Tarnow Articles

Learning Differences and Executive Functioning By Linda Narun, M.A., CCC-SLP

The concept of executive functioning was first described by Baddeley, and has been discussed in other articles in this newsletter. This article describes how poor working memory and executive functioning can affect the development of academic skills and hamper progress with individuals diagnosed with ADHD.

One of the components of executive functioning is a skill referred to as "working memory," which is the brain's ability to hold information, scan incoming data, and make changes in behavior as necessary. It is composed of three basic systems. The first is described as "the phonological loop" where the development of speech and internal language is used to track and hold information while it is being processed and acted upon. The second is the "visuospatial sketchpad," used to hold spatial information that cannot be tracked with words. The third system is related to attentional control.

By the time most individuals reach adulthood, most of these underlying skills have become automatic and are used without their being aware of the complexity of brain activity required to achieve behaviors that seem so simple. However, for those who have experienced difficulty with underlying language, visuospatial skills or attention, automaticity is not achieved, and working memory compromised. As a result, academic achievement and well-managed behavior are negatively impacted.

Children with learning disabilities very often have poor oral language skills. If oral language skills are poor, it is more difficult to develop internal language necessary for self-monitoring, an important executive function. Poor language abilities are sometimes difficult to discern because the difficulty does not always affect the development of conversational ability. Children often talk a great deal, but may not be able to respond to a question and formulate a specific response. They may not follow directions well, which is often attributed to the ADHD, but may in fact be a result of slow auditory processing or a failure to understand the more complicated features of language. Consider a child who is given this instruction by a teacher, " Complete all the odd numbered problems on page 46, then hand in your math and start answering the chapter questions in your social studies work book." The problems a child faces in completing these tasks can be very difficult because they are unable to hold the sequence of events in working memory, plan their actions, and complete the assignments to the best of their ability. Hence we often feel that the student is unmotivated because we know they can do the math and at least should attempt some of the social studies. Often the student is discouraged from asking for repetition as he does so often. Anxiety increases and the classroom work often ends up as homework or the student receives an incomplete grade.

Reading skills, particularly comprehension, can also be severely impacted by poor working memory. If the sound system of language, or phonology, is not automatic, each word must be actively processed, and the meaning of each word held in memory so that sentences, especially when they become more complex, can be understood. If, in addition, syntactic development is poor, the order of words must be retained to understand the underlying meaning. In a sentence like, " The dog was bitten by the boy," it is important to pay careful attention to the word order. Without the knowledge of syntactic order or the attention to see "who did the biting," individuals who are impulsive and whose underlying skills are not automatic may respond to conventional wisdom that the dog did the biting. If, additionally, spatial difficulties are present and the /b/ is perceived as /d/, more attention will have to be paid to the decoding of the words. These problems become greater with longer sentences, paragraphs and chapters when information must be held in working memory, processed and understood. It may, therefore, be seen how poor skills and working memory impact the ability to answer questions relating to the main idea, making inferences and drawing conclusions. When skills integrate them into a meaningful whole.

Math skills are particularly affected by poor working memory. When completing a multi-step problem, like regrouping numbers or long division, information from preceding steps must be retained and used for the next step to be completed efficiently. The brain must remain organized for these steps to be completed sequentially and accurately. Often students complain that they have poor math skills, but when underlying problem solving skills are evaluated, they do very well. The difficulties often lie in the executive processing and working memory, rather than in the area of math per se.

Written expression is the most difficult academic task to be accomplished, as it requires the integration of many skills. Information must be organized and formulated, vocabulary selected, words spelt correctly, and then written in grammatically correct sentences. The student with poor executive functioning and poor language skills is likely to have more difficulty than most other students. Even writing a sentence in response to a short question can be challenging, as information that should have been held in working memory must be selected as appropriate and then formulated into a sentence which is capitalized and punctuated correctly.

A large number of individuals with ADHD have coexisting language learning weaknesses and deficits. Therefore, it is important when diagnosing ADHD to also evaluate the underlying language and visuospatial skills on which executive functioning is dependent. Parents' and teachers' frustration with ADHD children is often the result of the child being able to do difficult tasks, but failing because they do not complete simple aspects of a task. It then appears as if the student is simply unmotivated and doesn't care. He is able to demonstrate his good problem solving but is disorganized; completes homework but does not hand it in; fails to write assignments down, and soon. These are apparently the "easy things," but the difficulties that arise from not being able to set a goal, plan strategies, and continually check to see if the strategies are working, are the failure of the executive function to perform appropriately. When viewed in this way, the "simple" tasks, are not necessarily so simple.

When devising therapy plans for individuals with learning differences or ADHD, we must take the issues of executive functioning and working memory into account. If the ADHD is treated, but the language learning weaknesses are not addressed, therapy cannot be optimally successful. As our knowledge of the brain and its organization increases, we are able to provide a variety of techniques to assist in its development. Language learning and self-managementSM therapy in addition to medical management remain very important. Computer based programs like Fast ForWord and Interactive Metronome assist greatly with the development of neural pathways in the brain and brain organization. Both these programs are based on theories of neuroplasticity and the brain's ability to change and develop.

As the child or adult develops better skills, we must also be sure that he or she is in educational and family environments that allow him or her to practice these skills so that they can become automatic and rewarding. Therefore, work with the family and school is important so that all can be facilitating the development of active learning and monitoring of behavior. In so doing, we can minimize the anxiety, passivity and loss of motivation of a learner who feels he has no way to be successful.

As educators and parents, we must develop "executive functioning" with regard to the child. Set short and long term goals for the child, develop strategies to help him achieve success, and give him time to learn and feel positive about his efforts and himself. As he feels more successful, motivation and better performance are likely to follow. We all have the same goal: to help students love to learn, reach their potential and become valued members of the family.

Carter, Rita Mapping The Mind (University of California Press 1998) 188
Baddeley, Alan D. et al (eds.). Handbook of Memory Disorders (Chirchester, John Wiley, 1996)
Carter, Rita Mapping The Mind. (University of California Press 1998) 188