How Pediatric Speech Therapy Helps Children Develop Their Executive Skills
If your child is having trouble with focus, impulsivity, or completing tasks from start to finish, then read on.
What are Executive Skills?
Executive skills are what we in the biz are referring to when we say cognition. [This is not intelligence. I repeat: This is NOT intelligence]. Different from the brain functions for speech and movement that can be clearly observed, executive skills are invisible and act behind the scenes. I like to think of executive skills as our brain boss, or as the director of a play: They are there to develop a vision, make plans, keep everyone on task, manage time, and execute smoothly.
Executive skills are controlled by the front part of our brain, and include:
Attention
Inhibition
Planning
Organization
Problem solving
Time management
Self-awareness / self-monitoring
All of these non-verbal cognitive skills dictate the way we move, speak and remember information. Think about your adult self going grocery shopping for a moment. Ideally you make a list (plan, attend), possibly set that list up by food category, or place in the shop (organize), think about how much time you will need to travel and spend at the store (time management), substitute an unavailable item with another (problem solve), resist the temptation to buy something that you know will go uneaten (inhibition), keep your cart nearby to avoid blocking others (self-awareness, environmental awareness).
What Do Executive Skills Look Like in Childhood?
Executive skills develop in childhood through communication and play. They are present at every developmental level, and can be observed across most activities. Here are some examples:
The length of time a child will sit for an art activity in preschool, or for some more basic dump-and-fill play in the early years is a function of their attention
The elaborateness of their block tower, and the imaginary world created around it is a function of a child’s planning, organization, attention, and problem solving
A child’s ability to keep a conversation on topic showcases their attention, inhibition, and self-awareness
Sharing and kindness are obvious when a child breaks their cookie in half to share with their friend, but it is the executive skill of problem solving that guiding this action
As children get older, they further develop their executive skills and become aware of how and when they need to move more quickly, slow themselves down, or prioritize tasks properly to complete assignments. Without the executive skills of self-awareness or self-monitoring, children cannot take charge of their own growth and learning.
We all struggle with our executive skills from time-to-time, and compensate in our own ways (Lists! Timers! KeysPhoneWallet!). But more pointed intervention is often essential for individuals whose brains are wired in ways that make attention and regulation difficult.
What Do We Do in Speech-Therapy to Support Executive Skills?
Several of us on the Brooklyn Speech Therapy team have expertise in rebuilding executive skills for children who are recovering from strokes and brain injuries. Therefore, support for executive skill development is embedded into all of our speech therapy sessions regardless of a child’s primary communication challenges. Here are some examples:
We make “play plans” that require children to focus slightly longer than their baseline while employing frequent reward and reinforcement systems. This nudges them to the next level and keeps them going with a positive spirit.
Self-monitoring is subtly and consistently encouraged in speech therapy (“hmm does that sound like the right sound to you?”; “wait do we say “ranned”, or ran?”)
Our sessions revolve around lightly structured play that often follows a sequence of steps (we love obstacle courses), and encourages children to move through tasks with organization in mind.
For little ones, we work to expand their play routines to involve more steps, or imagination. Read more here about how expanding play improves communication.
For some of our older kids, who need more executive skill support we design neighborhood scavenger hunts with lists to tick off, or go on executive skill “outings” to learn about time management and map skills
Therapy Teams Improve Executive Skill Development
While our speech therapy sessions support healthy development of executive skills for all of the children we see, sometimes executive skills are the primary goal. Speech, language and communication challenges for children who are neurodivergent (e.g., those with ADHD, ASD, or sensory processing disorder) are very often due to their system of executive functioning.
For neurodivergent children to benefit from speech therapy and improve their communication, we need to help their executive skills flourish. Doing so requires understanding what keeps them regulated at the “just right level” for learning, what they need to boost their physical endurance, and what can be done to support them in school.
This is where therapy teams come in! We build and work within teams of Occupational Therapists, Physical Therapists and teachers to make sure we are not treating speech and language in a silo. We love to learn from our therapy colleagues about how best to help children make lasting progress with their communication.
