Executive functioning refers to the area of the brain, the frontal lobe, that regulates behaviors, emotions, and is responsible for impulse-control, motivation, planning, organization, sustaining and maintaining attention, processing complex information, understanding social cues, and sustaining age-appropriate conversation. Although core knowledge and abilities (e.g., academic skills, intelligence) and emotions may stem from other parts of the brain, it is the frontal lobe that mediates, controls, and regulates information.
Children with frontal lobe deficits and executive dysfunction have symptoms consistent with attention-deficit, mood disturbance, and challenges surrounding behavior. Children are often prone to temper tantrums, aggression, emotional outbursts, poor impulse control, and may have difficulties using appropriate judgment. They may be either overly impulsive (e.g., acting without thinking about the consequences of their misbehaviors) or lack initiation or motivation to carryout daily life tasks (e.g., poor hygiene) or participate adequately in school. Social problems are often present, such as lacking understanding of appropriate social boundaries and others may describe them as “socially immature.” Although they desire friendships, they often lack self-awareness and appropriate self-monitoring skills, which interfere with their ability to develop appropriate social relationships. Although these children may demonstrate relatively intact neurocognitive abilities, they very often struggle applying their knowledge to new situations or lack understanding of what to do or how to behave in specific situations, which often impacts classroom functioning. These children are often described as “smart, yet scattered.”
The frontal lobe continues to grow into early adulthood. As such, most children typically have problems with attention, impulse-control, regulating their emotions, and controlling their behaviors to some degree. Nonetheless, most children are able to function without difficulty. However, those with frontal lobe deficits and executive dysfunction demonstrate evidence of more difficulty, and these challenges interfere with their ability to function at an age-appropriate level. Interventions (e.g., therapy) often helps to improve functioning and can teach the child effective coping strategies. Understanding the child’s neurocognitive profile can be useful for using their strengths to compensate for their weakness. Behavioral approaches usually work best. Medication may also be useful, though should always be used in conjunction with behavioral intervention.