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Executive Function Training for Kids with CHDs

Ages 8 - 24 Years

Are you or your child messy or disorganized? Do you have trouble making plans and following through on tasks? Is it tough to make decisions, inhibit behaviors, or solve problems flexibly? Executive function problems are common among people with congenital heart defects (CHDs). They often become apparent in late elementary school, and can remain a challenge through adulthood. For some people, executive function training or tutoring can help.

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Executive Functions

"Executive functions" are the ways people think when they are focusing and paying attention. For example, executive functions include:

  • Staying organized

  • Planning time

  • Being flexible

  • Controlling emotions

  • Paying or switching attention

  • Starting new tasks

  • Working towards a goal

  • Breaking big tasks into steps

  • Monitoring and reflecting on performance

The executive functions develop rapidly in early childhood, and then gradually through middle childhood and adolescence. People finally have mature executive functions in their late 20's.

Challenges with executive functions are common in people with heart defects. When people do not get help for executive function deficits, they can have problem at school, work, and home.

School Support for Executive Functions

Public schools often offer help in executive functioning. Students who qualify for Special Education or a 504 Plan can get help as part of their education program. In some schools, executive function training is part of a general education curriculum.

Families who are worried about their child’s executive function should ask their school district what executive function services are available.

Private Executive Function Training

In addition to school services, families can often hire tutors or therapists who can help students with executive function. They might offer these services in a clinic, in a private practice, or at a home. Usually, these services are not covered by insurance. Families can ask their doctor, therapist, or teacher for recommendations of executive function tutors in their community.

When families have access to them, executive function training can help many students be more successful in school, and in daily tasks.

How Can Executive Function Coaches Help?

Executive function training might include helping students to:

  • Organize their materials

  • Use a calendar or planner

  • Develop work plans for long assignments

  • Practice solving problems multiple ways

  • Use strategies to break down big assignments

  • Identify feelings, and work on controlling them

  • Get started on new tasks without procrastinating

  • Work for longer periods at a time without stopping

  • Pay attention and learn during class

  • Study for a test or quiz

Taking a Long View

In typical development, executive function skills are not fully established until a person is between 25 and 30 years old. In people with heart defects, the process may be slower, and some people may always lag behind their peers in executive function skills.

When someone has executive function deficits, they can use a combination of:

  • learning and practicing skills that they are able to improve

  • using tools and strategies to compensate for skills that remain impaired

Together, these approaches can allow people to be successful students, workers, and friends despite underlying executive function challenges.

This content was reviewed by a psychologist at Boston Children's Hospital.

Developmental care is best when it is local. Families local to Boston can receive care from the Cardiac Neurodevelopmental Program (CNP). Families from other regions can use the link below to find their local care team.

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