How the developing brain of a child who was internationally adopted may differ from a typical child’s brain and what interventions might help? Part 3: Executive Functioning and Self-Regulation

How the developing brain of a child who was internationally adopted may differ from a typical child’s brain and what interventions might help?

Part 3: Executive Functioning and Self-Regulation

This is part 3/4 in this series of blog post.

This topic is also available as a full presentation.  For more information, click here.

After learning about the developing brain, stress pathways, and impact on children who are internationally adopted, the question remains, “What can parents do?”  Research implies that the stress pathways that are deeper in the brain are biologically embedded early in life, so I image this to be like the Colorado River in the Grand Canyon which unlikely to change its course.  However, the pathways to and from the prefrontal cortex are like hundreds of meandering streams that easily change course and adapt to changing demands.  The research points to the prefrontal cortex as a potential area of intervention.  The prefrontal cortex is known to control a set of skills called “executive functioning,” which is considered the manager of the brain.

What is executive functioning?

  • Higher level cognitive skillsexecutive functioning work of children
    • Self-regulation (focusing attention, filtering distractions, controlling impulses, coping and calming skills)
    • Problem-solving (goal setting, making a plan and considering possible scenarios, sequencing steps and following directions, recognizing errors and correcting them, evaluating self-performance, achieving a goal)
    • Multitasking (prioritizing, remembering and working with multiple pieces of information)
    • Flexible thinking (switch approach to a task, consider new ideas or strategies, can make choices and decisions)
  • Develops later than most other areas and continues to develop throughout childhood and adolescence

Executive functioning isn’t a specific activity, but it is about how you perform an activity.  Examples below show how activities can be modified to demand minimal, moderate, or high levels of executive functioning skills:

child drumming

Minimal- Turn on music and watch child dance

Moderate- Dance with your child, imitate them and encourage them to imitate you

High- Pause the music and freeze. Take out instruments (or any objects) and make music together, use the tools in a lot of different ways.

reading

Minimal- Read through the book start to finish

Moderate- Read, but pause and let the child fill in familiar words or have the child point to pictures or answer basic questions

High- Make up a story to go with the pictures. Predict what might happen next. Ask questions without clear answers (I wonder why he did X, or what would you do if you saw X?). Act out the story together.

Minimal- Complete each step with child, adult directed

Moderate- Tell your child to get ready for bed, then watch and correct each error.get ready for bed

High- Tell your child to get ready for bed. When mistakes happen, comment and wonder out loud- “What might happen if the water keeps running?” “I wonder where dirty clothes should go?” “How can we tell if our teeth are clean?”

Minimal- Tell your child to sit down, what to do first, second.., sit with them and correct their work.

Moderate- Organize and prioritize for your child to make it easier, then have them complete the work. Circle what needs correction and have your child fix his or her own work.

High- Make a plan together about when to get the work done- estimate how long it might take and what needs to get done. Help your child prioritize and organize, then step back and let him or her do the work. Encourage your child to check their own work and praise the effort to self-correct. Allow some mistakes. Help when asked.

Minimal- Ask for a report of what he or she did that day

Moderate- Discuss the day’s events, everyone contributing. Comment using self-evaluation and reflection on choices.

High- Discuss day’s events, but also bring into the discussion higher level thinking about local and global events and issues. Spend a lot of time wondering and thinking about others.

Researchers have been working on identifying how to teach executive function skills or how to train parents/caregivers to facilitate the development of executive functioning.  The evidence is still limited.

  • A review by Diamond (2011) of effective interventions in preschools summarized this, “Diverse activities have been shown to improve children’s executive functions – computerized training, non-computerized games, aerobics, martial arts, yoga, mindfulness, and school curricula. Central to all these is repeated practice and constantly challenging executive functions… To improve executive functions, focusing narrowly on them may not be as effective as also addressing emotional and social development (as do curricula that improve executive functions) and physical development (shown by positive effects of aerobics, martial arts, and yoga).”
    • So it isn’t so much about what you do, it is about how you do it.  apple picking
  • Research has found the following:
    • baby and dadTwo programs for child who are in foster care or have experienced abuse/neglect show that parenting skills and parent-child relationships matter.  Programs that teach caregivers to be sensitive and responsive to infants’ and toddlers’ needs cause a more normal pattern of cortisol in saliva of the children (indicating more normal stress responses).
      • Programs that promote healthy parent-child relationships through positive parenting practices result in more normal patterns of cortisol in saliva of the children (indicating more normal stress responses) and improved behavior.
    • IMG_0877-XLA literature review showed that physical activity promotes executive functioning skills, with the most gains in inhibition skills (the ability to stop a response, such as stopping running when a parent yells “wait” or not hitting back when a sibling pokes you).
    • While the evidence is not clear yet, research on increasing executive functioning skills suggests a variety of approaches: mindfulness/ mediation, training specific cognitive tasks, specific school curriculum, using language to mediate behavior, and the potential role of music.
  • The Gunnar Lab for Psychobiological Research, through the University of Minnesota, is currently researching this exact topic. The results are not yet published, but the most recent newsletter outlined preliminary findings. They are doing a long-term study of the effects of several different training programs related to self-control (executive functioning) deficits and children who are internationally adopted.
    • Self-control-mindfulness training- focused on making a child more aware of feelings, senses, actions and teaching ways to self-calm.
      • Children showed improvements in attention tasks (increased EEG activity in brain areas that monitor for errors).  However, teachers did not report gains in classroom performance.
    • Executive functioning training- gave a child direct practice in impulse control, paying attention, remembering information, and thinking creatively.
      • Children showed improvements in emotional regulation (less intense EEG findings when mistakes were made).  Teachers reported more prosocial behaviors in the classroom.
    • Both groups had 12 sessions over 6 weeks, with homework after each session.  Follow-through at home was minimal after program ended.

As a parent and professional, I find the lack of research on interventions to be concerning.  The science clearly defines the problem, but not nearly enough focus has been on developing practical interventions that can help to improve outcomes for children.  The U of MN research study is promising, but very limited so far in findings.  What I think can be concluded is that positive change is possible through interventions focused on teaching parents and on interventions that teach children specific skills. In the next post, I will explore the normal developmental progression of executive functioning and self-regulation skills and what a parent might do at each stage to promote development of these skills.

child playing on beach

Paige Hays is an occupational therapist who provides in-home, pediatric occupational therapy services in the south metro area of the Twin Cities, MN. She is a mother of 2 girls, avid DIYer, and a highly skilled and experienced OT. She specializes in working in pediatrics, with diverse expertise ranging from cognition and sensory issues to working with children with neuromuscular disabilities or complex medical needs.  www.paigehays.net