Fri, September 8, 2023

An Introduction to Executive Functioning: When to Step Back versus When to Scaffold

Anna Levy-Warren Clinical Psychologist

Let’s say you have three children: eight, ten, and twelve years old. The middle child has significant executive function (EF) challenges. Let’s observe what unfolds at breakfast.

But first, how are you feeling at this moment? Are you anxious? It’s perfectly reasonable if you are. A lot depends on this morning routine going smoothly. You must get to work, get the kids to school, etc., and at some point—and what could make or break meeting these responsibilities—caffeine has to enter your system. Let me state that more accurately: An absolutely insane number of things have to happen to make this miracle of departure possible. We’ll return to that later.

For now, cue breakfast:

With her prefrontal cortex online and nailing the developmental needs of her age, the 12-year-old enters the kitchen dressed and retrieves a bowl from the cabinet, a spoon from the drawer, milk from the fridge, and cereal from the pantry with the automaticity of a seasoned expert. The eight-year-old follows suit without hesitation, the internal self-talk apparent, but inaudible. He ignores the dog barking and focuses on the goal of breakfast. Little pivots happen when the bowl is out of reach and his favorite cup is missing. Both kids bring all of the breakfast items to the table, sit, and eat. Tasks initiated, distractions ignored, routines in mind, decisions made, plans executed, all in three minutes and without your involvement. Wow! That was easy. And you brewed your coffee while it all unfolded!

Now let’s turn our attention to the ten-year-old. Just as you go to take your first delicious sip, they stumble into the room, looking lost, wearing a pajama top, jeans (in 90-degree weather), and one sock. You may scoff at the perceived hyperbole, but this is a daily reality when living with a human with particularly challenged EF. You look at your coffee, you look at your child (who you suspect is lacking all orientation to the where, when, and why of this morning’s plan), and you sigh.

In exciting news, you are unknowingly in a choose-your-own-adventure novel at a choice point. Option A: Tell your kid each step of preparing breakfast and make a beautiful plan for future mornings, all while your coffee runs cold. Or, Option B: Do it yourself. The latter would take under 60 seconds with no drop of hot coffee sacrificed. The former might take seven precious minutes as you prompt every step and your coffee turns lukewarm. The reality is that the seemingly simple breakfast-making steps don’t come intuitively to this ten-year-old. They may feel criticized and frustrated, culminating in an age-inappropriate tantrum. Put simply, there is no automaticity of “breakfast” for this child. No sequence, no sense of timeliness and regard for all that must get done to get out the door. “Why are these steps so hard!?”, “Why is this so exhausting!!?”, we wonder as we sip cold coffee. These are the questions caregivers ask me every day and the ones I’ve asked myself when I stare at my own ten-year-old.

Now we’ve arrived at the heart of the lived experience of executive functions and what they do for us. Executive functions refer to an interrelated set of cognitive and meta-cognitive processes that govern goal-directed behaviors and enable us to manage everyday activities effectively. Executive functions involve attention, inhibition, working memory, strategic planning, initiation, flexibility, and self-monitoring. They allow us to self-regulate and adapt as we direct ourselves toward behavioral and life goals. As the air traffic controller of the brain, they are responsible for seeing the big picture, solving problems, delegating resources, and reviewing the outcome. Strong EF in kids looks like: picking a book and reading it all the way through, saying the socially appropriate thing or refraining from texting something inappropriate, changing routes without a meltdown when the usual bus isn’t running, acting empathically, imagining that the homework you are doing leads to an A in the class, holding directions in mind when completing a test, learning to read, or distilling the key points from what the teacher says. The hard news is that these skills take 25 years to fully mature and they do not develop evenly.

Extensive research indicates that proficient organizational and EF skills are foundational for achieving positive outcomes in academic, occupational, and social-emotional realms of life. Particularly relevant to the past few years and our imaginable future: strengthening EF can protect against psychological problems during stressful experiences. Clearly, it also plays a fundamental role in being a successful student and efficient and effective professional in the way our systems are set up to value speed, attention, and goal-oriented behavior. Although there is endless research on the importance of developing and strengthening EF, when you are a parent of that ten-year-old, in the tough moments, your kid’s proficiency in EF can feel like an impossible benchmark, or a symbol of failure. To get from concerned to empowered, we need to learn how to meet our kids where they are and grow them up from there. Knowing when to step back versus when to scaffold is crucial, and the more thoroughly we understand the specific skills of working memory, mental flexibility, and self-control, the more nuanced and sophisticated we can be in our approach.

