Finding the "Why" of Big Behaviors
Looking underneath the underneath
What Causes Big Behaviors?
Let's start off by saying this. As a speech therapist, I don't directly treat big behaviors. But even if their parent brings them in for some other reason, every time I get a child coming in with behavior struggles (which is my shorthand for "struggles to meet social expectations for behavior" because that's a mouthful), I'm always going to look into it during my assessment process. Because where there's behavior, there are unmet needs I can either help with directly (such as communication and cognition) or indirectly (such as mental health - there are so many communication skills required during treatment!).
As a speech therapist, I'm almost always going to be advising the parent to get other care professionals involved as well. (Getting occupational therapy - for sensory processing supports - and counseling involved are my most common recommendations, but sometimes I'll notice signs of other possible things going on and suggest seeing a specialist for further testing.)
[Spoiler Alert: I've found the culprits are almost always some combination of executive function struggles, expressive/receptive communication problems, emotional regulation struggles (due to mental health, trauma, PDA, etc), and/or processing delays/differences, combined with an environment with expectations that require these skills. I think what's not on the list - lack of motivation - is also telling.]
Step 1: The Case History
With the way the school system and health insurance work, evaluators very rarely get as much time as they want to do assessments. When I worked for a company that accepted insurance, regardless of how many things were going on, I got an hour to get it all figured out. One. Hour. And then no matter how complicated the case, I had to be done. After that, on my own unpaid time, I had to go write up the results and make a plan that's supposed to last me for six months based on whatever information I could grab in that measly hour.
When times are so tight, something's gotta give - and often that something is the case history. And that's such a pity, because that's where the best information is contained!
The school system was better, because at least I had the IEP to go off of. But it's difficult to communicate with parents, and you often don't have much teacher input to go off of, so you were left relying on the IEP. If you got lucky, the IEP would have all the information you needed! ...but if it didn't you'd risk finding out halfway through the year that your student had been exposed to alcohol in utero, and no one included that in the IEP. (Fetal alcohol spectrum disorders - which do not always have physical signs or intellectual involvement - are extremely underdiagnosed, are often not checked for, and cause some fairly predictable skill deficit areas.)
Now that I'm not in the position of having to rush anymore, I take my time gathering an in depth case history. I look into what's really happening in daily life, when problems crop up most, what seems to help, what seems to make things worse, the works. But if you're stuck, here's a resource I developed back when I was in your shoes. It's my checkbox-only case history form! It's fast and the lack of free response makes it less intimidating, so you're more likely to actually get the answers you need. The checkboxes also mean that you can get it translated into other languages you don't even speak and still have it be useful to you! Just compare the checkmarks with your English version and you'll be able to tell what the caregiver's answers were.
Now that I'm in my own private practice and can take a bit more time, I also have in depth conversations with caregivers. The sorts of things I'll be checking for are
1. Signs of other possible disorders
2. What the child's life is like
3. When and where problems tend to show up
4. How caregivers/child usually get around whatever communication struggles there are
5. Signs of misunderstood struggle. For me, words like "lazy", "unmotivated", "defiant", "stubborn", etc are signs that there's some skill my kid is lacking and I'm going to ask for details about what makes the caregiver think the child is that way. They also tell me what lens the caregiver is viewing their child's behavior through and the sorts of education that might be needed further on.
Step 2: Testing Language
First up, checking language. This is probably the official reason the parent will have brought their child to you anyways. But our "high behavior" population tends to have one of two issues with tests. It could be that they can't meet the behavioral expectations needed to take most formal tests. Alternatively, it could be that they're the sorts of kids that try to mask their struggles and have learned to perform skills in very specific environments (such as, say, answering fill in the blank questions in a calm, quiet testing room) but it doesn't carry over to real life. Kids like that will show up as having no language problems, when in fact they might have very significant problems.
Here are some ways you can get around that:
FORMAL NARRATIVE TESTING
Testing narrative production ability is an important part of the process because it is often impaired even if other areas don't appear to be. Please don't just look at the scores produced; look at the sample itself. Does it make sense? Is it coherent and cohesive? Are the pronouns clear or ambiguous? I have literally had a child chant to themselves "Character, setting, beginning, middle, end" before telling me a story. They were, in fact, technically able to produce all the components of story grammar. Their sample, however, was an absolute mess. Ambiguous pronouns, skipping around, chock full of grammar issues (even though he got fill in the blank grammar questions correct), lots of "um"s as they tried to find the right words, referring to knees as "toe knuckles", etc. Thanks to his coping mechanism (chanting the components of a story), he was able to technically pass the Test of Narrative Language. But regardless of his score, this is still a child with a disorder.
