What is Executive Function Training?
Executive functions represent a collection of processes that are responsible for goal setting, initiation and follow through of a plan, self awareness,, and managing cognitive and emotional functions during daily tasks. Executive functions include skills that are considered at the highest level of cognition. Executive functions are mediated by the frontal lobes of the brain and their dense connections with other cortical and subcortical regions of the brain which are responsibe for arousal, motivation, perceptual processes and motor control. When this system is not functioning well even the simplest tasks can be extremely challenging.
Although the frontal lobes mediate executive functions, the executive system, with its dense connections throughout the brain, is susceptible to malfunction when any of the systems sending information to the frontal lobes is malfunctioning. This is why individuals with any type of damage or delay to virtually any region of the brain may show some deficits in executive functioning.
The flow of information through the executive system is highly dependent upon other cognitive processes such as attention and memory.
Who Should do Executive Function Training
A number of disorders and conditions are associated with challenges with executive functions. Most often if there are cognitive challenges, there is a good chance there will be some challenges in the area of executive functioning. Some of the most prevalent disorders are:
- Attention Deficit Disorders
- Learning Disabilities
- Anxiety Based Disorders
- Traumatic Brain Injury
Although there are certain disorders which automatically require an evaluation of executive functions, there are several symptoms that, if present, can indicate the possibility of executive dysfunction.
Common Signs/Symptoms of Executive Dysfunction
Individuals who demonstrate difficulties in the area of executive functioning may demonstrate some of the following problems:
- Difficulties with Organization Skills
- Difficulties with Inhibition
- Difficulties Shifting Attention
- Difficulties with Emotional Control
- Poor Self-Monitoring Abilities
- Poor Working Memory Skills
- Difficulties with Task Initiation and Completion
- Difficulties Planning Things
Programs for Executive Dysfunction
Working memory is an executive function that individuals are contstantly using. Working memory involves holding information in the mind for a short time and then manipulating that information in order to perform a given task. Research has demonstrated that poor working memory is the main underlying cause for learning challenges, poor job and academic performance, and difficulties with attention.
Cogmed is a computer based training program that provides a variety of visual and auditory memory exercises to challenge the trainee’s working memory capacity. It is not a program that teaches skills, it is a program that helps reorganize the brain to provide a new platform for learning across all skills sets. The difficulty of each task is adjusted in real time based on the trainee’s performance. This allows for the trainee to be challenged enough but not to the point where they become frustrated and lose interest. The research has shown that with improved working memory comes improved overall attention, resistance to distractions, self-management skills and learning ability.
“Stimulation of the cortex may bring about improved functioning of subcortical structures.”
Although there are several programs which address the executive functioning system, the most impactful treatment for executive dysfunction is neurofeedback. Research has shown that through the thalamo-cotico-thalamic neural pathways, a bidirectional connection, the brain can obtain data about its own activity. This opens the door for brain training through direct stimulation of the various cortical regions using neurofeedback. Through this circuit, training at the cortical level will impact functioning at the subcortical (thalamic) level which is a core structure in the executive system. If any of the brain areas involved in executive function are identified as malfunctioning through the Brain Map, either cortical or subcortical, neurofeedback can provide direct training through specific lead placement on those areas for training. Stimulation of the cortex may bring about improved functioning of subcortical structures.
How Our Treatment For Executive Dysfunction is Different
As part of the intervention for executive dysfunction the client will participate in a integrated approach where neurofeedback and other cognitive training programs are used to promote improvement in cognitive areas which support executive functioning. These areas include memory, attention, processing speed, and often language. Once the executive systems begin to improve, the client will often need instruction on how to use the new skills that have suddenly emerged through the neurofeedback training.
This type of instruction frequently involves a “how to” approach to various tasks that require executive processes. Although theindividual’s cognitive system has changed and is now able to handle problem solving and execution of tasks, the client often requires some level of instruction because of the novelty of using these skills.