ASHA Connect Conference Part 3

The following are excerpts from our notes on a class on executive functions presented by Karole Howland of Boston University:

Developing Executive Functions in Young Students with Language Impairment

·      Executive functions:  The ability to maintain an appropriate problem solving set for attainment of a future goal.

·      Impact of Deficits in EF:

o  EF skills in preschool predict academic success

o  Children with poor EF skills are at risk for social/behavioral problems

o  EF skills are essential to the development of theory of mind

·      We cannot afford to wait until middle school to work on EF

·      Behavioral intervention often assumes the issues are based on a cognitive choice to misbehave, rather than behavior problems that need to be managed.  We need to think of executive functions as skills  that need to be developed 

·      Inhibition:  

o  Closely related to emotional regulation in preschoolers

o  Inhibition is hard work! 

o  Some types of inhibition:

§  Delay of gratification  

§  Emotional self-regulation 

§  Resisting distraction  

§  Conflicting action  

·      Cognitive Flexibility: 

o  The ability to change or adapt plans as circumstances demand

o  Requires recognition of the need for change

o  Requires the ability to inhibit the original action in favor of a new response

·      Planning:

o  Requires a future image-what is the goal? 

o  Requires a high degree of inhibition 

o  Requires working memory 

·      Teacher Ratings are more effective than formal testing to diagnose EF

·      Spoken Language Characteristics of Children with EF disorders

o  Disorganized and Tangential: Leaves out or mis-sequences steps, goes off topic. Vague references lead to confusion.

o  Uses verbal mazes as a result of word-finding and planning problems.

o  Excessive detail about minor points.

o  Insufficient detail about major points

o  Overproduction: Talks much but communicates little  

o  Underproduction: Planning demands are too high, shrugs, gestures, shuts down