Here are some free tests and measures that you can use to gather data.
This is freely available online and goes all the way from preschool to high school ages. What I like about these is all you're doing is getting the child to tell you a story out loud using the provided printable or digital wordless storybook. This makes it feel less test-like, which can really help when you're working with kids with high behaviors. Narratives also give you a better idea of real-world language, plus there's a fair bit of executive function involved in telling a narrative, so you'll be able to catch that too. And, of course, you'll (ideally) emerge with a robust speech/language sample. The best part? You can print the picture cards...or you can get them for free on the Boom card website and your kid can interact with them digitally. For some kids digital presentation goes much better.
The scores produced are criterion scores. In instances in which that is insufficient, however, I would suggest the following test - the ENNI.
2. Edmonton Narrative Norms Instrument (ENNI)
This is a free instrument available online, which is standardized for ages 4-9. I like it because if you cut and put it together right, it's also like a storybook and therefore not as aversive to many kids. It has norms for referential cohesion ("first mentions), story grammar, and syntactic complexity and is available in both English and French.
3. Sampling Utterances and Grammatical Analysis Revised (SUGAR)
If you have a child who can't complete any testing at all, or you just want to get more insights into, the SUGAR is great. All you need for this is fifty utterances - and hey, if you did a narrative based instrument, such as the ENNI or SLAM, you've already got that - and then you can do an analysis of the language. SUGAR is just a fancy way of saying you're transcribing the sample and then analyzing and comparing it to norms (handily available on their site) for total number of words, mean length of utterance, number of word clauses per sentence, and words per sentence in kids ages 3-8. All the videos on the site make it sound difficult, but once you know how to do it, it's rather more straightforward than you'd think.
All you need for this is a recording of them talking, so even if they can't handle the formal assessment with you, all you need is for their caregiver to record an audio sample of them talking, just in regular life, and get that back to you. SUGAR gives you norms for each age, including both the mean and the standard deviation for the population.
Pro tip for scoring the SUGAR: SUGAR just provides the mean and standard deviation for the population for each age - not a giant list of the specific percentiles. If you're not big into the math of calculating exact percentiles, you can just give the score and using the norms, say if it's "more than 1 standard deviation below the mean" or "more than 2 standard deviations below the mean" because those are usually the cut points that education and healthcare programs are looking for. If you want to get fancy you can use a site like this to calculate the exact percentile for you. You plug in the mean (the squiggly "u"), standard deviation (the squiggly "o"), the actual score (the squiggly x), and set it to "P(X<x)=" and it'll give you the decimal version of the percentile (so 0.422 would be the 42nd percentile).
4. CUBED-3
Okay, so this one is for kids that can more directly participate in more testing. It's a way that you can get a whole lot of data in a short amount of time. You'll get all the feedback that the other narrative tests give you, plus some informal insights into their memory as well. It also measures ability to determine word meaning from context, answer comprehension questions, answer questions requiring inferencing, retell a cohesive narrative (including episode complexity, vocabulary complexity, and sentence complexity measures), tell or write an original narrative. AND with the administration of a second part of the test, you can also check their reading decoding abilities (phonological awareness, letter sounds, digraph or vowel teams, high frequency words, etc). That's a LOT!
You don't have to administer the whole thing if you want - you can just administer parts and still get a formal score. The retell, the comprehension questions, and the reading measures are all separate measures. So if your kid hits overload partway through the second part, you can still get a formal score from the first.
Pro tip 1: Instead of saying "tell me the exact same story" as the prompt for the retell with this population I might just say "Tell me the same story as best you can remember. It doesn't have to be perfect, just do your best." On the inside, most of these kids are perfectionists and often very literal. It is impossible to just remember and tell the exact same story, word for word, from just one hearing/reading, so the "exact same story" prompt is setting our literal-minded kids up for failure. So you may need to use this looser phrasing.
Pro tip 2: I almost always change the prompt for the original narrative, because almost all of them are something along the lines of "tell me about a time you made a mistake". And what is really upsetting for kids with behavioral struggles? Talking about time they've made mistakes. I will see if they can do that prompt, but if they can't I'll state in the evaluation that I changed the prompt but still put the scores (any narrative can be plugged into their scoring formula). Something like "tell me about a time you went somewhere exciting" generally works. You could even present them with a few prompt choices and see which one they want. Having choices (autonomy) is really important for most kids with behavioral struggles so being able to choose a prompt may help them.
