Why Are You Calling Everything “Executive Function”?

Vitamin Deficiency And Vague EF Talk

I have a question for you. If somebody walked in your office tomorrow and said, this student is vitamin deficient, what would you say? After you said what, right? What would you ask? Hopefully you would say, which vitamin? Because that seems like that would be an important piece of information in the conversation, right? Is it vitamin D, B12, iron? Okay, well, technically iron's not a vitamin, but you get my point, right? I thought you'd get a kick out of my Texas twang. But you wouldn't just hear vitamin deficiency and nod your head and go, all right, got it. I know exactly what to do. Because they haven't given you enough information for you to know what to do. And yet, I think we do this in school counseling all the time. Somebody walks into our office and they say something like, This kid is really struggling with executive functioning. And we go, oh, like we know exactly what that means. We don't, but usually I think we're probably all picturing the same kid. The one that's disorganized, they're missing 14 different assignments, they can't find anything, they forgot their Chromebook charger again. They haven't written in their student planner since the third day of school. Maybe they're impulsive, they're bouncing all over the place. And somewhere along the way, somebody says, Yep, that's executive functioning. And you may even hear, have they been evaluated for ADHD? And everybody nods their head. But hang on a minute. What did we actually just identify? Because executive functioning, I think, has become one of those things that we say in schools that sounds super specific until somebody asks us to get more specific. And then we can't do it. It's like talking about trauma-informed or restorative practices. They're real things with real meanings, but we've stretched them and we've pulled them and slapped them onto so many different things that sometimes I personally hear those and think, I have absolutely no idea what you mean by that. And really, I think we do the same thing with executive functioning. Because a kid who loses every single paper that he's been given, a kid who can't get started on an assignment, who can't remember three directions in a row, who blurts out every single thought that enters their head, and the kid who's missing 14 different assignments may not actually all have the same problem. In fact, they may not all have an executive function problem at all. So before we talk about what we do with these kids, I think we need to back way, way up. Because what the heck are we actually talking about when we say executive functioning? Hey there, school counselor. Welcome back. If you've been around here for any length of time, you know I'm a big believer in getting underneath the words that we use in school counseling. Because sometimes we inherit an idea or a practice or a professional sounding phrase, and we repeat it so many times that eventually we never stop to explain what we're saying. And I think we've gotten there with executive functioning. We use it like an explanation, when a lot of the time it's just a label. And if we aren't clear about what we're describing, it's really hard to know what we're supposed to do about it. So if you're ready for some straight talk, my friend, some clarity on your work and maybe a little bit of rebellion. Hi, you are in the right place. I'm Steph Johnson, and this is the School for School Counselors Podcast.

What Executive Functions Do

All right, well, let's start with a thing that sounds obvious and we'll work our way down. Executive functioning is not just one thing. There is not some executive functioning switch somewhere in the brain that's either on or off, right? So, broadly speaking, when researchers talk about executive functions, they're talking about the mental processes that help us manage ourselves well enough to get something done. The research defines it something like this um higher level cognitive processes that help us regulate our thoughts and behavior toward a goal. And that's fine too, but nobody really talks like that, right? So think about this. You're driving to work, you're driving the same route, you drive every day, you get halfway to the destination, and the road is closed. So now you've got to stop doing what you do automatically every morning. Remember where you're trying to get, figure out another way to get there, and adjust your approach. Executive functions. Or you're sitting in a meeting and somebody says something and you have the best comeback ever. It is like the best of your life. But you would also like to remain employed. So you keep that little jewel to yourself. Executive functions. Or you're trying to cook dinner, something's on the stove, something else is in the oven, the dog is barking, somebody asks you a question, and then a timer is going off. And somehow you manage to handle all of that and still remember what you were cooking for dinner in the first place. Executive functions. We use this stuff all day long. You know it, and I know it. One of the most influential models in the research on executive function comes from Akira Miyaki and colleagues who looked particularly at three processes: inhibition, updating working memory, and shifting. So, in plain words, inhibition helps you stop yourself from doing the thing you want to automatically do. Working memory lets you hold information in your head while you're doing something with it. And shifting helps you change gears when the situation changes. And they found that all three of those things were related, but they're not all the same thing. There's actually a phrase for that. It's the unity and diversity of executive functions. Adele Diamond, who's another big name in this research, describes three core functions that look kind of similar to those: inhibitory control, working memory, and cognitive flexibility, with bigger things like planning and problem solving building from those. And if you've ever set through a training on executive function, you may be thinking right now, hang on a minute. That's not the list that I saw. Because you probably got a graphic somewhere in that training, and your graphic may have had eight executive functions: planning, organization, time management, task initiation, working memory, emotional control, self-monitoring, and metacognition. Now, sometimes versions of those have seven, sometimes they have 11, because apparently we're collecting them like Easter eggs at this point. And listen, those lists can be helpful. I'm not saying they're complete garbage. They can give us some language for talking about what we're seeing. But it's important to know that there's not one universally

