Executive Dysfunction - Socio-cultural Implications - Education

Education

In the classroom environment, children with executive dysfunction typically demonstrate skill deficits that can be categorized into two broad domains: a) self-regulatory skills; and b) goal-oriented skills. The table below is an adaptation of McDougall’s summary and provides an overview of specific executive function deficits that are commonly observed in a classroom environment. It also offers examples of how these deficits are likely to manifest in behaviour.

Self-regulatory skills

Often exhibit deficits in... Manifestations in the classroom
Perception. Awareness of something happening in the environment Doesn’t “see” what is happening; Doesn’t “hear” instructions
Modulation. Awareness of the amount of effort needed to perform a task (successfully) Commission of errors at easy levels and success at harder levels; Indication that student thinks the task is “easy” then cannot do it correctly; Performance improves once the student realized that the task is more difficult than originally thought
Sustained attention. Ability to focus on a task or situation despite distractions, fatigue or boredom Initiates the task, but doesn’t continue to work steadily; Easily distracted; Fatigues easily; Complains task is too long or too boring
Flexibility. Ability to change focus, adapt to changing conditions or revise plans in the face of obstacles, new information or mistakes (can also be considered as “adaptability”) Slow to stop one activity and begin another after being instructed to do so; Tendency to stay with one plan or strategy even after it is shown to be ineffective; Rigid adherence to routines; Refusal to consider new information
Working memory. Ability to hold information in memory while performing complex tasks with information Forgets instructions (especially if multi-step); Frequently asks for information to be repeated; Forgets books at home or at school; Can’t do mental arithmetic; Difficulty making connections with previously learned information; Difficulty with reading comprehension
Response inhibition. Capacity to think before acting (deficits are often observed as “impulsivity”) Seems to act without thinking; Frequently interrupts; Talks out in class; Often out of seat/away from desk; Rough play gets out of control; Doesn’t consider consequences of actions
Emotional regulation. Ability to modulate emotional responses Temper outbursts; Cries easily; Very easily frustrated; Very quick to anger; Acts silly

Goal-oriented skills

Often exhibit deficits in... Manifestations in the classroom
Planning. Ability to list steps needed to reach a goal or complete a task Doesn’t know where to start when given large assignments; Easily overwhelmed by task demands; Difficulty developing a plan for long-term projects; Problem-solving strategies are very limited and haphazard; Starts working before adequately considering the demands of a task; Difficulty listing steps required to complete a task
Organization. Ability to arrange information or materials according to a system Disorganized desk, binder, notebooks, etc.; Loses books, papers, assignments, etc.; Doesn’t write down important information; Difficulty retrieving information when needed
Time management. Ability to comprehend how much time is available, or to estimate how long it will take to complete a task, and keep track of how much time has passed relative to the amount of the task completed Very little work accomplished during a specified period of time; Wasting time, then rushing to complete a task at the last minute; Often late to class/assignments are often late; Difficulty estimating how long it takes to do a task; Limited awareness of the passage of time
Self-monitoring. Ability to stand back and evaluate how you are doing (can also be thought of as “metacognitive” abilities) Makes “careless” errors; Does not check work before handing it in; Does not stop to evaluate how things are going in the middle of a task or activity; Thinks a task was well done, when in fact it was done poorly; Thinks a task was poorly done, when in fact it was done well

Teachers play a crucial role in the implementation of strategies aimed at improving academic success and classroom functioning in individuals with executive dysfunction. In a classroom environment, the goal of intervention should ultimately be to apply external control, as needed (e.g. adapt the environment to suit the child, provide adult support) in an attempt to modify problem behaviours or supplement skill deficits. Ultimately, executive function difficulties should not be attributed to negative personality traits or characteristics (e.g. laziness, lack of motivation, apathy, and stubbornness) as these attributions are neither useful nor accurate.

Several factors should be considered in the development of intervention strategies. These include, but are not limited to: developmental level of the child, comorbid disabilities, environmental changes, motivating factors, and coaching strategies. It is also recommended that strategies should take a proactive approach in managing behaviour or skill deficits (when possible), rather than adopt a reactive approach. For example, an awareness of where a student may have difficulty throughout the course of the day can aid the teacher in planning to avoid these situations or in planning to accommodate the needs of the student.

People with executive dysfunction have a slower cognitive processing speed and thus often take longer to complete tasks than people who demonstrate typical executive function capabilities. This can be frustrating for the individual and can serve to impede academic progress. Disorders affecting children such as ADHD, along with oppositional defiant disorder, conduct disorder, high functioning autism and Tourette’s syndrome have all been suggested to involve executive functioning deficits. The main focus of current research has been on working memory, planning, set shifting, inhibition, and fluency. This research suggests that differences exist between typically functioning, matched controls and clinical groups, on measures of executive functioning.

Moreover, some people with ADHD report experiencing frequent feelings of drowsiness. This can hinder their attention for lectures, readings, and completing assignments. Individuals with this disorder have also been found to require more stimuli for information processing in reading and writing. Slow processing may manifest in behavior as signaling a lack of motivation on behalf of the learner. However, slow processing is reflective of an impairment of the ability to coordinate and integrate multiple skills and information sources.

The main concern with individuals with autism regarding learning is in the imitation of skills. This can be a barrier in many aspects such as learning about others intentions, mental states, speech, language, and general social skills. Individuals with autism tend to be dependent on the routines that they have already mastered, and have difficulty with initiating new non-routine tasks. Although an estimated 25–40% of people with autism also have a learning disability, many will demonstrate an impressive rote memory and memory for factual knowledge. As such, repetition is the primary and most successful method for instruction when teaching people with autism.

Being attentive and focused for people with Tourette’s syndrome is a difficult process. People affected by this disorder tend to be easily distracted and act very impulsively. That is why it is very important to have a quiet setting with few distractions for the ultimate learning environment. Focusing is particularly difficult for those who are affected by Tourette’s syndrome comorbid with other disorders such as ADHD or Obsessive-Compulsive Disorder, it makes focusing very difficult. Apraxia, an associated symptom of Tourette’s syndrome is the inability to carry out an action such as reading, without a neurological cause. Also, these individuals can be found to repeat words or phrases consistently either immediately after they are learned or after a delayed period of time.

Read more about this topic:  Executive Dysfunction, Socio-cultural Implications

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