OTHER FORMAL LANGUAGE TESTING
5. Adding on additional tests
Let's say you want to add on an additional test or subtest. For example, I find I get a good idea of expressive skills from the narratives, but I also like to check sentence comprehension ability when I can since it's often impaired in ways you might not catch. (Poor understanding of negation, not understanding pronouns completely right, etc.) First off, you're not likely to be able to do an additional comprehensive standardized test in the same day as the narrative portion. I usually split things up over multiple days now that I'm private. With kids who move quickly through the narrative, you may be able to fit in a subtest, though. I often throw in a sentence comprehension subtest, a vocabulary subtest, or sometimes a grammar subtest if I noticed grammatical errors during the narrative.
How do you make a test like this fun? Well, one thing I found with some kids was making the test silly. I printed out a bunch of Disney characters pictures and turned them into stick puppets. Then my puppets did the question asking! My elementary and preschoolers really loved that and I could often get a lot more done. They could also tell me who they wanted to ask the question, or they could roll a die to decide who asks the question.
I'm virtual now so this doesn't work for me anymore, but if you have a child who needs movement, for receptive tests where the child just has to point at one of four pictures, you could just put down some index cards on the floor to represent the choices and they could jump, crab walk, hop, etc to the card with their choice. Just make sure you monitor energy levels and your kid doesn't get overstimulated. Provide sensory breaks if possible.
INFORMAL LANGUAGE TESTING
There's an informal sentence comprehension test I like on Teachers Pay Teachers, which comes both in a PDF and Boom Card format. It checks comprehension of sentences with varying location concepts, quantity concepts, grammatical structures (including negation), coordinating conjunctions, subordinating conjunctions, and adjectives combined with a noun. I have zero connection to the store, but it's a useful product if you have a child who is more comfortable doing something that's more like a "game" (the boom cards) than a formal test. I wouldn't give the whole thing (there are a lot of questions!) just the specific concepts or structures you're interested in.
I also use this free list of common directions adults give children. I ask the caregivers to look through and mark the ones they themselves say most often, then I ask the child what each one means. Guess what? Most kids don't actually understand many of them. "But I've said it to him for years!" says pretty much every parent. Well, the thing is that kids want to do well - even the ones that don't seem like they do. So they'll try to get by with what they've figured out. Voice volume, context, gestures, and following along with others will help our kid seem to be able to "understand" the direction - but they often don't. I always tell my kids' parents that I'm not saying this is the source of all their struggles with behavior, but that we want to make sure that even if they are getting in trouble for not following directions, at least they actually understood the directions.
This is particularly true when it comes to directions which have non-literal language in them or are indirect. Think about the direction, "Walking feet!" People use that to simplify language by avoiding the negation of something like "don't run", but simply saying "walking feet" isn't explicitly a direction. To some kids, it's just an adult talking about feet that are walking. There isn't always the understanding that this is the adult's way of directing the child to slow down.
Treatment tip: You may need to practice - at a time where you have your child's attention - using different kinds of "feet" (walking feet, stopped feet, etc) before they understand this. Or you can just switch to saying "Walking feet". Or better yet, take a video of your kid/the group meeting expectations for walking in the hall. (This is an evidence based technique called "video modeling".) Practice watching the video and giving whatever verbal cue (walking feet, walk in line, etc) that would be given. Now you'll actually be achieving comprehension!
Directions with non-literal language:
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Keep it down
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Use your inside voice
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Keep/break your word
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Calm down
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Throw a tantrum/fit
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Call names
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Don't make fun of others
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Bother / bug someone
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Back talk
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Butt in / Cut off
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Don't pick a fight with others
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Use your words
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Kind words/hands
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Show some patience
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Use your manners
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Control yourself
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Stay on task
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Follow directions
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Do what you’re told
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Don’t take that tone
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Lose the attitude
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Apologize like you mean it
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Get in / out of trouble
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Make a sad/bad choice
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First time, every time
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Hands to yourself
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Walking feet
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Calm body/voice
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Gentle touches/hands
Tricky Vocabulary Related to Behavior
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Lie / liar (lying is frequently confused with "not correct")
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Fib
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Promise
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Whine
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Accident / on purpose
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Argue
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Interrupt
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Tattle
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Manners
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Cooperate / cooperative / uncooperative
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Focus
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Tone
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Safe / unsafe
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Gentle
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Attention
Also, you'll want to check common feelings vocabulary words. First make sure the emotions happy, sad, mad, and scared and the sensations hungry, tired, sick, and thirsty are understood and able to be used expressively. Then move on to more advanced words, such as frustrated, confused, worried, disappointed (kids think disappointed means mad because of how parents use the word), bored (although adults often get mad when kids say this, so it may be better to work on that more receptively), surprised, comfortable/uncomfortable, calm, and distracted.
