cultures may prioritize the value of independence to differing degrees, which can impact treatment goals. A desire for some reliance on others may be culturally appropriate, and patient and care partner preferences should be considered within the goal-setting process. People who are neurodivergent may have differences in EF skills (Shogren et al., 2021), and variability across different EFs is common. Clinicians are mindful of neurodiversity and work with the individual and their care partners to understand their priorities and to choose functional goals consistent with their values.

Please see ASHA’s Practice Portal page on Cultural Responsiveness for more information.

Counseling and Education

Counseling is an important part of treatment for EF deficits for both the affected individual and the family/caregivers. Both individuals and families may not be aware of the extent of EF deficits. This may be particularly true of a patient with an acquired diagnosis (e.g., ABI, dementia) that has changed the person’s EF abilities from prior to this event/diagnosis. In such cases, an individual may not be able to return to their typical home, school, and/or work environment. Family members and caregivers may be counseled on such items as

• changing expectations or activities due to EF deficits,
• providing supervision or monitoring for unsafe tasks (e.g., cooking, driving) and new responsibilities for the caregiver (e.g., assisting the individual with maintaining and following a schedule),
• strategies to support the individual with EF deficits by modifying the environment, and
• recognizing the importance of practicing strategies in everyday life to increase the generalization of therapy activities.

Conversely, clients and/or family members may underestimate a client’s abilities, including EFs. In this case, providing encouragement to gradually engage in increasingly complex activities, while using the strategies taught, can help increase confidence and participation in activities that clients value.

Treatment includes patient and family education about current deficits and their potential impact on the client’s safety, ability to complete school/job functions, and quality of life. Education for the patient and their care partner may also include providing information about support groups. Education for the client may focus on metacognition, when appropriate, which may help the patient gain a better understanding of their strengths and limitations.

Please see ASHA’s Practice Portal page on Counseling For Professional Service Delivery for further information. Mental health issues (e.g., anxiety, depression) can impact performance on EF tasks. SLPs refer individuals to a mental health practitioner (e.g., psychologist) when appropriate.

Collaboration and Teaming

EF deficits may be related to or co-occur with disorders or diagnoses treated by other providers. Neuropsychologists are key members of teams that collaborate on assessment and treatment of EF deficits. Neuropsychologists and school psychologists may provide extensive assessment of cognition, psychological status, and other factors. Neuropsychological evaluation encompasses many cognitive, behavioral, and emotional facets of EF and may assist in making determinations regarding cognitive capacity; selection of recommended treatments; and readiness for return to driving, school, and/or work. They also may make recommendations for appropriate psychological supports for work and school and detail biopsychosocial factors that may negatively impact cognition if left untreated. Communicating with a patient’s neuropsychologist and any other health providers may provide further insight into that patient’s deficits. In addition to the individual’s family and/or care partner, SLPs may also collaborate with

• the individual’s primary care provider,
• a physical medicine and rehabilitation physician,
• a neurologist,
• physical and occupational therapists,
• vocational rehabilitation specialists/job coaches,
• psychologists/psychiatrists/counselors/social workers, and/or
• school-based teams.

Multidisciplinary evaluation and communication among the team members is particularly important as deficits in one area may impact those in another. For instance, if physical or occupational therapists are working with a student on motoric deficits, the attention that students must allocate to compensating for those deficits may impact their ability to complete higher level cognitive tasks. SLPs review other team members’ documentation and discuss an individual’s progress when appropriate. Please see ASHA’s resource on interprofessional education/interprofessional practice (IPE/IPP).

ASHA Resources

• Assessment of Executive Functions in School-Aged Children: Challenges and Solutions for the SLP
• Coding and Payment of Cognitive Evaluation and Treatment Services
• Counseling For Professional Service Delivery 
• Dynamic Assessment
• Eligibility and Dismissal in Schools
• Executive Function Evidence Map
• How To: Writing Collaborative Goals for IEPs
• Individualized Education Programs (IEPs), Individualized Family Service Plans (IFSPs), and Section 504 plans
• Integrating Mild Cognitive Impairment Screening Tools in Audiologic Care: A Review
• Interprofessional Education / Interprofessional Practice (IPE/IPP)
• Populations Often Impacted by Executive Function Deficits
• Students Who are Deaf or Hard of Hearing in the School Setting  
• Tackling the Toll of Hearing Loss on Executive Function
• Untreated Hearing Loss in Adults 

Other Resources

• Activities Guide: Enhancing and Practicing Executive Function Skills with Children from Infancy to Adolescence
• Center on the Developing Child
• Fast Facts: Preventing Adverse Childhood Experiences
• Goal Attainment Scale
• Organizing Executive Function, Part One: Identifying and Assessing for SLPs
• RCSLT: New Long COVID Guidance and Patient Handbook
• Self-Regulation/Executive Function Issues [PDF]
• Training the Brain: Executive Function for Children with Hearing Loss

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About This Content

Acknowledgements.

Content for ASHA's Practice Portal is developed through a comprehensive process that includes multiple rounds of subject matter expert input and review. ASHA extends its gratitude to the following subject matter experts who were involved in the development of the Executive Function Deficits page:

• Sneha Bharadwaj, PhD, CCC-SLP
• Angela Ciccia, PhD, CCC-SLP
• Leah Kapa, PhD
• Jennifer Lundine, PhD, CCC-CLP
• George McCloskey, PhD
• Michael McLeod, MA, CCC-SLP
• Kelly Ann Peña, MA, CCC-SLP, CBIST
• Katharine Seagly, PhD
• Bridgid Waldron-Perrine, PhD
• Sarah Ward, MS, CCC-SLP
• Laura Wilson, PhD, CCC-SLP

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Executive Functioning vs Cognitive Functioning (Neurocognitive Assessment Tips)

• by Team Experts
• July 2, 2023 July 3, 2023

Discover the surprising difference between executive functioning and cognitive functioning in neurocognitive assessments with these tips.

What is the Difference Between Executive Functioning and Cognitive Functioning?

What role does working memory capacity play in executive functioning, can task switching ability impact executive functioning test scores, time management skills and their relationship to cognitive performance, problem solving skills: an essential component of executive functioning testing, common mistakes and misconceptions, related resources.

Overall, problem-solving skills are a critical component of executive functioning testing. It is important to assess a variety of skills , including analytical thinking capacity , logical reasoning ability , and creative problem-solving aptitude . Additionally, evaluating metacognition awareness, self-monitoring capability , and task initiation skill can provide valuable insights into the test-taker’s problem-solving abilities . However, it is important to be aware of potential risk factors, such as anxiety , learning disabilities , language barriers , attentional shifting difficulties, and time management difficulties , that may affect the test-taker’s performance .

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If a stroke affects your executive function, here is how it might impact you and some ways you can get help.

On this page

Problems with planning and problem-solving Signs of problems with planning and problem-solving What can I do about planning and problem-solving?

Problems with planning and problem-solving (executive function)

Many other thinking processes happen without us being aware of them, known as automatic processes. Together, many of these automatic processes are known as executive function.

Executive function is about planning and problem-solving. It includes all the things that allow us to organise, make decisions and know when we need to do something. It also involves the way we monitor what’s going on around us, and adjust what we think and do in response.

Signs of problems with planning and problem-solving

If a stroke affects your executive function, you may find it hard to:

• Work out how to do certain things. This could be a task that seems quite simple like changing the channel on the TV remote control, or it could be more complicated, like making a meal.
• Plan how to complete a task. You may not be able to think of all the steps that are needed to do something, such as making a cup of tea, or put the steps in the correct order.
• Begin or finish a task on your own. You may not realise that you need to do something, like get dressed, until someone tells you, or you may need someone to prompt you throughout a task to help you to complete it.
• Solve problems on your own. You may not be able to work out what to do if something goes wrong.
• Do more than one thing at a time (multi-task). You may find it hard to switch between tasks and remember where you were with each task.

