Occupational Therapy -> Executive Function

Executive Function

Executive function is a broad term used to describe complex cognitive processes which are used to think, make decisions, plan, and control behavior. Occupational therapists address executive functioning skills in order to help individuals participate in daily activities with as much independence and success as attainable.

Minor focus areas

Skilled interventions

  • Executive Functioning Skills Development

    Executive Functioning Skills Development targets the enhancement of cognitive processes necessary for managing daily tasks and achieving personal goals. This intervention focuses on skills such as task sequencing, goal setting, and problem-solving. By using visual schedules, checklists, and real-life scenarios, children learn to plan, organize, and execute tasks effectively. The approach is flexible, allowing for the child's unique cognitive style and strengths, and fostering an environment that encourages self-reflection and personal growth.
    Therapeutic activities typically include:
    • Task Sequencing: Breaking tasks into manageable steps to improve planning and execution. This can involve creating visual schedules or checklists to guide task completion.
    • Goal Setting and Planning: Developing skills in setting achievable goals and creating plans to reach them. This process encourages self-reflection and adjustment of strategies as needed.
    • Problem-Solving Exercises: Engaging in activities that require critical thinking and decision-making. These exercises can be tailored to real-life scenarios to enhance practical application.
    Occupational therapists work with individuals to develop personalized strategies and tools, such as checklists and visual aids, to support executive functioning in daily life.

  • Graphic Organizer

    Graphic Organizers facilitate the processing of complex information by breaking it down into manageable components, visually displaying relationships and hierarchies. Common types include Venn diagrams, flow charts, mind maps, and sequence charts. These organizers are used to aid in writing assignments, solving math problems, and managing projects, enhancing cognitive clarity and decision-making.

    Occupational therapists introduce Graphic Organizers in a contextually relevant manner, tailoring them to the individual’s specific challenges and goals. For students, this might mean using organizers to structure essays or study for exams. For adults, it could involve organizing tasks for a project at work or managing household duties.

    Therapy sessions might include teaching how to select the appropriate type of organizer for a particular task, customizing organizers with personal cues and symbols, and integrating their use into daily routines. As proficiency grows, individuals are encouraged to independently create and adapt organizers, fostering autonomy and confidence in their executive abilities.

  • Sign Language

    Incorporating Sign Language into therapeutic practices offers a unique approach to bolster executive functions. The process of learning and using sign language involves memory recall, attention to detail, and the sequential organization of hand movements, all of which are integral aspects of executive functioning. This intervention is particularly beneficial for individuals with auditory processing disorders, autism, and other communicative impairments.

    Therapists use Sign Language to help patients develop alternative communication strategies, which in turn, enhance their ability to plan, solve problems, and manage daily tasks. The tactile and visual nature of sign language helps reinforce neural pathways associated with executive control and can be especially effective for those who struggle with traditional verbal communication.

    Sessions typically involve teaching basic signs, gradually progressing to more complex phrases and conversations. Activities may include storytelling through sign, interactive signing games, and daily sign language use for routine activities. This not only aids in cognitive development but also improves social interaction skills.