Models Lists And What They Miss

agreed upon scientific list of the executive functions. There was a big systematic review in psychological bulletin that looked across 46 samples, almost 10,000 people. And the researchers weren't all finding the same neat little structure. Some models looked more like one big thing, some broke apart into pieces, and the picture kept changing across age groups and studies, which I think is really important for us to know. Because sometimes we talk about these lists like somebody went up on a mountain, disappeared in the clouds, and came back down carrying a scroll of the official executive functions. Here they are. There are eight. It has been decided. No, they're models. They are useful models, but they're just models. So if you've got a poster somewhere that says the eight executive functions, you don't have to go rip it off the wall, but you do need to understand what you're looking at. Because the science is way messier than the poster makes it look. And that's our first problem. Because when somebody says, this kid struggles with executive functioning, it sounds like they've told us something really specific, but they haven't. They've given us one great big giant category. It's like the vitamin thing again. This kid is vitamin deficient. All right, that's interesting, but I'm gonna need a little more information. There's another weird thing we've done with this. We've turned executive functioning into a type of kid. You know exactly what I mean when I say that, don't you? Are executive functioning kids. You probably just pictured somebody's face in your head right now. Usually a boy, messy, forgetful, impulsive, papers everywhere, has no earthly idea where his water bottle has gone. But executive functioning isn't a category of kid. You have executive functions. I have executive functions, and we use them all day long, including when we're not doing a very good job of it. Have you ever picked up your phone to check on one thing and 20 minutes later you find yourself scrolling social media still? You don't even remember what you picked the phone up for in the first place. You're just living in social media world right now. Or you know you need to get up and go do something, but you tell yourself, I'm just gonna sit here for a minute. And 25 minutes later, you're still sitting there. Or you could be really good at planning something complicated and still put off sending an email that literally would take 45 seconds. Y'all, that's us. Adults with fully grown adult brains, executive function and everything. So when we talk about executive functioning kids like they're this special population over there, not really. We all use these processes. We all have things we're better at and things we're worse at. And kids have the added complication that their brains and their executive function skills are still developing. Executive functions continue developing across childhood and adolescence, and they don't all necessarily develop at the same rate. Meanwhile, look at what we're asking kids to manage when they're at school. Multiple classes, different teachers, different rules, different due dates, bring the right materials, remember the directions, ignore that kid beside you. Start the assignment, stay with it, remember there's a project due on Friday. Remember to actually bring the project on Friday. And then after successfully getting it all the way from your house into the school building, for the love of Pete, turn it in. That's a lot. So when a kid isn't fantastic at every single piece of that, I don't think our first thought should automatically be, well, they've got a deficit. Kids are still developing this stuff. And having difficulty with some of it does not automatically mean that there's a disorder hiding underneath it. And that brings us to ADHD. You know how this goes. He's disorganized, he forgets everything, he has no sense of time, he doesn't finish anything, he's impulsive. And then somebody says, Yep, executive functioning. And we're about half a hop away from, well, do you think it's ADHD? Maybe, but

Executive Function Is A Skill Set

we did skip a few steps there. There absolutely is a relationship between ADHD and executive function difficulties. That is real. Willcut and colleagues did a big meta-analysis looking at 83 studies and thousands of people. And on average, the ADHD groups did show weaknesses across several executive function measures. So there is overlap. But here's the part that I think matters more for us as school counselors. It was not universal. People with ADHD do not all show the same executive function profile. And executive function deficits didn't account for every case of ADHD. The researcher's conclusion was that these executive function weaknesses were neither necessary nor sufficient to account for all cases of ADHD. In other words, you can say ADHD is associated with executive function difficulties, but you can't flip that around and say executive function difficulties mean they have ADHD. Those are not the same thing. So when we've got a kid who's disorganized, forgetful, impulsive, and not getting things done, we haven't diagnosed anything. We've described some of the things we're seeing. And even if executive functioning really is part of what's going on, we still haven't necessarily figured out why. Let's say you've got a kid who won't get started on assignments. Task initiation, right? Maybe. Unless he can't read it. Or he can read the words, but he doesn't understand what the directions are asking him to do. Or he's failed at this kind of thing so many times that as soon as the paper hits the desk, he is already sure about how this is gonna go. Or he only slept four hours last night. From across the classroom, those kids look pretty much the same, but they're not necessarily having the same problem. Same thing with she can't follow multi-step directions. Oh, working memory, maybe. But did she understand the directions? Was she listening when the directions were being given? Does she do better when they're written down? Does this happen one-on-one or in every class? Because now I'm getting interested. And y'all, this isn't me just sitting over here dreaming up alternative explanations for every executive function issue you've seen. There was a large meta-analysis published in Nature, Human Behavior that pulled together 180 studies looking at executive functioning across pediatric neurodevelopmental conditions. And executive function differences were not unique to ADHD. Their results supported executive function delay as a transdiagnostic feature across neurodevelopmental conditions. So basically, this stuff crosses diagnostic boundaries. And that's where I think we've skipped a really important question because we've been asking which executive function problem explains this behavior. But before we get there, do we actually know that executive functioning is what's causing the behavior in the first place? Because a kid who won't start an assignment might be struggling with initiation, or he might not be able to read it. Those are two very different problems. And I can give that second kid, the kid who can't read it, the best, most amazing student planner known to humankind. I can have it laminated, color-coded, I can put inspirational stickers all over it, but he's still not going to be able to read the assignment. Because just focusing on the label is not going to be helpful. And if we're being honest, in school counseling, we've done this with a lot of our other professional language.