What can I do about my planning and problem solving?

Practise, practise, practise.

• Planning and problem solving can be improved, but only with lots of practice. Your occupational therapist, clinical psychologist or clinical neuropsychologist can help you decide what activities to focus on, as it will be different for everyone.
• Once you’ve mastered one task, like making a sandwich, you’ll move on to more difficult ones, like cooking a meal.

Keep to a routine

• Dressing yourself in the same order every day will make it easier for you to relearn the steps and spot when you miss one.
• Developing a weekly routine can also help. If you know that Tuesday is laundry day or Wednesday is shopping day, it will prompt you to do these things.
• A daily timetable may also be useful. This can be especially helpful if you have problems getting motivated, also known as apathy, which is fairly common after a stroke.

Use prompts and reminders

• Write out instructions or checklists to follow when you do something.
• Stick up notes around the house to remind you of things that you may not think of on your own, like brushing your teeth.
• You could use brightly coloured stickers on the microwave or remote control, to remind you which buttons to press.
• Prompts do not have to be written down. Use pictures or recordings instead. Some people make up songs or acronyms to help them remember how to do things.

Talk it through

• It can help to talk through a task with someone before you do it, to go over the steps.
• Also think about what could go wrong, so that you know what to do if that happens.
• Concentration problems
• Memory problems
• Problems moving or controlling your body (apraxia)
• Problems with movement and finding your way around (visual perception)
• Confusion and denial (anosognosia)
• Problems noticing things on one side (spatial neglect)

Related pages

Tools to Bolster Executive Function Skills in Kids

• Child Development
• Executive Function

In this episode, Philip Zelazo and Ellen Galinsky join Under the Cortex to discuss their new paper in Current Directions in Psychological Science titled “Fostering Executive-Function Skills and Promoting Far Transfer to Real-World Outcomes: The Importance of Life Skills and Civic Science.” The conversation with APS’s Özge G. Fischer Baum reviews the many ways executive functioning skills are used throughout daily life. The authors describe the process they used to involve the community to determine what skills they focused on in their intervention and the intervention’s success. 

Unedited transcript

[00:00:07.140] – APS’s Özge Gürcanlı Fischer Baum  

People want their children to be successful at school and to secure good jobs. Executive function, a core set of attention regulation skills, is one of the predictors of success in life. What can be done to foster executive function skills to support children’s real-world accomplishments? I am Özge Gürcanlı Fischer Baum with the Association for Psychological Science. Today, I have the pleasure of talking to Philip David Zelazo from the Institute of Child Development at the University of Minnesota, and Ellen Galinsky from the Families and Work Institute in New York. They recently published an article on executive function in APS’s journal, Current Directions in Psychological Science. How do scientists and educators generally define executive function? Can we improve what is the civic science approach to executive function? There are many questions to ask. Philip and Ellen, welcome to Under the Cortex. 

[00:01:09.040] – Ellen Galinsky  

Thank you. 

[00:01:09.730] – Philip David Zelazo  

[00:01:11.350] – APS’s Özge Gürcanlı Fischer Baum  

I’m going to start with your personal stories right away. What brought you into studying executive functioning? 

[00:01:19.070] – Philip David Zelazo  

Well, as an undergraduate, I was interested in understanding consciousness, ideally from a scientific perspective, and I quickly got a sense of how challenging that would be. But I had an opportunity to take a course with Michael Petrides in neuropsychology. I was at McGill University, and he was a professor there. I learned about executive function and the consequences of damage to prefrontal cortex and the difficulties that patients with prefrontal cortical damage experienced. It occurred to me that it was a question of a disconnection between consciousness and the ability to act on the basis of that consciousness. And so I thought, here’s something that’s scientifically tractable. We can study how in the course of, for example, human development, people acquire the ability to act on the basis of what they know and to put their knowledge into practice. In other words, to make consciousness have practical consequences. And so that seemed to me one way of studying something that’s so intrinsically subjective in an objective fashion. 

[00:02:37.480] – APS’s Özge Gürcanlı Fischer Baum  

Yeah, great. Ellen, what about you? 

[00:02:40.500] – Ellen Galinsky  

I’ve practiced a form of research called civic science, which I know we’re going to talk about later. But I have done a series of studies asking young people about the issues that they faced growing up. I was doing a study on children and learning, and I went out and interviewed children around the country, I went to eight different parts of the country and talked to fifth through twelfth graders, and I found them pretty dead on arrival when they talked about school. They were just blah. I could not. I’m a good interviewer. I’m used to talking to kids. I did not get any energy from those kids. If I talked about not learning, I got them pretty animated, but talking about learning was a real pull. I have done research with the adult workplace and workforce and know how important engagement is. And so I wondered, what are we doing? Children are born learning. What are we doing to turn off this strive for learning that children have? So I decided to go back, pause my study, decided to look at the earliest, the beginnings of life, and to interview researchers across academic disciplines and look at the whole process of engagement and learning and how they were studying it, and then what we know about maintaining or increasing the engagement and learning versus it dimming. 

[00:04:05.110] – Ellen Galinsky  

That led me to executive function. Among the people I talked to was Phil. All roads were pointing toward Phil and the research that he was doing. From then on, I have continued to look at the importance of this set of skills that fall under the umbrella of executive function. 

[00:04:22.720] – APS’s Özge Gürcanlı Fischer Baum  

Yeah, I guess never too late to come back to a good research question. I’m glad you have been a science ambassador in the developmental science circles. Well, I would like to take a step back for our listeners, and I would like to ask you a basic question about your research. What is the link between executive function skills and real-world outcomes? What is really at stake here? 

[00:04:46.080] – Philip David Zelazo  

Well, there’s plenty of evidence that executive function skills are perhaps the single best predictor of important life outcomes, more so than IQ and SES even. What really matters, it’s not so much what you know, but whether you have the attention regulation skills to put what you know into practice. To me and to Ellen, I believe, this is the essence of the expression of agency, of human agency. What does it mean to be a human being? It means to be an agent, to be flourishing and feel like you’re effective in the world and you can have consequences and accomplish the kinds of values that you hold dearly. And not only that, but importantly, these are malleable skills. They’re skills that you can train that are not skills you’re born with. They’re skills that everybody has to learn. And under the right circumstances, everybody can learn them. And we’ve learned more and more about what those circumstances are and how to promote the healthy development of those skills. And so that’s what we’re trying to focus on. There’s so much more scientific knowledge available already than is put into practice. And we want to act on that. 

[00:06:08.340] – Philip David Zelazo  

We want to make sure that we leverage that science for the good of our society. 

[00:06:14.700] – Ellen Galinsky  

If I could say something to add to that. I am working with AASA in the United States, which is the organization of School Superintendents across this country. I’m a senior science advisor for them, and I visit a lot of schools. I walk in and just see missed opportunity, missed opportunity, missed opportunity, missed opportunity, missed opportunity, because teachers want kids to learn. They want them to thrive. Executive function skills are, as Phil just said, so highly predictive of both. Yet that knowledge is not being translated to teachers and parents. If they do know about them, they might think of them as soft skills, which they’re not. If they do know about them, they might think of them as compliance skills, be quiet, sit still, listen to the teacher. If If they do know about them, they may think about them as something for kids with ADHD or some executive function challenges, but they don’t know how important they are to everyday life. And that is a huge mission of ours, is to change that. 

