I met with a team of middle school teachers recently who were livid.  They had a very bright student who was “marching to the beat of a different drummer” in a way that was highly frustrating and disruptive to their classes.  Even though they reported that he often appears “lost” in class and there “seems to be a huge disconnect” with him, they still felt like his lack of listening, following directions, and following through on assignments was often “just a bunch of attention getting behaviors.”  After many months of his intrusive questions, dawdling and fidgeting around when doing independent seatwork, and repeatedly having late or missing assignments, they were convinced that “he’s doing a lot of this on purpose.”“He’s really smart, we see what he’s capable of, but he acts so stupid or clueless at times to try to get out of doing it.”  “It’s mainly attention-getting behaviors.”  “He is choosing not to do his work.”  “He can do it, but he just won’t.”

The teachers were understandably concerned that he was going to have a very hard time making it in high school.  And they were just exhausted by trying to figure him out.  What would motivate him?  What could get him to comply and to stay on task? To perform up to the potential they saw in him?

Welcome to the world of kids with executive function deficits.

Say what?!

The command and control center of the brain, located primarily in the frontal lobes, is responsible for the “executive functions” of paying attention, organizing, planning, managing time, initiating and following through on tasks, working memory, self-monitoring, impulse control, and emotional regulation.  Whew!

Our neurosciences are exploding with new research findings that are helping us to understand the critical nature of this part of the brain.  And the executive functions are increasingly critical aspects of human functioning in a rapid-paced, multi-tasking, information-overloaded society.

Imagine being really smart at understanding or knowing a lot of information, but unable to consistently “show what you know.”  Imagine not being able to manage the input and output channels of your brain so you can process and produce information as efficiently as others expect.

Imagine having all this horsepower under the hood of your car, but the control panel on the dashboard often goes haywire, and you just can’t control your speed or direction without frequent daily little glitches.

How frustrating would it be to be that student?  And to be that student’s parent or teacher?   I can tell you from dealing with these frustrations every single day in my consulting practice – very!

These kids are often diagnosed with one of the Attention Deficit Disorders, Autistic Spectrum Disorders, or Anxiety Disorders (including Tourettes and OCD), but they all have the same basic challenge: how to regulate their impulses and emotions in a way that gets them successfully through the demands of a typical day at school and home.

As Russell Barkley says, for many of them, it’s not a matter of knowing what to do, but doing what you know.  The breakdown is at the point of performance – especially when independent functioning is expected.  Self-control – inhibiting impulses, delaying gratification, sustaining attention and effort (especially on dull, tedious tasks that hold no intrinsic interest for the student) – is the very nature of the deficit.

Much of the cause is genetic and biochemical – a neurologic developmental delay in self-regulation.  Yet it certainly can be exacerbated by the environment – either aggravated by stress or inadvertently reinforced by adults and peers who feed into it.

Regardless, having executive functioning deficits may be an explanation for poor school performance, but it is never an excuse.  These students, just like any other students, need to be held accountable for appropriate behavior AND supported in a way that gives them the best chance to do so.

It is this critical balance between empathy and accountability, encouragement and enforcement, that will help make or break these kids.

Not one of them wakes up in the morning and says, “I can’t wait to screw up today!”  They are sick and tired of messing up, being corrected multiple times a day, and feeling like a failure.  Especially when they know better and at times can actually do better.  But the deficit is in maintaining consistent controls, and that’s what makes parents and teachers and these kids so crazy.

That’s also what often leads to the secondary problem of oppositional and defiant behaviors (often adding Opposional-Defiant Disorder to the diagnosis).  All too often, it becomes a vicious, downward spiral (especially in middle school and high school where the demands for independent functioning and the expectations for greater self-control increase tremendously).

In the coming weeks, we’ll focus on practical solutions and specific strategies for managing kids with a variety executive dysfunctions.  Stay tuned to learn how to boost your child’s ability to: get organized, plan ahead, stay focused, use time wisely, follow through on tasks, resist impulses, and stay in control of emotions.

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