Executive Functioning Milestones

Executive function is the mental process that enables us to plan, focus, remember instructions and multitask.

From childhood, we make around 35,000 decisions a day, using different combinations of executive strategies which are needed for the task and/or situation. For each one of those decisions, we require the executive functioning skills to perceive, be aware of the task that needs to be done, then do something to accomplish it, and constantly assess if we are doing it effectively.

Children with Executive Functioning difficulties are usually observed doing one thing at the time very well, but multitasking might be challenging. At school they are often required to multitask. An activity of ‘writing a story’ for example, requires the child to remember the instruction, recall facts, organise them in their mind, put in place the biomechanics of writing, and write their ideas on the paper, whilst all in order and keeping attentive throughout the process!

For that reason, challenges with executive functioning skills are commonly identified when starting school and the child is unable to participate effectively in activities. Those difficulties increase as the school curriculum expectations become more complex.

Different from other milestones, executive skills don’t have a concrete developmental scale as they vary for individuals of all ages. However, most executive functions seem to reach a plateau of maturity at about 12 years of age. After that, the skills already developed become more sophisticated with time.

Specifically, attention, working memory and planning reach maturity at about the age of 12. While higher cognitive functions such as language and intelligence continue to develop into the third decade of life.

Below is a table with an approximate age development of Executive functions:

Age	Executive Function Skills
6-12 months	Attend to things for longer amounts of time (still minimum) Behaviour is reflexive (not flexible)
1-2 years	Inhibits some reflexive behaviour inconsistently. Shifts attention to new things in environment
3-6 years	Increases impulse control, attention and concentration Resists some distractions Follows 2-4 step tasks Demonstrates knowledge of rules
7-9 years	Performs self-talk (talking to themselves to work through a task) Processes new information faster and more accurately Resists more distractions Develop goals Learn from mistakes and creates alternatives Switches between tasks
10-12 years	Increases impulse control, attention and concentration for longer periods of time Switches between multiple tasks Learns from mistakes and creates alternatives more often Plan and organizes tasks more effectively
Teens	Increases working memory capacity Increases cognitive flexibility Able to plan and organize more complex tasks Demonstrates better decision making and goal selection skills

Chapparo 2023

According to Dr Christine Chapparo, occupational therapist and professor at University of Sydney, the below are signs your child might be experiencing difficulties with Executive Functioning:

Pre-schoolers:

• Quits when things go wrong.
  • Child gives up easily or gets easily frustrated because they don’t know how to do/correct/ask for help.
  • Children with EF disorders are inflexible thinkers and are unable to come up with a new plan or alter their performance plan when needed
• Forgets what comes next.
  • Struggles to keep information in their mind and get stuck in middle of a task.
• Frozen in place
  • Unable to master everyday routines. When the day has the same routine day after day and is still not able to follow it. They have problems getting started. Struggle with the multi-step tasks.

Primary school:

• Trouble shifting between 2 activities.
  • Unable to do things in different ways. Prefer to do what they know.
  • Don’t complete tasks when interrupted.
• Trouble getting organised.
  • Body, objects, workplace.
• Rigid thinking
  • Get stuck on an idea.
  • Unable to change the rules in games or plans.
  • Feel frustrated when the rule or routines are changed.
• Misses the point.
  • They focus on unimportant details.
  • Miss the point of what they are supposed to be doing.
  • Difficulties identifying when to look at the big picture.

Upper primary school/High school

• Difficulties making social plans
  • Follow what other children do
  • Difficulty with planning and prioritising what to do in free time.
• Avoid and procrastinates
  • Difficulties getting started.
  • Daydream.
  • Unable to break down tasks into steps.
• Overreacts and take things personally.
  • Difficulty with emotional control.
• Out of sync socially.
  • Unsure when to stop talking.
  • Unable to question their own behaviour.
  • Unable to read other people’s cues.
• Surprised by failure.
  • Unable to evaluate their own performance.

Occupational Therapy interventions targeting Executive Functioning skills vary a lot, as it will depend on which part of the process of completing tasks each child is finding challenging. Contact our clinic if you feel your child requires assistance with their executive functioning skills!

Reference

Chapparo, C. (2023, March). Executive Function in School Students with Learning Difficulties: How can occupational therapy make a difference?  Professional Development Course presented for Zi Mey Events, Sydney, Australia.