[00:07:13.910] – Philip David Zelazo  

I’ll just add one quickly thing that indeed, a major objective is to change the way that schools in our country educate our children so that we first teach them the essential skills that they need in order to be able to learn effectively and efficiently, and then to be able to act on the basis of what they learn. And that’s not exactly the way that many schools and teachers understand their mandate. Instead, they figure, Well, that’s for parents. And these kids ought to come ready to learn, and then I can teach them how to learn reading, writing, and arithmetic. But there’s no reason why they can’t also Why teachers and the public school system in our country can’t also teach children how to regulate their behavior, how to take people’s perspectives, how to think critically, and all these things that depend fundamentally on executive function skills. 

[00:08:19.900] – APS’s Özge Gürcanlı Fischer Baum  

As we are speaking of change, you talk about training and how to change things for these children, right? Your article is about what makes executive function training successful. What types of skills are typically used in executive function training? 

[00:08:36.730] – Philip David Zelazo  

Well, typically there’s a narrow focus on executive function skills per se. We’ve learned a lot about executive function skills. It used to be a broad umbrella concept that’s a little ill defined. But in fact, we know quite a bit about what falls under that umbrella now. We have an understanding of specific executive function skills like cognitive flexibility, working memory, inhibitory control, reflection, the flexible reappraisal of approach avoidance, tendencies, these kinds of things. We have a deeper understanding of what executive function skills are, but they themselves are relatively fundamental skills that combine together with other executive function skills and non-executive function skills and things like mindsets and just contingent knowledge about the way the world works to allow for fundamental what we have been calling EF-based life skills. It’s these that are so important, so instrumental in bringing about the real-world outcomes that we’re most concerned about, Ellen. 

[00:09:57.650] – Ellen Galinsky  

If I could go back to your question, I I think that those executive function, what we think of as foundational executive function skills, like cognitive flexibility or working memory or self-control, inhibitory control, people tend to train them, and they train them in isolation, and they train them in a lab-like setting. So they might get increases in research on that particular skill in that particular setting, but they don’t really apply in ways that could be used in life in general. I think that leads to people going, Wait a minute, wait a minute. Phil, you probably want to talk about for our transfer here. 

[00:10:40.940] – Philip David Zelazo  

Yes, indeed. That was one of the ways that we structured this paper was that everybody knows now that executive function skills are so important for these real-world outcomes, but all the efforts to train them have tended to produce improvements in the trained skills that do not necessarily transfer or generalize to these real-world outcomes that executive function skills predict so strongly. Why is that? We offered a few Answers. One is that, and most generally, many training studies designed to train executive function skills aren’t designed particularly to promote transfer. So they train executive executive function skills in a single setting. We know from decades and decades of animal learning research that if you train a particular skill in a single setting, it doesn’t generalize to other settings. But if you train the skill in many different settings, then the animal learns that the setting doesn’t matter, and they’re better able to generalize those skills that are required. And then the other thing is they train the skills, but they don’t necessarily teach children what it is they’re learning and what it’s good for and what it can be used for. And then finally, we suggested that actually it’s not these skills per se that contribute in isolation to these real-world outcomes. 

[00:12:17.570] – Philip David Zelazo  

It’s these skills only insofar as they contribute to intermediate-level skills, configurations of executive function skills and non-executive function skills that together allow people to do things that allow for the expression of agency, for example, that allow people to take perspectives, relate to other people, make critical decisions, figure out how to act on those decisions, know when to stop, know when to keep trying, and all the other important things that make for an effective problem solver. 

[00:12:53.250] – APS’s Özge Gürcanlı Fischer Baum  

What I hear is that focusing on a single skill and training that skill doesn’t work because it is an isolated context. What needs to be done instead is finding the relevant context for those skills and tying them to real-life situations. Plus, Phil, one of the things you said, stuck with me, I’m a mom. Yeah, let the children reflect on what they learned, why they were doing those things. In a way, you are still studying executive function, but you are changing the context of it so we can see more direct effects of it. Is that right? 

[00:13:37.080] – Philip David Zelazo  

That’s exactly right. In the process, we’re centering the child and the child’s agency so that the child understands, I’ve got these skills. Here’s what they’re good for. I can use them for this, that, and the other thing that matters to me. 

[00:13:54.060] – Ellen Galinsky  

So many training programs or initiatives don’t ask children to reflect on what they’re learning, to pause, to step back, to think about what they’re learning and how it can be useful. We think that that’s a really essential part of the process, that reflection, that really does help with far transfer. 

[00:14:13.290] – Philip David Zelazo  

Not just awareness, It’s self-awareness. 

[00:14:16.090] – APS’s Özge Gürcanlı Fischer Baum  

Yeah. You classify tasks related to executive functioning. You said it in the passing, Phil. Can you tell our audience a little bit more about this classification? For example, what are those intermediaries intermediate-level skills that you are talking about? 

[00:14:33.080] – Philip David Zelazo  

Sure. We listed a few in the paper, only some of the possible intermediate-level skills. But setting goals and strategies is important. Perspective taking is important. Let me just give that as an example. In order to take somebody else’s perspective, you have to inhibit your own egocentric point of view. And that, by definition, involves cognitive of flexibility. And it also requires working memory to be able to keep your own point of view in mind and consider somebody else’s. And the whole process is reflective. And under certain circumstances, it can require that you regulate your emotions in order to consider somebody else’s point of view. So perspective taking is a classic example, it seems to me, of one of these broader intermediate level skills that requires not just one single aspect of executive function, but many executive functions, perhaps all of them. It also requires other things, like caring about what other people think and knowing that it’s important to work with other people in order to achieve common goals. 

[00:15:49.730] – Ellen Galinsky  

What we did was we looked at the literature fairly intensively and looked at the skills that across the ages that we think are particularly important. Phil has talked about setting goals and strategies, and then there’s also perspective taking, and then communicating and collaborating. All of these are using those core foundational executive function skills as building blocks, as Phil described with perspective taking. Then there’s problem solving, and that requires making meaning of the situation. It includes creative thinking because you’re thinking if you’ve got a problem of not just one solution, but multiple solutions and hopefully putting together information in new ways. It requires relational thinking, so you’re putting together different pieces of information, and it eventually requires critical thinking when you decide, Well, what am I going to try? You’re evaluating it, you’re figuring out what you’re going to try. Then I think the fifth skill that we mentioned is taking on challenges. A lot of people talk about resilience, but we see this as active. Resilience is more about coping with things when they happen to you. Taking on challenges that hard thing, which we think is essential in this world. All of these skills can be like a deck of cards you shuffle, and you could think of other skills that go with it. 

[00:17:09.560] – Ellen Galinsky  

But these, we thought, are the pretty important skills that we’re going to focus on for right now. 

[00:17:15.660] – Philip David Zelazo  

I would just add, too, that they are the fundamental skills that contribute to a developing sense of agency, and we believe, flourishing or thriving so that every individual can participate in in a collective society. This gets into civic science, right? Participate in democracy, be an agent, have a point of view, but also be able to work across differences and solve problems collaboratively. 

[00:17:46.170] – APS’s Özge Gürcanlı Fischer Baum  

You also discuss approaches for executive functioning interventions and propose the use of civic science. What is the difference between civic science and community-based research? 

[00:18:00.000] – Philip David Zelazo  

Well, they’re similar in many respects. They both involve collaborations between non-scientist citizens and scientists, and sometimes they’re involved in addressing collective problems. And so it’s intended to level the playing field between elite scientists on the one hand and citizens on the other. We’re not imposing, for example, solutions solutions on people who need it, but we’re working together across differences to solve problems collectively and collaboratively. And the idea behind civic science is that this can be a foundation for a healthy democracy so that everybody in the democracy understands we’re working collaboratively to solve broad problems, and we’re doing it in an evidence-based way. 