Working memory is the brain’s mental sticky pad. Let’s consider the 12-year-old going about her morning. She has routinized getting ready for school. Without prompting, she packs her bag with computer, keys, cell phone, wallet, and folders, remembers it is Wednesday with soccer after school and a day she picks up her brother, and checks the weather to be sure she dresses appropriately. She moves with ease around the house grabbing shin guards, cleats, sweatshirt, and bus pass for her brother in addition to her usual school-day materials. In contrast, her ten-year-old brother’s mental sticky pad has far less adhesion. The task, more of a project to him, of getting ready for school comprises so many unremembered steps. Turn off the alarm (hoping it was set!), get dressed, brush teeth, eat breakfast, grab your backpack…and that is actually a pretty macro view. For example, “get dressed” consists of many decisions (which socks?), each with a set of instructions (in which drawer are socks located?), and action initiations (put on socks). Each step requires holding in mind a where, when, and larger future goal of getting to school, and these steps don’t become “get dressed” until they are automatic and routine.

Mental flexibility is your “utility player” in the morning game. Let’s bring back our eight-year-old and say he is a superstar at adjusting and shifting perspectives. He can step out of his comfort zone and offer to switch positions at the dinner table if it makes things easier, resign himself without attitude to the second-choice cereal when his favorite runs out, and select the yellow bowl because he remembers his siblings’ aversion to it. These many little adaptations and changes happen with relative ease. Those who have great cognitive flexibility may even find excitement and fun in the spontaneity of adapting to the unexpected. However, the ten-year-old’s mindset is rigid and inflexible: if the spoon isn’t in the drawer, if the cereal available isn’t his top choice, it’s a disaster. The whole routine is disrupted. If the circumstances are not exactly as they were supposed to be, then they are completely new and thus uncomfortable and unacceptable. Creating a new plan requires self-control, our third foundational, executive function.

Self (or inhibitory) control is the blinkers (i.e., blinders) keeping the horse’s eyes on the path ahead for the journey at hand. Inhibitory control requires deciding what warrants your attention in a world of constant stimulation. The brain must orient, filter, maintain, and resist distractions so we can get ourselves out the door in the morning with both socks on. Each step requires a choice: where to go (downstairs for breakfast versus back to bed), what to do (grab cereal from the cabinet versus stopping to watch TV en route to the kitchen and choose cereal not snacks!), and so on. The 12-year-old stays focused and doesn’t allow her mother’s frustrations, the barking dog, or her brother’s tantrums to disrupt the course she’s charted to accomplish her job of readying herself for the day ahead. Persistent and goal-oriented, she will wrap up her morning routine and be out the door on time. Let’s compare her experience to that of her brother who lives without distraction filters. Competing stimuli and thoughts crowd and try to outcompete for his attention and inevitably distract from many component tasks of the morning routine: Mom seems upset. What happened? Was it me? The dog is barking. Is he hungry? Would he like a walk? He’s so cute! My siblings are bickering downstairs. What are they saying? Is it about me? There is a book on the floor. I wonder what will happen next? Oh, and my stomach is rumbling.

Now that we have some familiarity with working memory, mental flexibility, and inhibitory control, we can perhaps find a new appreciation for the number of EF processes required to accomplish the seemingly simple tasks of getting dressed and preparing breakfast. The children who neglected to change their pajama top and find that second sock, who are presently staring at the kitchen as if they’ve never seen it before, are not lazy, thoughtless, or willfully vexing, though it can feel that way. Despite these truths, your frustration because you need that hot coffee and one moment without playing the role of director, coach, teacher, and manager in addition to caregiver is also understandable and valid.

It’s useful to remind ourselves that there is a delay in important developmental requirements to complete even these basic tasks. There is no template for dressing and breakfasting in which the steps come forward in the same way for an adult as they would for a 12-year-old or for an eight-year-old regardless of what EF challenges they do or do not face. When your child struggles with EF outside of developmental norms though, the joking done by caregivers regarding how hard it is to leave the house with kids becomes more of a lived nightmare. It’s not funny; it’s painful. Caregivers are often left frustrated with their children for not complying with household “norms,” wondering if it’s an indication that they’ve let their kids down, and worried about whether and how they can help their kids pull it together.

How caregivers help their children acquire and account for differences in EF skills changes dramatically across the lifespan. We are constantly tasked with examining which choices our kids make in the context of their developmental age. Typically, EF skills will strengthen as we age, allowing us to manage the increased demands of life that accompany the maturational process; however, those with ADHD have around a three-year maturational delay in many of these areas. An array of biological, sociological, neurocognitive, and psychological factors all influence a child’s learning. All kids have ways in which they are older or younger than what the developmental pattern consistent with their chronological age indicates, and these developmental ages change in response to challenging conditions like stress, exhaustion, grief, illness, living through a pandemic, etc.

