Can We Improve Executive Functioning in Children With ADHD?

Takeaway: Our brain’s executive functions help guide us through day-to-day living, but they’re underdeveloped in children with ADHD. Techniques like brain training, neurofeedback, and mindfulness can help tackle these problems, but ideally, you’ll need a specialist to help customise a tailor-made care plan for your child.

ADHD (Attention-Deficit/Hyperactivity Disorder) can be a really frustrating experience for both children and parents.

Children with ADHD have brains that are easily distracted. They find it hard to stay focused on one thing, and they’re often hyperactive and impulsive. So, for example, they might be cleaning their room one minute but then get distracted by a toy they come across and start playing. Or they might lose interest in what a teacher is saying and start doodling instead. If they’re particularly restless, they might start disrupting the class or answering out of turn. (Learn more about ADHD.) The point here is that they’re not doing any of this on purpose, and are just responding to a brain that’s wired differently. Still, it gets in the way of life. They’ll find it hard to stay organised in class, regularly hand in assignments late, lose track of steps in larger projects, annoy people with their impatience, and so on. And as a parent, you might find it frustrating to try and reign her in.

These sorts of challenges come up because children with ADHD have issues with their brain’s executive functions.

Our brains have a group of mechanisms called executive functions that help regulate our behaviour. They’re like a tiny manager that makes sure we’re setting goals, sticking with our priorities, keeping our emotions in check, adapting to changes in our plans, etc. It’s a long list but we can fit each item into one of three categories: working memory (our ability to keep something in mind and use it to solve a problem), flexible thinking (using ideas in new ways), and impulse control (staying on track by ignoring fleeting impulses). (Learn more about executive functions.) These skills take years to develop, so most children struggle with them. But children with ADHD struggle more than usual.

We get a better idea of how important these executive functions are if we look at life without them.

Imagine a day in the life of a child with underdeveloped executive functions. Getting to school on time is a challenge because she’s extremely disorganised. She forgets things when packing her bag and doesn’t allow herself enough time to get ready — so she’s flustered even before reaching school. In class, they’re discussing a book everyone has just read, but she finds it hard to organise her thoughts despite having a lot to share. She might start to get frustrated but not know how to control herself. And so she interrupts people to say whatever comes to mind, which annoys everyone. Now what could have been a fun exploration of a great book has become a disaster. Think of what a week or month feels like when this sort of pattern repeats itself in a neverending loop!

These misadventures with ADHD makes most parents curious about how to improve their child’s executive functions. And there are quite a few options.

Children’s brains might be wired a certain way but that doesn’t mean we can’t change the wiring. Scientists use the term ‘brain plasticity’ to describe how a child’s brain can always be tweaked to help her live a better life. And here are three examples of how we can use this plasticity to help children with ADHD.

1. ‘Brain training’ to teach new skills.

We can encourage children to work on individual skills (like paying attention, solving problems, controlling emotions, etc.) using a range of fun games and exercises. These techniques can help form new connections in a child’s brain, which in turn will help change her behaviour. The trick is to nudge children in the right direction without making it seem too much like work. Here are some examples:

• Playing games. We can use imaginary role-play to teach young children how to control impulses. For example, one child can be a scientist working on a new invention, and her friend can be the assistant/engineer who helps her. By playing these roles, they’re learning to choose appropriate behaviour, which teaches them to inhibit impulses to break character. (Plus, it’s a controlled setting to practise social skills, emotional control, and more.) Older children can play card and board games to improve memory, planning, and strategic thinking. Or they could try fantasy computer games where they have to wrap their minds around complex imaginary worlds, characters, and adventures.
• Music and dance. Learning an instrument means you train working memory by tracking a melody, improve hand-eye coordination by holding chord patterns, develop discipline by practising regularly, and more. Dancing also trains working memory through complex choreography and has the same elements of physical coordination, focus, and discipline.
• Children love telling stories, and with practice, they’ll learn to create nuanced plots, characters, and inner emotional worlds. And this does things like developing their working memory, helping them understand feelings/emotions, and so on. Plus, if they start telling group stories — where each person contributes a sentence in turn — they’ll learn mental flexibility as they adapt to new input, and will have to concentrate even harder to keep track of the twists and turns. If they know more than one language, they can also practise switching between them as they narrate their stories.

2. ‘Neurofeedback’ to rapidly change behaviour.

Our brains run on electrical impulses, which give out brain waves. And we can monitor a brain’s activity by looking at the waves it emits. Neurofeedback is a technique to change these waves, and in turn, change how a brain functions. It works by giving a child real-time feedback about an activity she’s doing. For example, you could ask her to smile, which gets her brain working in a particular way. And since you’re tracking her brain waves, you’ll know as soon as she’s losing the smile — at which point you’ll remind her to keep smiling. This immediate feedback helps her connect her outward action (the smile) with her inner feelings (monitored via her brain waves). And this novel data gives her a deeper level of insight and control. People involved in neurofeedback research say the same principles can be applied to training executive functions, but this hasn’t been fully proven yet. Still, it’s a fascinating tool that shows great potential.

3. ‘Mindfulness’ to improve self-awareness.

Brain training and neurofeedback work on improving a child’s executive functions. But mindfulness can help her make full use of what she’s already developed. For example, if she gets anxious when asked a question in class, this anxiety will cloud her thinking. But if she can recognise that she’s anxious and calm herself down, she’ll have a better chance of answering the teacher’s question. And mindfulness — the ability to root yourself in the moment and be aware of what you’re thinking and feeling — can help with this. (Learn more about mindfulness therapy for children.)

There are so many ways to approach ADHD and executive function challenges, but they need to be customised to your child’s needs.

Each child has a unique set of strengths, challenges, and life circumstances — all of which affect the kind of support she needs. And this is why we suggest consulting a specialist for a more tailor-made care plan. The Ed Psych Practice offer face-to-face and online assessments, consultation, advice, and problem-solving strategies for parents, nurseries, schools, and universities in London. We have psychologists, paediatricians, and therapists who can help assess your child and offer guidance and support. To consult with us or set up an appointment:

• Phone: +44 (0) 78 3344 7356
• E-mail: Office@TheEdPsych.com

Want to see how else you can help your child? You might enjoy some of our other posts.

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• Self-Regulation & Your Child’s Path to Daily Happiness
• How Psychotherapy Can Change Your Child’s Life

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