Cognition and Executive Skills
What is cognition?
The term cognition is used across multiple disciplines and definitions can vary. Simply put, cognition refers to processes involved in thinking, the process by which we understand and incorporate new knowledge. Cognitive processes include attention, memory, perception, language and reasoning. These processes are largely interrelated, affecting one another.
Cognition and Executive Skills
Healthy executive functioning relies on intact cognition. Aspects of executive functioning directly indicate cognitive functions (e.g., attention and memory) but also include higher level skills such as behavior regulation (e.g., self monitoring, impulse control, etc.), organization and planning. A large body of research over the past few decades shows that children with better executive functioning have numerous positive lifetime outcomes such as higher income and education, better family relationships and better health.
Problems with Executive Skills
Executive skills begin to develop in the first year of life and continue developing through early adulthood. Children with executive function problems tend to be smart but have trouble getting through their day. They may seem disorganized and have difficulty managing their time. They may get in more trouble than their peers as they have difficulty controlling their impulses or managing their emotions. ADHD and executive dysfunction go hand in hand. Impairments in attention are inclusionary criteria and children with ADHD will almost always have problems with memory, impulse control, and regulating emotion.
What can be done?
The good news is that executive skills can be improved with intensive, goal-directed treatments. The first step is to identify the areas of executive functioning that are impaired which requires input from caregivers and educators. The child is included in this process when appropriate. Other underlying factors are ruled out (e.g., language disorder, overall cognitive impairment). Plans are developed that directly address lagging executive skills within specific problem areas identified by teachers and caregivers. Plans include managing factors external to the child (e.g., the environment, visual supports, language directed at the child, etc.), directly teaching the new skill to the child and determining and consistently applying a consequence. When emotion regulation is problematic, functional analysis of behaviors, alternative choices and practice are often used.
For older children (middle school through college), time management tends to be an overarching challenge. Time management is addressed using a programmatic intervention customized to the child’s specific needs. Often, when time management is improved, other organization skills automatically improve. Organization, task initiation and sustained effort are often targeted through homework organization and completion. In sum, executive skills are targeted through meaningful activities that are necessary for academic and social success. Although executive skills can be significantly improved with proper intervention, that change is an effortful process. The child must be scaffolded on a daily basis at first and release of control must be deliberate and systematic.
What does language have to do with executive function?
Executive functioning is a neuropsychological concept referring to the high-level cognitive processes, one of which involves meta-cognition (Dawson and Guare, 2010). Metacognition is the ability to effectively evaluate our thinking. We plan, execute our plans, monitor our actions, regulate our emotions, etc. most effectively when we think through actions and consequences (meta-cognition). Language mediates this ability; thus, accessing language to “talk yourself through decisions” is paramount. Further, an important component in the treatment of emotion regulation is the development of effective interpersonal communication (pragmatic language).