Step 3: Checking Executive Function
EXECUTIVE FUNCTION TESTING
This is a huge, huge issue with kids with struggles meeting behavioral expectations. I would go so far as to say that, at least with my kids who can speak, lacking skills in executive function are where I usually trace most of the problems back to.
Whether you are a caregiver, an educator, or a healthcare provider, you're unfortunately unlikely to have learned much about executive functioning in school. I have a bachelor's in psychology, a master's in communication sciences and disorders, and completed a concentration in autism during my master's degree. Yet I'll be honest, I learned next to nothing about executive function from either of those degrees, despite how critical it is to all three subjects. It was only through extensive continuing education (this was my favorite course for in-depth understanding, highly recommend, but if you're looking for something free with practical ideas, this video presentation is great) that I learned about it and WOW did it explain so many things - behavioral struggles foremost among them.
(I tried to just put a short list here and save the rest for a different article, but I am apparently incapable of writing about the massive paradigm shift that is executive function without going in depth. Please note; I am not an executive function expert and my interpretations of each concept are not guaranteed to be "practically perfect in every way". For ideal explanations, I recommend taking Tera Sumpter's SEEDS of Learning course, or just digging in deep to executive function research. For practical purposes, however, this should do just fine.)
There are layers of executive function skills that I actually think about like building a house. You have the bits of the house as you can see it from the outside, the parts of the house that you can see after someone invites you in, and then you have the building frame and foundation that even a building inspector can't observe directly, at least not in full. I think that's a really good metaphor for some of the deeper executive function skills because it shows how even those who are actively trying to evaluate the "house" can still miss struggles in these areas.
Foundational skills - if there's a problem here, you'll see a cascade effect in later skills; attempts to treat the higher level skills directly are often stymied by a failure to identify the needed foundational skills that are missing.
1. Awareness / Perception
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This is simply noticing what's going on around you in a broad way, regardless of where your attention is directed. If a child is so involved in the sensory joy of lining up toys, or consistently tripping over materials on the floor because they didn't notice them, those are signs that they
2. Attention
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Focus: Directing attention to something
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Sustained focus: The idea of fully sustained attention is a myth, as our minds will always wander. When we talk about extended periods of attention, we're actually referring to your ability to a) recognize when your mind has wandered and b) bring it back to the original subject of attention. The breakdown could be in either subskill.
3. Working memory
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Working memory is your ability to hold information in your mind for short periods. It breaks down into two components: nonverbal working memory and verbal working memory.
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Nonverbal working memory is your brain's ability to simulate the outside world. People sometimes refer to it as the brain's visuospatial sketchpad, but in truth the simulation can be using any of the senses; vision is just the most common. This is also how you hold onto one or more concepts or idea of something in your mind; for instance, when you're comparing a cat and a dog you have to hold your mental simulation of both in your brain at the same time. On top of that, it's how you pull up your long-term memories. The video presentation I referenced earlier does a great job explaining nonverbal working memory and aids.
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Have a child who is just missing countless other higher executive function skills? Check nonverbal working memory, because it is a common underlying skill deficit and SO MANY higher level executive function skills build on this. Think about it. Making a plan, predicting the consequence of an action, pacing yourself in a task, keeping track of time, having the comfort of simulating that something unpleasant won't last forever, or that you'll get to go back to something you love later on, just so many skills rely on simulation.
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Verbal working memory is how you store speech sounds in your memory for short periods of time. It is also called the "phonological loop" for this reason. You don't have to have physically heard them in your ears, either. You could read this non-word, "quorp", translate the letters into a phonological representation, and then use your verbal working memory to loop that in your head as well.
