S1 E4: What is Executive Function?

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• EPISODE RESOURCES

  Dr. Jason Fogler, M.A., Ph.D is a senior staff psychologist; Co-Director of the ADHD Program and Training Director of the LEND (Leadership Education in Neurodevelopmental & related Disabilities) Program in the Division of Developmental Medicine at Boston Children’s Hospital; and an Assistant Professor of Pediatrics and Psychology at Harvard Medical School.  He co-leads his Division's Clinical Outcomes Workgroup to improve care for what has come to be known as "complex ADHD": Attention Deficit/Hyperactivity Disorder with one or more co-occurring conditions, including mood and anxiety disorders, learning disabilities, disruptive behavior disorders, and posttraumatic stress.  He has been providing neuropsychological testing, organizational skills training, and parent guidance for children and teens with ADHD for over a decade.  

  Please note that the views proposed in this podcast episode by Dr. Fogler are not necessarily representative of the views and policies of Boston Children’s Hospital, Harvard Medical School, or the Maternal Child Health Bureau. 

• EPISODE TAKEAWAYS

  • Executive functions help individuals organize, plan for, and execute many different tasks in life, especially with regards to learning.

  • There are different ways of conceptualizing executive functions. Alexis & Jason operationalize EF as: Working Memory, Inhibition, and Cognitive Flexibility (Diamond 2013; Nigg 2017)

  • A metaphor for executive function is to consider an orchestra with many different component parts working at the same time. If any one player, instrument, or conductor is off within the orchestra, you will notice it. All that goes into coordinating our minds and bodies, executive functions are involved, however, we may not notice this set of cognitive skills until something goes wrong.

  • The prefrontal cortex, where executive functions are developing, does not fully form until at least the mid to late 20's, early 30s.

  • Another metaphor is a cable bridge (like the Zakim bridge). We cross the bridge all of the time but don't realize all of the different components that allow you to cross the bridge. Each cable is akin to another executive function that allows you to "cross bridges".

  • Executive function skills are involved in so many aspects and behaviors of day to day life, such as flexible thinking, reflecting on your own thinking, self advocating for what you need, inhibiting impulses, planning, etc. 

  • The prefrontal cortex, which activates executive functions, is coordinating with other parts of the brain that activate aspects of day to day functioning, like language, motor movements, emotions, etc. Therefore, if our executive functions are compromised or not fully developed, other areas of our brain and functioning can be impacted. This was seen in the story of Phineas Gage when brain injury to the prefrontal cortex led to various behavioral problems.

  • "Visual scratchboard" is when we visualize information in our mind via the parietal lobe of the brain. However, the prefrontal cortex (executive functions) interact with this part of the brain to hold, organize, and manage the information. 

  • Emotional turmoil and stress responses can weaken our executive functioning. 

  • Even the brightest and most talented people can struggle with executive functions.

  • Neuropsychological assessment is a way of assessing neurological/ cognitive functioning and executive functions.

  • Parent guidance provides support to parents on how to support their child who has executive function challenges. It takes time, patience, and strategizing to figure out how to provide this support, there's no silver bullet. It can be nuanced and depend on context, the individual, and circumstances.  Collaboration is key. Supports can include behavioral modifications, educational accommodations, and/or medication if preferred. 

  • Individuals may compensate for their executive function challenges. Support can help learn new ways and strategies rather than just compensating. Sometimes what worked in the past may not work now, so it helps to reflect on the tools and strategies and how they work for you. Much like starting a new habit, hang in there and try again and allow others to support your journey. 

• TRANSCRIPTION

In this episode, Dr. Jason Fogler joins Alexis Reid to discuss Executive Function. Both Dr. Fogler and Alexis Reid work with individuals, families, caregivers, and systems who are aiming to improve and support executive function skills and in this episode, they break down some of the history, challenges, and benefits of executive function and ADHD. 

Be curious. Be Open. Be well.

The ReidConnect-Ed Podcast is hosted by Siblings Alexis Reid and Dr. Gerald Reid.

*Please note that different practitioners may have different opinions- this is our perspective and is intended to educate you on what may be possible.