[00:19:00.240] – Ellen Galinsky  

Could I just describe this? Would it be okay to describe it in action? Because I’m one week out from publishing a book that’s based on civic science that Phil helped me a lot with. I’ve always used this as a process, where when I start a study, I both look at the literature and I have my own questions and hypotheses, but I go out to the people who are the so-called subjects of the study, and they become the co-creators. When I started to do a book on adolescent development, I went out to, it turned out to be 38, 14 to 18-year-olds, and I asked them, What do you want to know about your own development? When I interview researchers, What do you want me to ask them? What wish do you have that could improve your life or life of people your age? What would that wish be? What should the adults know about people your age? I asked them very open-ended questions. Completely me in a different direction. What they wanted to know had very little to do with what there was a big literature on. What they wanted to know, because I was looking at adolescents 9 through 19, why don’t people like teenagers? 

[00:20:12.590] – Ellen Galinsky  

Why do people hate teenagers? Why are people so anti-teanagers. They asked me to ask the researchers, for example, for three words to describe the typical and the stereotypical teenager. There’s not a lot of studies about the conceptions of adolescents, but that took me in a very different direction. What I did then was to go out and interview researchers using the questions that kids had asked in my own questions. I also then did a nationally representative study that Phil helped me enormously with, of close to 2,000 parents and children, again, taking the questions from kids I had interviewed, plus the literature, plus the people who served as advisors to the study, my own questions. Then I interviewed 60 of those families from the sample with more questions that came from the… Because questions always lead to answers that lead to more questions. Then the pandemic happened, so I went back again to see how the kids were faring with a whole set of hypotheses from the kids and their parents. Then Phil and I did a study of executive function in 22 schools in six states. That became my book, The Breakthrough Years. Very different book than most books on adolescents. 

[00:21:26.410] – Ellen Galinsky  

Very, very different because it combines the wisdom of kids, the wisdom of parents, the wisdom of researchers, my own putting it all together. It just tells a very different story about how to help kids both learn and thrive. 

[00:21:43.060] – Philip David Zelazo  

It’s not only more democratic than your average study in the sense that it’s involving so many different voices and perspectives, but also it’s so much more effective as a result because a scientist lenses are limited, and child’s lenses are limited, and a parent’s lenses are limited, and so forth. But it’s the collaborative working across those different perspectives that yield something greater and more democratic. 

[00:22:15.760] – Ellen Galinsky  

Most books about teenagers or adolescents are, Why are they doing wild and crazy and stupid things? Why are they wild? The internet is destroying their brains, blah, blah, blah. I look at the impact of social through a scientist and through a kid and parent lens. But kids and parents are loving this because it gives them, at least I’m one week out. It’s exactly a week ago today, my book was published. But it gives a very different lens that kids and parents are saying, Thank you for listening. They really appreciate being heard in a world that’s so, sadly, anti-teanager. You could not talk about another group of people in the way that we talk about teenagers. You couldn’t do it. 

[00:23:02.670] – APS’s Özge Gürcanlı Fischer Baum  

Yeah. Like Phil said, it is democratic. Another word for it, I guess, is participatory science, right? You involve the students, children, and the parents. Yeah, that is wonderful, and that is the right approach. We usually see this in social psychology or other related work, but it is very novel for cognitive science, and I am very excited about that personally. I want to go back to A little bit to your interventions. Can you tell our listeners about the daily family routine intervention you designed and implemented? How did this intervention use attributes that you view as most important to a successful intervention design? 

[00:23:47.850] – Philip David Zelazo  

Sure, I’d be happy to. The idea there was to privilege the voices of parents and to create an intervention that allowed for communication and exchange among parents and also between parents and scientists, and to ask them, What are the pressure points in your life that you’d like to address? We envisioned that helping parents to understand how to use routines as a way to engage their children, specifically in collaborative problem solving, to engage their children in an activity that would allow them to encourage reflection, and also have very practical and immediate consequences for a particular family. Some parents, this was something that was done through Head Start in their parent engagement activities. Parents would come in the afternoon, a certain number of them, 8:00 to 12:00, sitting around a table with a facilitator, and parents would be asked, What are the pressure points that you face? And some parents said, Well, getting my kids to bed at night, or getting everybody to have a calm and enjoyable dinner or getting out of the house in the morning or something like this. And so they were able to articulate what they saw as the pressing problems that needed to be addressed. 

[00:25:27.960] – Philip David Zelazo  

The facilitator and we we worked with those parents to assess what are the current routines that occur in their family and how would they like to change them. Then we tried to be supportive in terms of moving them towards whatever it is that they wanted to achieve. Interestingly, one of the biggest benefits of that intervention appeared to be the opportunity for parents to hear from and communicate with other parents and recognize that this is a shared problem, that I’m not the only one who’s struggling with these various issues. They got feedback not only from the facilitator and from us, but from other parents, too. But within that, it was a model of, I’m going to collaborate with my child to define what are our goals, what would I like to achieve? In that context, to do things like, Well, let’s Let’s be mindful. Let’s be goal-directed. Let’s set some goals. Let’s figure out what are the things that we have, the capabilities that we have to achieve those goals. It was a delivery device, so to speak, to educate parents and for them to educate us about how best to support their sense of agency and problem solving and so on in the context of their own particular particular lives. 

[00:27:01.880] – Philip David Zelazo  

One of the consequences of it was that parents ended up being more autonomy supportive as a result of that. We know that autonomy, supportive parenting, supporting your child’s developing sense of agency, giving them choices, allowing them to feel empowered. In other words, giving them the license to practice their executive function skills by solving problems and being cognitively flexible and goal-directed and all these other things. That was perhaps the single most salient outcome of that intervention. 

[00:27:40.730] – APS’s Özge Gürcanlı Fischer Baum  

Thank you very much for this great conversation. Ellen Phil, is there anything else that you would like to share with our listeners? 

[00:27:48.980] – Ellen Galinsky  

No, we felt very honored to have this publication out in the world. We just hope anyone who is interested in this work, a civic science, executive function, interventions to improve executive function and other aspects of children learning and thriving, and adults learning and thriving will be in touch with us. 

[00:28:11.220] – Philip David Zelazo  

Indeed. Thank you. Yes. 

[00:28:14.200] – APS’s Özge Gürcanlı Fischer Baum  

Yeah. Thank you very much. This is Özge Gürcanlı Fischer Baum with APS, and I have been speaking to Philip David Zalazo and Ellen Galinsky. If you want to know more about this research, visit psychologicalscience.org. Do you have questions or suggestions for us? Please contact us at [email protected] . 

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Teaching: Phenomenological Control—What Is Reality, Really? 

Phenomenological control refers to the ability to construct subjective experiences that distort objective reality. Teaching tips and guidelines for this fascinating area of research.

New Research From Clinical Psychological Science

A sample of research exploring: genetic associations anxiety, depression, and executive function; motivation and emotion regulation in depression; and sense of agency over thoughts in obsessive-compulsive disorder.

A sample of research exploring callous-unemotional traits and anxiety, mediators and mechanisms in psychotherapy research, executive function and depressive symptoms across development, and core deficits in borderline personality disorder.

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The Hechinger Report

Covering Innovation & Inequality in Education

Why schools are teaching math word problems all wrong

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CENTRAL FALLS, R.I. — When Natalia Molina began teaching her second grade students word problems earlier this school year, every lesson felt difficult. Most students were stymied by problems such as: “Sally went shopping. She spent $86 on groceries and $39 on clothing. How much more did Sally spend on groceries than on clothing?”

Both Molina, a first-year teacher, and her students had been trained to tackle word problems by zeroing in on key words like “and,” “more” and “total”  — a simplistic approach that Molina said too often led her students astray. After recognizing the word “and,” for instance, they might mistakenly assume that they needed to add two nearby numbers together to arrive at an answer.

