Creating Executive Functions in School-Aged Children with Attentional and Working Memory Problems

Darlyne G. Nemeth, Ph.D., M.P., Kayla M. Chustz, B.S. & Patricia McElroy, Ed.S., NCED
Presented at the 2019 C W Austin Learning Disability Conference February 2, 2019

Executive Functions are “all of the cognitive skills needed to regulate your thinking, feeling, and behavior, often to reach a goal”(Branstetter, 2014). Children with Executive Functioning disorders have problems with listening, shifting, being on time, organizing, planning, procrastinating, forgetting, pacing, initiating, wandering, and losing things. Most significantly, these children have Working Memory and Attentional issues. Nemeth (2018) defines Working Memory as “the mortar between the bricks that allows learning to cement/take place.” Together, children with Working Memory and Inattentive problems have the following school-related difficulties: Reading and Listening Comprehension, Language Comprehension, Learning to Spell, Vocabulary Learning, Following Directions, Note-taking/Test-taking, Writing, and Complex Learning.

How do we behaviorally identify these Working Memory and Attentional problems? Working memory problems usually involve the following: Difficulty following multi-step directions, Has to frequently re-read in order to comprehend, Has to write things down or else will forget, has a hard time with mental math, and has difficulty multi-tasking. Attentional problems usually involve the following: acts impulsively from an early age, tends to “jump first, think later,” doing the first thing that comes to mind, has trouble considering “if-then” logic (cause and effect), needs constant reminders, difficulty considering consequences, and is impulsive with work, making careless errors.

Medication management for attentional problems may be needed; however, the following caveats are offered: 1) Just because it looks like ADHD and acts like ADHD, does not mean it is ADHD, 2) Questionnaires are not sufficient to make this diagnosis, 3) This could be a mask or costume for an underlying problem, and 4) Must investigate thoroughly. The primary goal of ADHD medication management is to control the following symptoms: inattention, hyperactivity, and impulsivity. This may include, but not be limited to, medication management, behavioral intervention, biofeedback therapy, psychoeducational intervention, school consultation, coaching/skills training, and school accommodations.

In conclusion, children are deeply affected by biogenetic, psychosocial, and environmental factors. They must be carefully guided through the developmental years of infancy, childhood, and adolescence, so that they can become responsible adults who contribute to society. This takes community effort. Therefore, a comprehensive evaluation and intervention program for children who are exhibiting executive dysfunction, working memory difficulties, and attentional difficulties is recommended.

From Evaluation to Medication to Intervention to Accommodation,
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