Children diagnosed with ASD are known to present with a range of executive functioning needs. While educators and special education teams work to implement accommodations, modifications and supports to provide students with ASD what they need to access their education and surrounding environment, much of the time students do not develop an understanding of how to create the tools for themselves. Recent research indicates that individuals with ASD exhibit an increase in executive functioning needs throughout development, with particular increase noted in challenges in flexibility, indicating the need for increased provision of direct instruction in these skills (Rosenthal, et al. 2013). These skills are critical to development of independent living skills, educational and occupational functioning as well as social functioning given that executive functions (EF) are responsible for the set of brain functions responsible for directing and controlling perceptions, thoughts, feelings, and behaviors. EF skills are required for people to effectively plan, execute, and follow through with tasks and solving of everyday problems. Most individuals diagnosed with ASD present with deficits in executive functioning.
Common skills needed for good executive functioning include:
- Response Inhibition: The capacity to think before acting.
- Working Memory: The ability to remember information while performing other tasks.
- Emotional Control: Self-regulation of emotions to maintain behavioral control.
- Flexibility / Shift: The ability to revise plans and incorporate new information when needed.
- Sustained Attention: The capacity to continue attending to tasks despite distractors, fatigue, disinterest, etc.
- Task Initiation: The ability to start projects without significant procrastination or external supports.
- Planning / Prioritization: The ability to create a strategy or plan to achieve a specific goal.
- Organization: The ability to create and monitor systems to organize information or materials.
- Time Management: The ability to monitor the amount of time available for a task and to manage the time keeping in mind limits and deadlines.
- Goal-directed Persistence: The ability to sustain effort directed toward a goal despite possible competing interests or activities.
- Metacognition: The ability to reflect and view one’s self in a situation and observe one’s own problem solving, self-monitoring, and self-evaluation.
In many schools, psychoeducational evaluations reveal areas of EF that would benefit from supports. In a student’s Individualized Educational Plan (IEP) who has been identified as having these needs, there is likely to be a list of accommodations and modifications to support these needs; however, there are rarely goals associated with teaching students these skills. For example, a student who is identified as having difficulties with planning and organization might then have an accommodation of being provided tasks with the steps broken down or with deadlines for each step of an assignment. While this support is often crucial to a student’s success, it does not necessarily teach the student how to use this strategy for him or herself when the support is not present. So, let us fast forward to college when the same student is assigned with a term paper; after years of having tasks broken down for him, he does not know how to approach what appears to be a large assignment in an organized manner to meet the deadline at hand. If in high school or middle school, an accompanying IEP goal had been developed targeting the student’s understanding of how to break down complex tasks and the student had been provided with direct instruction in how to develop an organized plan for large projects and assignments, then the student is more likely to be independently successful in other settings in which those supports are not present.
Additionally, building one set of skills does not develop another and IEP goals are likely needed across domains of EF. Supports for students with ASD and accompanying EF deficits should focus upon the following steps:
1) Provision of accommodations linked with identified areas of need. Example: Provision of directions in small, distinct steps for students with attentional difficulties, planning/organization needs or time management challenges.
2) Provision of modifications linked with identified areas of need. Example: Modifying worksheets with less information on a page to support attention.
3) Provision of goals targeting development of compensatory skills and strategies linked with identified areas of need. Example: Teaching a student how to develop and use a checklist by looking at the steps needed to complete a task, performing each step on the checklist and completing the list in sequential order (for students with planning/organizational and time management needs).
When providing students with direct instruction in EF strategies, instruction should utilize their known areas of strength. For example, many individuals with ASD present with strength in the area of visual processing and reasoning. As such, instruction in these strategies should be comprised of both auditory and visual instruction as well as instruction for the student in how to generate the visual support for himself. Instruction in compensatory skills should be delivered in a manner in which the student understands how and why these skills will assist him to be more independent in completing a variety of tasks. It is important that as a part of this process the student is learning about his own strengths and needs to know how to effectively manage challenges as well as to advocate for assistance when needed. For example, if a student understands that he exhibits difficulty with working memory and creating a checklist will help him to successfully complete his assignments, he is more likely to engage in acquisition of this skills than if it is presented as yet another task for him to do (Ozonoff & Schetter, 2007; Guare, Dawson & Guare, 2013).
In addition to the direct instruction of EF strategies, provision of parent training in ways of supporting their child at home is crucial to establishing lasting success and generalization of skills. When parents are taught how to support their child using the same strategies as used at school, students are more likely to recognize the strategies and comprehend how to develop them for themselves. For example, if working memory is identified as an area of difficulty for a student and checklists are implemented at school to facilitate accurate task completion daily, checklists should be used at home to facilitate accurate chore completion or completion of an after-school schedule. Not only is generalization of the strategy more likely to occur if it is used across settings, but the students are likely to learn compensatory skills with greater speed if they are occurring in multiple environments.
The key to facilitating student success and future independence is to step beyond provision of accommodations and modifications and to teach students how to develop compensatory skills for themselves so they are prepared to enter a world that does not always provide these supports to them.
For additional information Spectrum Services or Dr. Cody’s practice, visit: www.spectrumservicesnyc.com or contact Dr. Cody directly at KatherineCodyPsyD@gmail.com or (917) 512-7751.
Guare, R., Dawson, P. & Guare, C. (2013). Smart but Scattered Teens: The “Executive Skills” Program for Helping Teens Reach Their Potential. New York: The Guilford Press.
Ozonoff, S. & Schetter, P.L. (2007). Executive Dysfunction in Autism Spectrum Disorders: From Research to Practice. In L. Meltzer (Ed.), Executive Function in Education: From Theory to Practice, (133-163). New York: The Guilford Press.
Rosenthal, M., Wallace, G.L., Lawson, R., Wills, M.C., Dixon, E., Yerys, B.E. & Kenworthy, L. (2013). Impairments in real-world executive function increase from childhood to adolescence in autism spectrum disorders. Neuropsychology, 27(1), 13-18. http://dx.doi.org/10.1037/a0031299
(not cited in article)
Dawson, P. & Guare. R. (2009). Smart but Scattered: The Revolutionary “Executive Skills” Approach to Helping Kids Reach Their Potential. New York: The Guilford Press.
Dawson, P. & Guare, R. (2010). Executive Skills in Children and Adolescents: A Practical Guide to Assessment and Intervention. New York: The Guilford Press.
Meltzer, L. (2010). Promoting Executive Function in the Classroom. New York: The Guilford Press.