ADHD Overlap And Missteps

Trauma-informed, restorative practices. Those are real things. They have actual meanings. But then sometimes we stretch them so far that trauma-informed basically becomes we try to be understanding. And restorative becomes we talk to him about what happened. Okay, but what did you actually do? And executive functioning is getting pretty dangerously close, in my opinion, to this kid has trouble doing school. The problem isn't that these words don't mean anything. The problem is that once we stretch this phrase far enough, it can start meaning almost anything. And our professional language is supposed to make us more precise. Sometimes I think we use it to avoid being precise. Listen to the difference between these. This student has executive functioning difficulties. Okay, now compare it to this. This student completes his assignments, puts them in his backpack, brings them back to school, and then frequently forgets to turn them in. Which one sounds more professional? Probably the first one. But which one actually gives me something I can work with? It's the second one by a mile. So before you give me the label, tell me what the kid does. Let's go back to our original kid. This kid needs help with executive functioning. Okay, what are you seeing? He never turns anything in. Does he do the work? Sometimes. Does he know what he's supposed to do? Yep. Does this happen in every class? Nope, mostly English. Oh, okay. Now I'm interested. Because executive functioning made this sound like a characteristic of the kid, but now I know something I didn't know before. It changes. Whatever's happening isn't happening the same way everywhere. And that's important. Maybe executive functioning is involved, but maybe it isn't. But I've already learned more from the phrase mostly in English than I did from executive function problem. And that's where I think we need to be really careful about how certain we are about what we think we know. He has 12 missing assignments. That's an observation. He may be having difficulty with executive functioning. That's a hypothesis. He has ADHD. That's just somebody trying to diagnose, y'all. Those are not interchangeable. But in schools, we blow right through all three of them like they're basically the same thing. They are not. So when somebody tells you this kid has executive functioning problems, you don't have to correct them. You don't have to launch into a lecture about the research standing in the middle of the teacher's lounge. But you do need to ask, what are you seeing? Because executive functioning gives us the neighborhood, but it doesn't give us the address. And if I'm being honest, this is kind of where I thought it was going to end this episode, but let's not. Let's keep going. Because when I started digging into all this, I thought I knew what the end point was going to be. Don't just say executive functioning. That was going to be the vibe. Figure out which executive function the kid is struggling with. Working memory, inhibition, cognitive flexibility, task initiation planning. Find the right one. Except, how do we actually do that? If a kid can't follow a series of directions, can I confidently tell you that that's a working memory deficit? No. I can tell you what I saw. I can have some ideas about what might be going on, and I can gather more information. But that's different from deciding that I think I know what's going on inside this kid's brain. And then I found a study that really caught my attention. Toplac West and Stanovic reviewed studies comparing two common ways of measuring executive functioning. One was performance-based testing, and the other was ratings of executive functioning in everyday life. And you'd think those two would line up pretty well, but they didn't. Across all of the studies they reviewed, the median correlation of performance-based testing to rating scales was around 0.19. That's not great. And stay with me here because I don't want to turn this into, oh, executive functioning testing is garbage. Don't do it. That is not what I'm saying. If you read on, what the authors argue is that these two kinds of measuring aren't just interchangeable ways of measuring the same thing. They appear to be capturing

Measurement Gaps And Better Questions

different aspects of executive functioning. So think about that for a minute. Because if formal measures of executive functioning can give us different pictures depending on how we're measuring it, I probably need to have a little bit more humility before I look across my desk at a parent and go, yeah, they got working memory deficits. We got to be careful about this. And maybe, just maybe, our first job isn't to figure out which executive function is broken. Maybe our primary responsibility is just to find the moment the wheels fall off. What is this kid trying to do? What actually happens, and where does it fall apart? And maybe, more importantly, when does it not fall apart? Because that's where things start getting really interesting. He turns his work in for math, but not English. She can follow three steps when they're written down, but not when they're spoken. He can get the assignment started when somebody's sitting with him, but on his own, he'll sit there and stare at it for 20 minutes. She remembers every single thing she needs for volleyball practice, but somehow walks into science without a pencil for three days in a row. Now we've got something to investigate. And it tells us a whole lot more than how they have executive functioning problems. And it keeps us from applying this professional sounding label and convincing ourselves that we've explained this kid. Because again, executive functioning gives us the neighborhood. And sometimes we're not even in the right neighborhood. So the next time somebody walks in your office and says, This kid needs help with executive functioning, before you start grabbing the student planners and the small group curriculums, just ask, what are you seeing? Because executive functioning has not explained that kid. It's given us somewhere to start looking, which leaves us with one really obvious question. Okay, Steph, now what the heck am I supposed to do? That's where we're gonna go next. Because when I went looking at the interventions that actually worked, they looked very different from a lot of the baloney I've seen that claims to be executive function support in schools. We'll get into that one next time, so keep listening. But until then, take care.