Reference links

  • Effectiveness of Pediatric Occupational Therapy For Children With Disabilities: A Systematic Review 1
    www.ncbi.nlm.nih.gov     Author: Iona Novak and Ingrid Honan - A. Parent partnership within an occupational therapist intervention is effective and worthwhile Occupational Therapists embrace the principles of family-centered care (Hanna & Rodger, 2002), where the parent is the decision-maker and the expert in knowing their child, and the therapist is a technical resource to the family. B. Activities-based, ‘top-down’ interventions deliver bigger gains. Numerous occupational therapy interventions exist, aiming to improve motor, behavioral and functional outcomes (Fig. 3), affording many choices to families and clinicians. The greatest number of effective green light interventions was at the activity level of the ICF, indicating that daily life skills training using a ‘top-down’ approach is a strength of the occupational therapy profession.
  • Interventions Within the Scope of Occupational Therapy to Improve Children’s Academic Participation: A Systematic Review 2
    watermark.silverchair.com     Author: Grajo, Candler, & Sarafian - Effectiveness of interventions to improve academic participation of children and youth ages 5–21 yr. Interventions that use choice, creative engagement, collaboration with parents, and support by cross-age peers show promise in enhancing children’s attitudes toward literacy and participation in literacy activities. Low strength of evidence supports the use of weighted vests and stability balls, and moderate strength of evidence supports the use of yoga to enhance educational participation. Moderate strength of evidence supports the use of creative activities, parent-mediated interventions, and peer-supported interventions to enhance literacy participation. Strong evidence supports therapeutic practice for handwriting intervention, and low strength of evidence supports various handwriting programs as a replacement or additional instructional strategies to enhance handwriting abilities. Citation: Lenin C. Grajo, Catherine Candler, Amanda Sarafian; Interventions Within the Scope of Occupational Therapy to Improve Children’s Academic Participation: A Systematic Review. Am J Occup Ther March/April 2020, Vol. 74(2), 7402180030p1–7402180030p32. doi: https://doi.org/10.5014/ajot.2020.039016
  • Your Child’s Early Development is a Journey 1
    www.cdc.gov     Author: Centers For Disease Control and Prevention - Skills such as taking the first step, smiling for the first time, and waving “bye-bye” are called developmental milestones. Children reach milestones in how they play, learn, speak, act, and move. Click on the age of your child to see the milestones:
  • Steps For Implementation: Positive Reinforcement 2
    csesa.fpg.unc.edu     Author: Neitzel, J. (2009). Steps For Implementation: Positive Reinforcement. Chapel Hill, NC: The National Professional Development Center On Autism Spectrum Disorders, Frank Porter Graham Child Development Institute, The University of North Carolina - Reinforcement is an evidence-based practice used to increase appropriate behavior and teach new skills (e.g., replacement behavior in place of an interfering behavior). This document outlines the steps for implementing positive reinforcement with learners with ASD. Positive reinforcement is the contingent presentation of a stimulus (i.e., reinforcer) immediately following a learner’s use of a target skill/behavior. This relationship between using a target skill/behavior and receiving reinforcement increases the future rate and/or probability that the learner will use the skill again.
  • Occupational Therapy Practice Guidelines For Early Childhood: Birth–5 Years 2
    watermark.silverchair.com     Author: Clark and Kingsley - Cognitive delays: home-, community-, and preschool-based interventions. To address cognitive development in premature infants, use of NIDCAP, home-based EI, touch-based interventions, and reading aloud to the child and incorporating home programs when working in clinics. The REDI program, the Read It Again program, and teaching specific cognitive skills all improved cognitive outcomes for a range of preschool-age children who were at risk for or had a specific diagnosis associated with developmental delays. Infant–maternal attachment: skin-to-skin, KC, and parent training programs such as the MIT program. The Incredible Years, MIT, and teacher training in PBIS were all effective in improving child behavior. Parenting behaviors: direct parent training, the Incredible Years, and PCIT. Parent-delivered massage, attachment training, and the Play Project are all interventions that showed a significant impact on parental stress, anxiety, or depression. Motor outcomes: use of NIDCAP, CIMT, and BIT for children at risk for and diagnosed with CP. Home-based interventions using parent coaching and clinic-based interventions that used home programs were also effective for short-term motor development, underscoring the value and benefit of well-written home programs and coaching parents to support their child’s development. Feeding and eating: repeated-exposure interventions, nonnutritive suck, and parent training to support the child’s feeding and eating are all effective options. Toileting: The use of a wetting alarm is supported when toilet training toddlers. Sleep: use of parent training, positioning devices in the NICU, and touch-based interventions are all effective. Citation: Gloria Frolek Clark, Karrie L. Kingsley; Occupational Therapy Practice Guidelines for Early Childhood: Birth–5 Years. Am J Occup Ther May/June 2020, Vol. 74(3), 7403397010p1–7403397010p42. doi: https://doi.org/10.5014/ajot.2020.743001
  • How An SLP and OT Collaborate Long-Distance - The ASHA Leader BLOG 1
    leader.pubs.asha.org     Author: Stephanie Sigal, MA, CCC-SLP, Michelle Bonang, OTR/L - As speech-language pathologists, we all experience stories of working as an interdisciplinary team. In this story, co-treatment brought us together and keeps us in touch today. Our relationship naturally affected us professionally, but personally as well. This story shares some of my adventures—I’m Stephanie Sigal, an SLP in Manhattan, with my friend and colleague Michelle Bonang, an occupational therapist in Vermont. Together, we teach each other invaluable skills.
  • Variables Related to Successful School-Based Practice 1
    www.nbcot.org     Author: Case-Smith, Jane.  - Three themes were identified: "Finding the key" described a procedural reasoning process in which the participants searched for the underlying reasons for each student's behaviors and performance. "The whole child" emphasized the importance of the student's psychosocial core and described the therapist's use of interactive and conditional reasoning to form supportive relationships with their students. Because each participant valued the student's vision of a new self, she was able to help the student achieve new social roles and improved self-esteem. "Whose success is this?" told of the importance of a cohesive team, which included the parents, to the child's success. The child's achievement of important life goals and success as a student seemed to be the result of a team effort to which occupational therapy contributed.
  • Milestone Moments 1
    www.cdc.gov     Author: Centers For Disease Control and Prevention - These developmental milestones show what most children (75% or more) can do by each age. Subject matter experts selected these milestones based on available data and expert consensus.
  • Leveling Up Regulatory Support Through Community Collaboration 1
    pubs.asha.org     Author: Amy C. Laurenta and Jacquelyn Fede - While behavioral intervention methodologies and societal expectations for masking remain prevalent, in recent years, there has been a greater emphasis placed on understanding the underlying factors contributing to problematic and challenging behaviors. Furthermore, there has been greater recognition of the need to address those underlying factors as the primary areas to target for effective intervention that can actually help autistic individuals navigate their environments in school and as they transition out of school and into the real world (Prizant et al., 2006a). To provide this type of ethical, efficient, and sustainable support, it is imperative for clinicians to understand emotional or energy regulation as a developmental construct and then to understand its relationship to challenging behaviors.
  • Executive Functioning Skills 1
    www.theottoolbox.com     Author: The OT Toolbox - Executive Functioning Skills guide everything we do.  From making decisions, to staying on track with an activity, to planning and prioritizing a task.  The ability to make a decision, plan it out, and act on it without being distracted is what allows us to accomplish the most mundane of tasks to the more complicated and ... Read more
  • Autism Spectrum Disorder and Other Development Disorder 1
    www.who.int     Author: World Health Organization - Psychosocial interventions that are effective in reducing core symptoms and improving adaptive skills and functioning are available, but they are very resource intensive. Increased evidence on affordable service delivery models and effective and scalable capacity-building approaches are required. Interventions mediated by parents and other non-specialist providers have the potential to significantly increase access to care.
  • Reading: A Review of the Current Research On Vocabulary Instruction 0
    www2.ed.gov     Author: National Reading Technical Assistance Center, RMC Research Corporation - This review of current vocabulary research confirms the benefits of explicit teaching over implicit teaching in promoting vocabulary development. Results from this review suggest that effective and efficient research-based methods are available when selecting a particular instructional approach. The findings also suggest several instructional implications for promoting word knowledge: • Frequent exposure to targeted vocabulary words. Biemiller and Boote (2006) found that repeated Reading a storybook resulted in more significant average gains in word knowledge for young children. • Explicit instruction of targeted vocabulary words. Biemiller and Boote (2006) also found that word explanations taught directly during the reading of a storybook enhanced children’s understanding of word meanings. In addition, Nash and Snowling (2006) found that using a contextual approach to instruction produced more significant vocabulary gains than lessons that emphasized learning word definitions. • Questioning and language engagement. Scaffolding questions that are, moving from low-demand questions to high-demand questions promote greater gains in word learning (Blewitt, Rump, Shealy, & Cook, 2009). Vocabulary instruction should include teacher-student and interactive activities that target new words (Coyne, McCoach & Kapp, 2007). In summary, active vocabulary instruction should permeate a classroom and contain rich and exciting information. In addition, vocabulary instruction should cover many words that have been skillfully and carefully chosen to reduce vocabulary gaps and improve students’ abilities to apply word knowledge to the task of comprehension.

