Lazy Kid or Executive Dysfunction?

Do you have a student who seems incredibly lazy? Intentionally forgetful? Absolutely unmotivated? Deliberately late? Do you feel like a broken record? Constantly asking where his homework is? Constantly asking him to clean out his desk? Constantly asking her to pick up stuff around her desk? Do you have a student who is chronically distracted? Are you repeating directions to get the student back on task when he gets distracted? Do you have a student who knows the information but can’t seem to communicate it to you in a logical sequence? Do you ask a question and get an answer that’s related but not quite connected to the question? If so, it might be that the student is not using these behaviors intentionally.

One of the least studied and most frequently overlooked contributors to academic and behavioral problems is a problem in the frontal lobes of the brain known as executive dysfunction (Parker, 2001). Students with executive dysfunction have problems of a neurobiological nature that particularly affect “planning, flexibility, organization, and self-monitoring (Ozonoff, 1998, p.282). These students may have “difficulty picking a topic, planning the project, sequencing the materials for a paper, breaking the project down into manageable units with intermediate deadlines, getting started, and completing the activity. And because these students frequently underestimate how long something will take, they’ll generally leave the project until the night before it is due” (Packer, 2001, p. 2). Just imagine how difficult it would be if you had trouble organizing your time, materials, belongings, thoughts or any combination of these!

If you believe your student has executive dysfunction (also called executive function deficits—called “executive” because the tasks are often the responsibilities of a company executive), consider helping the student to organize himself. Begin by developing a relationship with the student that is emotionally supportive. Emphasize that you want the student to succeed. Help the student to understand his problems and that there are strategies he can use to organize him/ herself. For example, you could say, “Kids with executive function problems have difficulty in certain areas. There are many ways you can help yourself. Let’s talk about the areas and supports. Then you can choose which ways to help yourself.” Then describe the following potentially troublesome areas and potential supports that are identified in the shaded area. (Linda Parker, 2001):

Managing time

• Use time management techniques such as the use of checklists, prioritized “To Do” lists, and prioritizing assignments.
• Estimate how long a task will take and then check on the accuracy of your estimate.
• Plan for more time to do a project that you think you will need.
• Break long assignments into chunks with time frames for completing each chunk.
• Establish intermediate deadlines for big projects with your teacher and show her the project at these deadlines.
• Use a word processor and time management software such as the Franklin Day Planner, Palm Pilot, Lotus Organizer.
• Write the due date on the top of each assignment in a brightly colored marker.

Managing space

• Ask the student to identify ways he would like to organize himself.
• Have separate work areas with complete sets of supplies for different activities.
• Schedule a weekly time to clean out your desk and book bag (in school).

Managing materials

• Leave a large supply of pencils/pens in the class-room with the teacher.
• (For younger students) Have one notebook in which all assignments are recorded. Ask your teacher to check the assignments at the end of each day to insure that the assignments are recorded properly and that the necessary materials to complete the assignments are packed in your book bag. Also ask her to make sure the due date for each assignment is written at the top of each page.
• (For older students) Use a three-ring binder with organized sections enclosed by a zipper. Headings could include “Assignments Due/Date,” “To Do Tonight,” “Ongoing Work.” Use dividers in the notebook that are color-coded (e.g., Red for assignments that must be done right away, yellow for those due at the end of the week, etc.).
• Color code materials. Cover the textbook for one course in the same color as the notebook for that course. Use the same color coding to prioritize assignments.
• Establish a daily routine for school organization and include a written version of it in the notebook (e.g., turn in homework at the beginning of classes, get out paper/text/pen and check blackboard for assignment, prepare to leave class three minutes before it ends—pack books, papers, etc., turn in assignment book for checking and initialing at the end of each day, etc.). Use this same approach at home (e.g., do homework at a certain time, have parent initial homework, clean out book bag, check for necessary supplies for school).
• Obtain two copies of each textbook. Mark one “To be left in school” and the other “To be left at home.”

Managing work

• Use a checklist to guide you through an independent assignment. Include items such as: get out pencil and paper, put name on paper, put due date on paper, read directions, ask teacher to further explain if needed, do work, put work away in note-book in appropriate section (e.g., to do tonight, to do this week), write assignment on assignment sheet, get teacher to sign, take home and complete work.
• Finally, have the student identify which strategies she would like to try using and get started. Consider meeting with the student after a week to evaluate her use of the strategies. Be sure to praise the student’s progress rather than focusing on areas of continued disorganization. In addition, suggest that student’s family be included so that they can help him or her continue the strategies at home.

As the educator you can support the student (and others) by making some changes in the classroom. Some suggestions (Stokes, 2001, pg. 6) you can implement include:

• Maintaining a highly structured classroom.
• Using a written (visual) schedule to keep the student focused and “on task” so that he or she can complete tasks as independently as possible.
• Giving written directions whenever possible (dry erase boards, index cards, etc.) rather than auditory prompting.
• Giving fewer problems/questions on worksheets and/or creating boxes next to each question so the student can check it off as it is answered.
• Making the classroom as distraction free as possible (away from windows, doors or favorite activity areas).
• Keeping assignment folders in specific and consistent places.
• Using a visual calendar for both school and home to help the student anticipate events.
• Using a visual timer to help the student understand time constraints.

Also, if you suspect a student has executive dysfunction, consult with your school psychologist. While executive function deficits are most commonly associated with Autism Spectrum Disorder, they also are known to occur in students with ADHD, Fragile X Syndrome, conduct disorder, obsessive-compulsive disorder, traumatic brain injury, and schizophrenia (Ozonoff, p. 277). Although there are currently no agreed-upon protocols that constitute a battery of tests for executive dysfunction, several tests have been used in research that seem to tap into aspects of the disorder. These include the Matching Familiar Figures Test (Waterhouse & Fein, 1982), Wisconsin Card Sorting Test, and various computerized tests. For more information on tests and their purposes, see the resources at the end of this article.

Teach your student with executive dysfunction to organize himself. In addition, provide support by making some adaptations in your classroom and in your interaction style. Remember that students with executive dysfunction are not unmotivated or willfully engaging in problematic behavior. They really cannot organize and flexibly solve problems themselves without appropriate supports.

Resources

Ozonoff, S. (1998) Treatment of executive dysfunction. In E. Schopler, G. B. Mesibov, & L. Kunce (Eds.), Asperger syndrome or high-functioning autism (pp 263-289). New York: Plenum Press.

Pennington, B.F., Rogers, S.J., Bennetto, L., Griffith, E.M., Reed, D.T., & Shyu, V. (1997). Validity tests of the executive dysfunction hypothesis of autism. In J. Russell (Ed.), Autism as an executive disorder (pp. 142-178). New York: Oxford University Press.