Some weaker readers, lost in a sea of text, couldn’t recognize any words at all.

“I saw how overwhelmed they would get,” said Molina, who teaches at Segue Institute for Learning, a predominantly Hispanic charter school in this small city just north of Providence.

So, with the help of a trainer doing work in Rhode Island through a state grant, Molina and some of her colleagues revamped their approach to teaching word problems this winter — an effort that they said is already paying off in terms of increased student confidence and ability. “It has been a game changer for them,” Molina said.

Perhaps no single educational task encompasses as many different skills as the word problem. Between reading, executive functioning, problem solving, computation and vocabulary, there are a lot of ways for students to go wrong. And for that reason, students perform significantly worse overall on word problems compared to questions more narrowly focused on computation or shapes (for example: “Solve 7 + _ = 22” or “What is 64 x 3?”).

If a student excels at word problems, it’s a good sign that they’re generally excelling at school. “Word-problem solving in lower grades is one of the better indicators of overall school success in K-12,” said Lynn Fuchs, a research professor at Vanderbilt University. In a large national survey , for instance, algebra teachers rated word-problem solving as the most important among 15 skills required to excel in the subject.

Teacher takeaways

• Don’t instruct students to focus mainly on “key words” in word problems such as “and” or “more” 
• Mix question types in any lesson so that students don’t assume they just apply the same operation (addition, subtraction) again and again
• Teach students the underlying structure — or schema — of the word problem

Yet most experts and many educators agree that too many schools are doing it wrong, particularly in the elementary grades. And in a small but growing number of classrooms, teachers like Molina are working to change that. “With word problems, there are more struggling learners than non-struggling learners” because they are taught so poorly, said Nicole Bucka, who works with teachers throughout Rhode Island to provide strategies for struggling learners.

Too many teachers, particularly in the early grades, rely on key words to introduce math problems. Posters displaying the terms — sum, minus, fewer, etc. — tied to operations including addition and subtraction are a staple in elementary school classrooms across the country.

Key words can be a convenient crutch for both students and teachers, but they become virtually meaningless as the problems become harder, according to researchers. Key words can help first graders figure out whether to add or subtract more than half of the time, but the strategy rarely works for the multi-step problems students encounter starting in second and third grade. “With multi-step problems, key words don’t work 90 percent of the time,” said Sarah Powell, a professor at the University of Texas in Austin who studies word problems and whose research has highlighted the inefficacy of key words . “But the average kindergarten teacher is not thinking about that; they are teaching 5-year-olds, not 9-year-olds.”

Many teachers in the youngest grades hand out worksheets featuring the same type of word problem repeated over and over again. That’s what Molina’s colleague, Cassandra Santiago, did sometimes last year when leading a classroom on her own for the first time. “It was a mistake,” the first grade teacher said. “It’s really important to mix them up. It makes them think more critically about the parts they have to solve.”

Another flaw with word problem instruction is that the overwhelming majority of questions are divorced from the actual problem-solving a child might have to do outside the classroom in their daily life — or ever, really. “I’ve seen questions about two trains going on the same track,” said William Schmidt, a University Distinguished Professor at Michigan State University. “First, why would they be going on the same track and, second, who cares?”

Schmidt worked on an analysis of about 8,000 word problems used in 23 textbooks in 19 countries. He found that less than one percent had “real world applications” and involved “higher order math applications .”

“That is one of the reasons why children have problems with mathematics,” he said. “They don’t see the connection to the real world … We’re at this point in math right now where we are just teaching students how to manipulate numbers.”

He said a question, aimed at middle schoolers, that does have real world connections and involves more than manipulating numbers, might be: “Shopping at the new store in town includes a 43% discount on all items which are priced the same at $2. The state you live in has a 7% sales tax. You want to buy many things but only have a total of $52 to spend. Describe in words how many things you could buy.”

Schmidt added that relevancy of word problems is one area where few, if any, countries excel. “No one was a shining star leading the way,” he said. 

In her brightly decorated classroom one Tuesday afternoon, Santiago, the first grade teacher, gave each student a set of animal-shaped objects and a sheet of blue paper (the water) and green (the grass). “We’re going to work on a number story,” she told them. “I want you to use your animals to tell me the story.”

“ Once upon a time,” the story began. In this tale, three animals played in the water, and two animals played in the grass. Santiago allowed some time for the ducks, pigs and bears to frolic in the wilds of each student’s desk before she asked the children to write a number sentence that would tell them how many animals they have altogether.

Some of the students relied more on pictorial representations (three dots on one side of a line and two dots on the other) and others on the number sentence (3+2 = 5) but all of them eventually got to five. And Santiago made sure that her next question mixed up the order of operations (so students didn’t incorrectly assume that all they ever have to do is add): “Some more animals came and now there are seven. So how many more came?”

One approach to early elementary word problems that is taking off in some schools, including Segue Institute, has its origins in a special education intervention for struggling math students. Teachers avoid emphasizing key words and ask students instead to identify first the conceptual type of word problem (or schema, as many practitioners and researchers refer to it) they are dealing with: “Total problems,” for instance, involve combining two parts to find a new amount; “change problems” involve increasing or decreasing the amount of something. Total problems do not necessarily involve adding, however.

“The schemas that students learn in kindergarten will continue with them throughout their whole career,” said Powell, the word-problem researcher, who regularly works with districts across the country to help implement the approach. 

In Olathe, Kansas — a district inspired by Powell’s work — teachers had struggled for years with word problems, said Kelly Ulmer, a math support specialist whose goal is to assist in closing academic gaps that resulted from lost instruction time during the pandemic. “We’ve all tried these traditional approaches that weren’t working,” she said. “Sometimes you get pushback on new initiatives from veteran teachers and one of the things that showed us how badly this was needed is that the veteran teachers were the most excited and engaged — they have tried so many things” that haven’t worked.

In Rhode Island, many elementary schools initially used the strategy with students who required extra help, including those in special education, but expanded this use to make it part of the core instruction for all, said Bucka. In some respects, it’s similar to the recent, well publicized evolution of reading instruction in which some special education interventions for struggling readers  — most notably, a greater reliance on phonics in the early grades — have gone mainstream.

There is an extensive research bas e showing that focusing on the different conceptual types of word problems is an effective way of teaching math, although much of the research focuses specifically on students experiencing difficulties in the subject. 

Molina has found asking students to identify word problems by type to be a useful tool with nearly all of her second graders; next school year she hopes to introduce the strategy much earlier.

One recent afternoon, a lesson on word problems started with everyone standing up and chanting in unison: “Part plus part equals total” (they brought two hands together). “Total minus part equals part ” (they took one hand away) .

It’s a way to help students remember different conceptual frameworks for word problems. And it’s especially effective for the students who learn well through listening and repeating. For visual learners, the different types of word problems were mapped out on individual dry erase mats.

The real work began when Molina passed out questions, and the students— organized into the Penguin, Flower Bloom, Red Panda and Marshmallow teams — had to figure out which framework they were dealing with on their own and then work toward an answer. A few months ago, many of them would have automatically shut down when they saw the text on the page, Molina said.

For the Red Pandas, the question under scrutiny was: “The clothing store had 47 shirts. They sold 21, how many do they have now?”

“It’s a total problem,” one student said.

“No, it’s not total,” responded another.

“I think it’s about change,” said a third.

None of the students seemed worried about their lack of consensus, however. And neither was Molina. A correct answer is always nice but those come more often now that most of the students have made a crucial leap. “I notice them thinking more and more,” she said, “about what the question is actually asking.”