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The thing about verbal working memory is that it is independent of meaning. For example, I could tell you "In ten minutes, there's going to be a visiting group of students from China here. When they leave, say 'zai jian". Unless you happen to speak Mandarin, those words mean nothing to you. Yet you *can* remember the speech sounds and even produce them on demand in ten minutes. How? By repeating it to yourself over and over and over in your mind, using your verbal working memory to keep the sounds in your mind for the period you'll need to hold the information.
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Where many general tests of working memory go wrong is that they use real words; meaning that you have both the concept of the word (which your nonverbal working memory can grab hold of) and the speech sounds of the word (which your verbal working memory can replay). If they're both impaired, your results won't be affected, but if only one is impaired, you can compensate for it by using your other form of working memory. This can make it seem as though there is no deficit even if, in fact, there is a very significant deficit in one of the two types of working memory.
4. Inhibition
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This is the ability to keep ourselves from acting on our impulses. There are two subcomponents here. First, we need to be able to simulate the future/pull up simulations of memories from the past in order to understand when and why we should inhibit an impulse. And you need to be able to pull that up extremely rapidly, in time for you to use that information to inhibit. And second, you need to have some sort of plan for what to do instead to actually keep yourself from acting on that impulse.
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Example: You're trying to diet but someone put your favorite candy on your desk. How do you inhibit the impulse to eat it? First, you need to recognize that this is an impulse that needs to be inhibited. But recognition isn't enough; you need to have something to do to help you act on your desire to inhibit it. Maybe you'll remind yourself that you're working on your health. Or perhaps you'll tell yourself you can have a piece of sugar free candy instead. You could even give it to someone else to get rid of the temptation, or at least move so you can't see it. And all this planning and decision making and future simulating the effect of candy on your health is requiring nonverbal working memory.
Mid-level skills that build on those:
Each of these requires one or more of the previous foundational skills in order to be able to succeed in.
Task control skills
1. Getting started on a task (initiation)
This is often baffling to see, when you have a kid that you present with something really basic (like asking a high schooler to write a paragraph, which you're sure they have the skills to do) and they just...don't. You ask them again to do it. Maybe you tell them they only have to write half a paragraph. You tell them they can go take a break in calm corner and then come back and do it. But no matter what you try, none of it works. Or maybe you ask them to do the same task, but they yell that they can't or they break their pencil or they come up with delaying tactics over and over.
These are just some of the ways that struggles with initiation can present. When you have a task that's on your to do list and it feels overwhelming for you, what do you do? Well, what everyone will tell you to do is break it up into smaller tasks. Why? Because in order to initiate a task a) it has to feel doable [it can't be so overwhelming that you shut down] and b) you have to know where and how to start. One problem that can result in this is that if you don't have the nonverbal working memory to simulate out a task, you can't break it up. It feels too big and you freeze because you can't tell where to start.
Note that the same thing can happen even if you do normally have the executive functioning skills to do a task, but are too emotionally overwhelmed. The simplified metaphor we use to explain it to kids is that their "downstairs brain" (the parts in charge of basic survival and emotional reactions - the limbic system, brain stem, etc - which are lower in the brain) gets overwhelmed and makes it so your brain can't listen to the "upstairs brain" (the cerebrum, which is physically higher in the brain and controls executive function, problem solving, and planning among other things). In short, when something is wrong and we're dysregulated we aren't going to be able to use our executive function skills as well, if at all. So if you've got a kid who has anxiety around writing, they're probably going to struggle with initiation even if they normally don't.
2. Stopping when asked
As you might imagine, this requires inhibition. If you don't have inhibition, you're not going to be able to stop doing something you're enjoying when someone asks you to. It also requires awareness of the environment, as if you don't notice that you've been asked to stop, you're not going to be able to.
3. Shifting attention
Let's say that you were doing something and someone starts talking to you. Your ability to tear your brain away from what you're doing and move it to listening to them represents a shift in your attention.
4. Pausing a task and then returning to it
This is your ability to shift your attention back to something it had left. This might be after a more significant pause, or it could be after something as simple as pausing during an intercom announcement and then going back.
Monitoring and regulating skills
5. Energy regulation
Are you using the right amount of energy, both for what your task requires and for what you're going to need as the task continues? Projecting the future is part of this. Imagine if a marathon runner thought to themselves "Okay, this is a race where the fastest person wins, so when they say go I'll start running as fast as I can". They would expend all their energy at the beginning and not have enough to actually finish. This is the executive function component of energy regulation. Another skill you need to regulate your energy is sensory regulation, which is a whole other set of critical skills. I'll probably add something about that later on, but for now suffice it to say that occupational therapy is great to get involved if you suspect sensory regulation struggles.