Focusing on our children’s strength areas in the context of their developmental age allows us to increase the effectiveness of the actions we take to help bolster their growth areas. Instead of comparing your child to milestones tied to chronological age, seek to identify your child’s real developmental age, and how you can help them grow into the next age. What is the honest next step, not the place where, on paper, they “should be”? Compared to their peers, that ten-year-old could present as 12 years old in math and six years old in his ADLs (Activities of Daily Living). Support him in progressing to seven years old in the latter category and not ask that he jump to ten years old to align with un-individualized metrics and/or societal pressures. It is not babying your ten-year-old to lay out their clothes for them the night before if that is what they need at this point to accomplish dressing themselves successfully the next day. Will you do this forever? No, but laying out clothes is a possible next step to reinforce a positive behavioral development when they make it to the kitchen in the morning wearing both socks and no pajama top, inspiring a warm smile versus an exasperated sigh from you. And because the brain loves reward, it is more likely to repeat what prompted that approving smile from you. Our goal is scaffolding our kids just enough to make it possible for them to manage the next developmental task well and independently.

From infancy through toddlerhood, caregivers, in effect, serve as the executive functions for our kids’ brains. We regulate, soothe, direct, and support them through and between activities, essentially acting as their dedicated, external air traffic controllers. As children’s brains develop and establish set structures, caregivers can step back and foster a gradual transition to greater autonomy while simultaneously providing a space for taking risks, learning from mistakes (and never framing mistakes as “failures”), and stretching toward independence.

Returning to our morning routine, take out a sheet of paper and start to do the work collaboratively with this ten-year-old. If your child is developmentally younger, visually map out, or if older, type it out on the computer, each teeny tiny step and the amount of time needed for dressing, breakfasting, and getting out the door, along with how long each intermediary step takes. Particularly for younger kids, consider laminating the plan and equipping them with a dry-erase pen to check off each step each day. If you need to leave the house at 8 a.m. for school, you need to be getting shoes on at 7:50 a.m. Ten minutes to put shoes and socks on? Yes, it requires that much time for kids who cannot remember where they left their shoes, who are prone to throwing tantrums about rain boots versus sneakers, or who experience sensory sensitivity and must adjust the seam of the sock on the left foot to the precise feel-good location. Bottom line: assume nothing, work backwards, incorporate time buffers, anticipate potential roadblocks, and plan for contingencies together.

What are some other concrete ways to strengthen EF across the life span and help improve the efficiency and effectiveness of your day? Start by identifying one thing that drives you crazy or would positively impact your life the most if it improved? Lean in with your kids. This would be faster on your own, but even if it’s slower, this needs to be a collaborative, bottom-up process with your child. Get behind their eyes and guide them to voice and acknowledge their own frustrations. Breathe, vent to friends, try to see these as growth areas, and work together to design supports that will be personally meaningful and accessible to them. Find each of your child’s growth edges and the next step needed to reach that delicious, successful feeling. Ideas to consider: Make a family calendar that is large and color-coded that helps everyone anticipate vacations and nights out. Or map out the morning routine using an actual visual map. Or use an actual sticky pad when the internal one isn’t functioning. Recognize the real challenges in external stimulation derailing the goal of getting out of the house in the morning and allow headphones to block the noise or designate a code word or a gentle pre-established touch as a reminder to get back to focusing on the goal at hand.

Imagine how many more choose-your-own-adventure decisions there are in the book for the caregiver raising a child struggling with crucial skills or struggling themselves. Keep a developmental lens and exercise your superpower as a caregiver who deeply knows their kids and can see where they excel and where they falter. Find their growth edge at this moment. Caregivers must make hard choices every day, factoring in many circumstances, about where to channel our energy. Where is the right place to push for the next level of independence or EF strengthening? I’ve spent the past 20 years working with people who wrestle with executive functions, and the last ten parenting one of these individuals. I have mornings where I put my own blinkers on and just get through because I am tired, but when I can, I dig deep and lean in to find the growth opportunity. Equipped with colored pens, and fueled by lukewarm coffee, I pull out the calendar and map out the week with my ten-year-old, and dream of the hot coffee this work will allow for in the near future.

Anna Levy-Warren, Ph.D. is a licensed clinical psychologist based in Manhattan, and a graduate of New York City independent schools. She is the founder, CEO, and a supervisory team member of Organizational Tutors. She is a co-founder of Dwellness, which provides in-home therapy for individuals and families. She also offers executive functioning and leadership training through an affiliated company, STEEL Advising. Learn more at

This article first appeared in the 2023 issue of the Parents League Review. Get the current issue of the Review free with a family membership. Or purchase it separately.

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