This story about word problems was produced by The Hechinger Report , a nonprofit, independent news organization focused on inequality and innovation in education. Sign up for the Hechinger newsletter .

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Why Cross-Functional Collaboration Stalls, and How to Fix It

• Sharon Cantor Ceurvorst,
• Kristina LaRocca-Cerrone,
• Aparajita Mazumdar,

Research shows that 78% of leaders report “collaboration drag” — too many meetings, too much peer feedback, and too much time spent getting buy-in from stakeholders.

Gartner research shows 78% of organizational leaders report experiencing “collaboration drag” — too many meetings, too much peer feedback, unclear decision-making authority, and too much time spent getting buy-in from stakeholders. This problem is compounded by the fact that companies are running as many as five types of complex initiatives at the same time — each of which could involve five to eight corporate functions and 20 to 35 team members. The sheer breadth of resource commitments across such a range of initiatives creates a basic, pervasive background complexity. To better equip teams to meet the demands of this complexity, Gartner recommends the following strategies: 1) Extend executive alignment practices down to tactical levels; 2) Develop employee strategic and interpersonal skills; and 3) Look for collaboration drag within functions or teams.

Corporate growth is the ultimate team sport, relying on multiple functions’ data, technology, and expertise. This is especially true as technology innovation and AI introduce new revenue streams and business models, which require significant cross-functional collaboration to get off the ground.

• SC Sharon Cantor Ceurvorst is vice president of research in the Gartner marketing practice , finding new ways of solving B2B and B2C strategic marketing challenges. She sets annual research agendas and harnesses the collective expertise of marketing analysts and research methodologists to generate actionable insights.
• KL Kristina LaRocca-Cerrone is senior director of advisory in the Gartner marketing practice , overseeing Gartner’s coverage of marketing leadership and strategy, cross-functional collaboration, proving the value of marketing, and marketing innovation and transformation.
• AM Aparajita Mazumdar is senior research principal in the Gartner marketing practice , co-leading the research agenda for marketing technology.  Her research focuses primarily on marketing strategy and technology topics such as cross-functional collaboration and marketing technology utilization.
• AN Anja Naski is senior research specialist in the Gartner marketing practice . She edits the Gartner CMO Quarterly journal, highlighting the latest insights on critical challenges facing CMOs. Her research covers topics related to marketing operations, CMO leadership, and cross-functional collaboration.

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Executive Function

Using the mind’s “executive functions”, psychological pandemic solutions are required for the entire population..

Posted April 14, 2020 | Reviewed by Matt Huston

The current medical crisis is an unexpected global challenge, and people are in confusion mode. Pandemic solutions are required for the entire population, not only for hospitals. Basic human understanding demands a sharpening to become more agile and precise in meeting emerging needs.

Executive Functions and Critical Thinking

I distinguish between the process of critical thinking and executive function skills, a concept used in neuropsychology. Critical thinking is an ongoing activity; executive functioning is optimal, deep, and intermittent—focused precision at particular times. This sharpening includes self-monitoring and future anticipation. The two levels of thinking are not mutually exclusive. Overlap occurs, but viewing them as different adds clarity to their meaning.

Day-to-day reasoning ability is using critical thinking to identify and problem-solve. Within critical thinking, the executive functions (e.g., working memory , thinking abstractly, and complex decision-making ) are needed to manage the intricacies that novel, uncommon, or unprecedented dilemmas pose. These complex processes are frontline tools acting to name, organize, and plan problem-solving. The goal is adapting to unprecedented internal and external realities. This ability means managing oneself alone and with others by identifying current alternatives and future consequences.

Today more than ever, people feel “ stressed out,” irritable, and emotionally over-reactive. The good news is that brain-based executive abilities can meaningfully temper anxiety , stress, and mood. Stress increases excess cortisol that weakens immunity and lowers resistance to infection. Thus, stress reduction helps one’s “biomental” well-being.

A review of the executive functions—neuroanatomy—begins with their brain base in the cerebral cortex and limbic system. An outline of seven executive functions and how they operate follows. Last, applying them to life management skills—mindful critical thinking in the real world—in this era of COVID-19 ’s unexpected dilemmas complete this discussion.

The Brain Base of Logic and Reason

Executive abilities involve multiple brain areas, including:

• Dorsolateral Prefrontal Cortex (dlPFC) , which is key to fluid reasoning
• Anterior Cingulate Cortex (ACC) , which integrates emotional experience and cognitive skills
• Orbitofrontal Cortex (OFC), important in value formation and choice

With this base of reasoning is an underlying core of emotionality in the brain’s amygdala and limbic system. The synchrony of reason and emotion yields empathy, the essence of self-compassion and care for others.

Executive Functions

Although separated into several groups, the executive functions work in an “entourage” fashion—each supporting and enhancing one another.

Seven executive functions:

• Self-awareness
• Nonverbal Working Memory
• Verbal Working Memory
• Emotional Regulation
• Motivational Regulation
• Planning and Problem-Solving

Self-awareness centers on self-directed action—an awareness of what you are doing.

Inhibition is impulse control and self-restraint. It acts to stop thinking and behavior and redirects not working successfully or acting harmfully.

Nonverbal working memory centers on self-directed sensing, mental imagery , and the awareness of time. It guides behavior by memory and anticipation—a map to orient thought and action toward future goals.

Verbal working memory allows for the preservation of a limited amount of speech-related information for use. It can show up as talking to oneself either out loud or silently.

Emotional regulation involves modulating feelings that arise when evoked by notable events.

Motivational regulation involves self-directed motivation . Internal stimulation, not needing constant guidance from others, is the driving force.

Planning and problem-solving : This executive function innovates a plan that can be refined, reformulated, and updated, so that trial and error sharpen it toward efficacy.S

Full cognitive, emotional, and impulse control development is neurologically complete by 25 to 30 years old. The precision of each function and their impact varies among people and context.

Applying Executive Functions and Mindfulness to Manage COVID-19

Self-sequester demands to distance from another. This contextual reality emphasizes that mindfulness and work on executive functions are mostly individual rather than social. Individual leadership and personal accountability remain foremost. Individual actions have a collective impact.

Western health care systems have been built on the concept of patient-centered care, but an epidemic requires a changed perspective—community-centered care. This shift occurs both by direct modeling and more effective interpersonal functioning. Social distancing is needed, but socializing from a distance calls for innovative tactics.

Creative paths, for example, include distance and online learning, webinars, telehealth , emails, or video chats with significant others. Thus, quality time replaces the “empty calories” of excessive social media and gaming. Beginning a brief autobiography is a fantastic exercise in mindfulness. Starting with “Who am I?” churns self-reflection.

Important matters to consider are the stressors of newfound interpersonal closeness and the “cabin fever” of being sequestered in place. Defusing the strain of prolonged tight living conditions is countered by open communication, intentional cooperativeness, and humor .

The combination of proactive coping (executive skill planning) and mindful, present-moment awareness helps settle one’s mindset and reduce stress.

The following interventions support internalizing effective cognitive skills. Executive reasoning , grounded in cognitive functions, has a base in stable emotionality. This emotional even-handedness is not perfect tranquility, but a paused state used as the platform for enhancing, if not amplifying, focus, problem-solving, and planning.

Therefore, slowing down by intentionally pausing in thought and behavior best prepares the ground for thought refinement.

Mindfulness is one of the best tools to use. To engage in effective mindfulness: pause, breathe slowly, pay attention , in the present moment, on purpose, and non-judgmentally. Amid this, maintaining an underlying curiosity amplifies one’s receptivity to learning. Curiosity characterizes the prepared mind, ready to take chances when opportunities appear. Preparation underlies the robust resilience of those exposed to stress and trauma .

The following lists 12 self-directed guidelines to organize and orient thinking toward effective goal accomplishment.