6. Self-monitoring
This is just noticing your accuracy, progress, etc on something you're doing. We have to use this all the time - when we're reading, writing, cooking, even driving. You have to have awareness and attention to do this, as well as the nonverbal working memory to compare what you're intending to do to what you're actually doing.
7. Self-correcting / self-modulating
This is acting on the information that you noticed. It requires the self-monitoring from before, but also the inhibition to stop and correct errors you noticed, plus the nonverbal working memory to figure out how to make the correction.
8. Sense of time
This is pretty straightforward. Do you accurately notice time passing? And can you guess about how long something will take? This requires nonverbal working memory and awareness.
9. Pacing
There are two subskills here. You have to first determine the pace required for the task and then stick to that pace as you go through the task. To determine the pace, you need nonverbal working memory to simulate out how long everything will take. To be able to stick to that pace, you need inhibition and self-monitoring. So this is actually a much more complex skill than it seems.
10. Flexibility
This is the "cognitive flexibility" that so many try to address directly without ever checking to see if the underlying skill required for it - nonverbal working memory - is in place. In order to have flexible thinking, you need to be able to hold multiple ideas in your head at the same time. To flex with a routine change, you need to be able to simulate in your head what the change is going to be like. If you can't simulate that change, it can feel just like a giant, overwhelming abyss. Or even the flexible thinking required to understand multiple meaning words or figurative language. You have to be able to hold both possible interpretations in your mind (nonverbal working memory) and then determine which makes sense.
Top level skills:
This is the outside of the house - the skills whose lack will be apparent even on the surface.
1. Anticipation
This is a skill that requires nonverbal working memory. Sarah Ward really helped me see how this skill is a big area of difficulty for our kids with executive function struggles. Let's say that it's read aloud time right now and it's always time to do math after reading. As the teacher nears the end of the book, our kids with good executive function are thinking, "Okay, circle time is almost over, then because math is next, the teacher is going to tell us to go get our number lines. Where did I put my number line? Oh yeah, it's in my backpack, I'll need to ask the teacher if I can get it."
What about our kid with poor executive function? Well, they're surprised when the book ends because they didn't notice that there weren't many pages left (poor awareness). Their thoughts are all over the place - they could be thinking about the book, but they might just as easily be thinking, "The fluff on the carpet looks like my dog's fur, I wonder if dogs come in here after the kids leave for the day?" (Low attention) Then the teacher says "Okay, it's math time!" (Which our kid didn't simulate coming up, because of their poor nonverbal working memory.) And our kid says, "Wait, what? I don't want to do math!" And then has to rapidly adjust to this "change in plans"...even though it's the exact same thing they do every day. This is what poor anticipation looks like.
2. Organization
This isn't just "their desk is messy" sort of organization; it's also the organization of your approach to a task. Are you reading the directions or jumping right in? Have you figured out what needs to be done first, or are you just doing the first thing that comes to mind? This skill requires nonverbal working memory, inhibition, awareness, self-monitoring/correcting, and many other previously listed skills.
3. Planning
This goes along with organization. To make a plan you have to both identify what you want to achieve (your goal) and then how to get there. And what do you need in order to do that? You've probably guessed at this point that the answer is nonverbal working memory. This time you're not just holding one or two concepts in your mind, but rather you're trying to hold a whole sequence. And you're actually going to be self-monitoring and correcting your own simulation!
4. Decision making and prioritizing
Okay, so you've made it through everything else. But you've hit a point where you're going to have to make a judgment call. Do you freeze up, or can you make a choice (including what you need to prioritize first)? You have to simulate multiple possibilities in order to make the call.
Hopefully after all of that it's clear just how much executive functioning is needed for simple everyday life. That's why I took you through so many skills - and believe it or not, that was the abbreviated list! You see how a breakdown with any of these can lead to big feelings, lots of problems, lots of getting in trouble, and yes, lots of big behavior. When you start to see the skills deficit, however, you can start to implement the supports needed to develop some of these skills - but you have to see it first!
There really isn't much for testing executive functioning right now, at least not tools that really break down the skills to this level. Two measures that seem quite good are the McCloskey Executive Functions Scale (MEFS) and the SEFF-Q (a screener). They can both be helpful in guiding you as you get going with executive function. Long term, though, you're going to be wanting to build these skills on your own so that even before you grab a formal measure, you're already able to catch areas that need work.