Activity List(s)

Related Disorder(s)

  • Autism Spectrum Disorder - Autism Spectrum Disorder (ASD) is a complex developmental condition that involves persistent challenges in social interaction, speech and nonverbal communication, and restricted/repetitive behaviors. The effects of ASD and the severity of symptoms are different in each person.
  • Attention-Deficit/Hyperactivity Disorder (ADHD) - Attention-Deficit/Hyperactivity Disorder (ADHD) is a disorder marked by an ongoing pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development.
  • Neurological Conditions - Types of neurological conditions may include: Alzheimer’s Disease, Dementias, Brain Cancer, Epilepsy and Other Seizure Disorders, Mental Disorders, Parkinson’s and Other Movement Disorders, and Stroke and Transient Ischemic Attack (TIA).

Assessments

Organizations

Organizations who selected this major focus area as their top area of expertise.

  • ACES Speech Therapy, LLC

    ACES Therapy

    Private Practice
    6 - 10 employees

    ACES Therapy is a team of compassionate, highly trained & experienced therapists located in Eldersburg, Maryland. We are dedicated to helping children, adolescents and their families meet the needs of every child and young adult. We aim to provide the highest quality of services in an enriching and enjoyable environment where all children can thrive. Our Speech-Language Pathologists (SLP) perform thorough evaluations and develop individualized treatment plans. Services are provided in one-to-one or small group therapy sessions addressing areas like articulation, expressive/receptive language, reading, writing, fluency, social language, & auditory processing. The occupation of children is to grow, learn, do schoolwork, and play. Occupational Therapists (OT) can help your child with physical, sensory, or cognitive disabilities by assisting them with primitive reflexes and everyday activities like dressing, eating, focusing, writing, and playing. You may seek out an OT if your child struggles with coordination, has difficulty with attention or sitting still, has sensory aversions, or has trouble with executive functioning & organization. An OT can help with self-regulating behavior & emotions, or if they struggle to do daily activities that other same age peers can easily complete. Advocating for students with disabilities requires a firm understanding of federal and state educational regulations, as well as knowledge of parental rights. Our Educational Advocate can help you navigate the complex world of special education. We will help you build a healthy, positive relationship with your child’s school, while providing you with resources, tips, and guidance through the IEP or 504 process. We will explain your educational rights to you, review your child’s educational records, listen to your concerns, help you generate ideas to propose to the IEP/504 team, and assist in navigating areas of potential conflict. Research shows that when families and educators work collaboratively, the outcomes are more mutually satisfying and benefit the child long term.

Therapists

Therapists who selected this major focus area as their top area of expertise.

  • Bethany Ayer

    Bethany Ayer

    OTR/L

    I am a licensed Occupational Therapist with extensive experience in brain injury, physical disabi...