1.) scheduling short- and long-term tasks and assignments

2.) an abundance of cues such as signs (e.g., face masks), notes, lists, timers, and so forth

3.) outlining daily routines

4.) fluidly updating these sequences as circumstances change

5.) continuously reinforcing on-task behaviors

6.) using positive reinforcements rather than overemphasizing negative reprimands

7.) estimating timelines required to complete tasks

8.) breaking down larger tasks into smaller steps

9.) constructing daily, weekly, and monthly schedules

10.) prioritizing schedule sequencing from critical to urgent to important

11.) refining the routine as needed with time

12.) improving general problem-solving skills by remembering to pause and use mindfulness throughout the day.

Incorporating the pandemic solutions above is a resilience strategy. Enhancing executive capacities refines reasoning and successful adaption to unexpected events. What works for you is key. Mindfully applying these cognitive enhancers is active coping. The stress and anxiety of uncertainties become less overwhelming. Resiliencies to the challenging onslaughts from COVID-19 expand if viewed as opportunities—however unwelcome—for renewing your mind.

Ninivaggi, F. J. (2020). Learned Mindfulness: Physician Engagement and MD Wellness . New York: Elsevier Academic Press.

Barkley, R. A. (2012). Executive Functions: What They are, How they Work, and Why They Evolved . New York: Guilford Press.

Frank John Ninivaggi, M.D., F.A.P.A., is an associate attending physician at the Yale-New Haven Hospital, an assistant clinical professor of Child Psychiatry at the Yale University School of Medicine.

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At any moment, someone’s aggravating behavior or our own bad luck can set us off on an emotional spiral that could derail our entire day. Here’s how we can face triggers with less reactivity and get on with our lives.

• Emotional Intelligence
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Quality Function Deployment (QFD): Unveiling Its Strategic Impact

Quality Function Deployment (QFD) is a structured approach to designing and delivering products and services that align with customer desires and expectations. By transforming customer needs into clear action and design attributes, QFD serves as a bridge between consumers and producers. In the modern industrial landscape, rife with competition and continuous innovation, QFD emerges as a vital tool, enabling organizations to prioritize their efforts and resources effectively, thus leading to enhanced customer satisfaction and business performance. This article strives to delve deep into the nuanced concepts of QFD, unveiling its strategic impact and dissecting its multifaceted implementation.

Understanding the Concept of QFD

QFD is grounded in the philosophy that products should be designed to reflect customers' desires and needs. To make this possible, the QFD process functions as a translator of customer requirements into design targets and quality benchmarks throughout the product development lifecycle. An expert in the field would recognize that QFD is not merely a tool but a comprehensive, multi-disciplinary approach that necessitates deep customer understanding and robust cross-functional collaboration.

The cornerstone of QFD lies in its emphasis on customer requirements. These are captured and categorized meticulously, often with a focus on the Voice of the Customer (VoC), which serves as the guiding light for the entire development process. Collecting this data is a rigorous activity, often necessitating direct interaction with customers through interviews, surveys, and focus groups, thus ensuring the voice captured represents genuine customer sentiments.

QFD does not exist in isolation; rather, it correlates with other quality techniques such as Six Sigma, Lean, and Total Quality Management (TQM). Integrating QFD into an array of quality control methods enhances its holistic nature, fostering efficient product development processes that are lean and customer-centric. Organizations that successfully marry QFD with these methodologies often see marked improvements in quality and customer satisfaction.

The Four Phases of QFD

The product planning phase.

The initial stage of QFD, the product planning phase, begins with a meticulous identification of customer requirements. Teams engage in collecting detailed customer feedback and structuring these into hierarchical needs, which are often manifested in the form of a "House of Quality" matrix. This matrix serves as the foundational step in translating nebulous customer desires into concrete, measurable product features.

Accurate translation is key; each customer requirement must be associated with corresponding technical descriptors that provide a quantifiable means of assessing whether the product design truly meets customer expectations. This dialectic between customer needs and design features is foundational, necessitating iterative refinement to ensure alignment.

The Product Design Phase

During the product design phase, QFD takes on a more substantive role in molding the product concept. Developing potential product concepts is often an iterative process involving creativity and structured analysis. Teams explore a variety of ideas, diligently assessing each against the mirrors of technical feasibility and customer desire.

Selecting the best product concept from the myriad possibilities is no trivial task. It requires a confluence of strategic foresight, market knowledge, and technical expertise. The selected concept will be one that best delivers on the customer's voice while maintaining design integrity and feasibility.

The Process Planning Phase

In the third quarter of the QFD journey, the focus shifts to process planning. Here teams determine the specific process steps required to produce the product, ensuring that these steps can reliably reproduce the quality levels that customers expect. Every aspect of the production process is scrutinized against the customer's requirements, with a consistent emphasis on achieving high quality with minimal waste.

The teams evaluate the process capability and adjust workflows to deal with potential variability, aiming to construct a robust manufacturing process that will consistently deliver to customer specifications. In essence, the essence of the QFD process planning phase is to translate design reliability into production consistency.

The Production Planning Phase

Rounding out the QFD approach is the production planning phase, where detailed plans are devised to anticipate and address potential issues that might arise during the actual production. Risk assessments, continuous improvement strategies, and contingency planning are all keystrokes in this stage.

At this juncture, it is also critical to institute rigorous monitoring and control processes to ensure that deviations from the product requirements are identified and rectified promptly. The feedback loop created here not only perfects the current project but also informs future QFD efforts, cycling back to the tenet of relentless improvement.

Implementation of QFD

Embarking on a QFD project requires careful preparation, beginning with articulating project objectives and securing strong executive support. Clarity in goals ensures that all QFD activities are geared toward a unified vision, whereas executive backing provides the necessary resources and ensures organizational alignment.

The execution of a QFD project is a sequence of incremental, interlinked steps that build upon one anothersuch as capturing customer voices, developing design concepts, and detailing production processesguided by the QFD matrixes. At every juncture, decisions are data-driven, rooted in customer insights, and calibrated against technical capabilities.

Role of a QFD Team

A QFD project is typically led by a cross-functional team, drawing expertise from different departments such as marketing, design engineering, and manufacturing. Each team member contributes unique insights, helping to build a well-rounded and robust approach to product development.

However, QFD implementation is not without challenges. These may vary from misalignment of team members to inadequate customer knowledge, leading to misprioritized features or even project failures. To overcome such obstacles, it's imperative to foster a culture of open communication, ongoing project management, and continual learning. Anecdotes from successful QFD projects often highlight the necessity of addressing these challenges head-on with creativity and dedicated problem-solving.

The Benefits and Limitations of QFD

Benefits of implementing qfd in an organization.

Organizations that implement QFD can look forward to myriad benefits. Chief among these is the alignment of products and services with customer preferences, which engenders increased customer satisfaction and loyalty. Moreover, because QFD facilitates clear communication across different departments, it can lead to better cross-functional collaboration and more efficient resource utilization.

Real-world examples of successful QFD implementation are numerous and span various industries. Companies like Toyota and Xerox have been known to deploy QFD to great effect, integrating customer feedback into their product development cycles and achieving substantial market success as a result.

Potential Limitations and Critiques of QFD

Despite its benefits, QFD is not a panacea and does face criticisms. Some argue that it can be overly complex and time-consuming, which may not be suitable for every company or project. Others point out that it requires a significant cultural and organizational commitment, which may be challenging for some to achieve.

Critiques of QFD often revolve around issues of scalability and adaptability. However, these limitations can often be mitigated through careful planning and implementation, as well as tailoring the QFD process to the specific needs and circumstances of the organization.

The Future of QFD

Evolving developments in the qfd technique.

As businesses evolve and customer demands become ever more complex, the QFD technique is also adapting. Embracing digital tools and data analytics is enhancing its precision and speed, allowing for more nuanced and sophisticated interpretations of customer data.

Moreover, the integration of QFD with sustainability goals and the rising ethos of social responsibility is likely to be an area of growth. The ability to design for not just functional quality but also environmental and social impact is expanding the QFD framework and its strategic relevance.

Predictions and Implications for the Future of QFD

The future of QFD appears promising as it continues to intertwine with technological advancements.

Predictions for QFD include a greater focus on global trends such as the Internet of Things (IoT) and smart manufacturing processes, which will enable even closer synchronization between customer needs and product offerings. In the wave of big data, QFD's ability to cut through the noise and laser-focus on actionable customer insights will be invaluable.

The exploration of Quality Function Deployment reveals it as a pivotal component in the strategic toolkit for modern organizations. The methodical alignment with customer needs that QFD facilitates is a cornerstone of competitive advantage. Given the dynamic changes in customer preferences and the pace of technological innovation, the continued research and application of QFD are not just beneficial but essential for organizations aspiring to maintain relevance and excellence.

Professionals interested in mastering this influential methodology may find value in pursuing a problem solving certificate , particularly through online certificate programs that specialize in quality management disciplines. Endowed with comprehensive knowledge and a commitment to user-centered design, a professional well-versed in QFD strategies is better positioned to make meaningful contributions to product development and thus the overall success of an organization.

What is the strategic importance of Quality Function Deployment in product development and management?

Understanding quality function deployment.

Quality Function Deployment (QFD) stands as a systematic approach. It integrates customer requirements with company capabilities. QFD focuses on customer satisfaction. This translates into competitive advantage.

The Role of QFD in Product Development

QFD ensures customer voices shape products . It turns customer desires into design targets. This applies throughout the product lifecycle. Teams understand what matters most to customers. QFD reduces the risk of product-market misalignment.

The tool streamlines communication . It breaks down silos between departments. Cross-functional dialogue grows stronger. Everyone sees the big picture. This collaboration pushes innovation. QFD fosters a culture of shared goals.

Enhancing Product Management with QFD

QFD serves as a planning tool . It prioritizes features based on customer values. This allows for strategic resource allocation. Teams focus on high-impact attributes. This leads to efficient use of time and costs.

It offers a quantifiable method to track progress . Metrics and benchmarks guide development. This clarity aids in performance evaluation. Teams can adjust strategies with solid data.

Strategic Benefits of Implementing QFD

- Enhances customer satisfaction : Directly addresses user needs.

- Reduces time to market : Streamlines the development process.

- Improves product quality : Aligns output with expectations.

- Cuts costs : Prevents overengineering and misdirected efforts.

- Encourages team unity : Provides a common reference point.

QFD transforms customer insights into tangible products. It aligns multidisciplinary efforts towards value creation. In strategic product management, QFD acts as a guide. It ensures decisions reflect customer priorities. Effective deployment of QFD can cement a company's market position. It anchors product development in customer-centric innovation.

How does QFD ensure a customer-focused approach in the development of new products or services?

Understanding qfd in product development.

Quality Function Deployment (QFD) stands out as an organized approach that ensures customer satisfaction takes the lead in crafting new products or services. This method integrates customer requirements with business goals. It also aligns the intricate aspects of product development with market expectations.

Customer Voice Takes Center Stage

QFD begins with listening . It emphasizes gathering the customer’s voice. This produces a list called the voice of the customer (VOC). Direct feedback, surveys, and market research contribute here. With VOC, designers and engineers have a clear picture of customer needs.

Turning Needs into Specifications

The next step involves translating these needs. Specialists in QFD transform what customers express into specific, actionable technical requirements. They use the House of Quality , a visual matrix, to manage this. Designers find this matrix a powerful guide for aligning customer desires with product features.

Encouraging Cross-functional Collaboration

QFD fosters teamwork. Different departments—the likes of engineering, marketing, and manufacturing—must collaborate. Each brings its expert perspective. They together ensure the product delivers on customer expectations.

Prioritizing Customer Requirements

Not all customer desires hold equal weight. QFD tasks teams to prioritize. They figure out which needs bear the most influence on customer satisfaction. These top the priority list. This ensures the final product emphasizes them.

Consistent Reality Checks

The process entails constant reality checks. Engineers and designers must keep verifying whether their efforts align with customer expectations. Adjustments are routine.

Reducing Missteps and Waste

By focusing sharply on customer needs, QFD cuts back on mistakes. It reduces waste that arises from misaligned product features. Practically, this means fewer revisions and a speedier time to market.

Building a Customer-Focused Culture

Adopting QFD fosters a culture that values customer feedback. This mindset permeates the entire organization. It prompts a continuous loop of receiving and integrating consumer input.

Continuous Improvement

QFD does not stop at product launch. It urges ongoing feedback gathering and product tweaking. This mindset helps organizations stay ahead in satisfying their customers.

In summary, QFD ensures businesses keep their eyes on the prize—customer satisfaction. It aids in bringing forth products or services that align with consumer needs and expectations. This systematic approach champions the customer at every stage of the product's lifecycle.

In what ways does the implementation of QFD contribute to enhancing efficiency and effectiveness in an organization's workflow and processes?

Quality function deployment and organizational performance.

Quality Function Deployment (QFD) is a structured approach. It translates customer requirements into relevant company processes. The tool fosters a customer-focused development cycle. Its implementation enhances both efficiency and effectiveness. These improvements occur across various organizational workflows.

QFD Boosts Efficiency Through Clear Direction

QFD clarifies customer expectations. It provides a roadmap for product development. Teams understand what to prioritize. This clarity reduces wasted effort. It minimizes the risk of unnecessary revisions. Resources are allocated more wisely. Teams concentrate on high-value activities. These activities lead directly to customer satisfaction.

Enhancing Effectiveness with Customer-Centric Insights

A customer-centric strategy emerges through QFD. This strategy ensures products meet market needs. Teams focus on features that matter to the consumer. Continuous feedback loops are established. They allow for real-time adjustments. These adjustments align products more closely with customer desires. Effectiveness increases as customer satisfaction does.

Streamlining Communication and Reducing Silos

QFD fosters interdisciplinary communication. Cross-functional teams collaborate more effectively. Silos break down. Everyone understands the desired outcome. A shared vision guides decision-making. Communication barriers decrease. Information transfer accelerates. Collaboration creates more innovative solutions. These solutions are crafted with cross-departmental insight.

Prioritizing Tasks and Reducing Time to Market

Time to market speeds up with QFD. Teams know the critical quality characteristics. They concentrate on delivering these swiftly. Delays decrease. Product development cycles shorten. The market receives products quicker. The organization benefits from a competitive edge.

Comprehensive Understanding Leads to Informed Decision-making

QFD provides comprehensive product insight. This insight aids data-driven decisions. Teams base actions on holistic understanding. Guesswork minimizes. Risks identify earlier. Predictive measures are possible. They thwart potential issues. The organization operates more strategically. Efficiency and effectiveness are heightened.

Continuous Improvement as a Culture

With QFD, continuous improvement becomes second nature. Each project teaches lessons. These lessons integrate into future cycles. Processes refine over time. Error rates fall. Quality rises. Employees engage in an improvement culture. Skills sharpen. The organization grows stronger and more competitive.

In conclusion, QFD drives both efficiency and effectiveness. It does so by honing in on customer needs. It aligns products and processes to these needs. Teamwork improves. Communication channels open. Innovation thrives. Operations streamline. The result is a more agile and responsive organization.

He is a content producer who specializes in blog content. He has a master's degree in business administration and he lives in the Netherlands.

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