How executive function impacts speech and language
Listen, friends. This past year, I have taken a deep dive into the world of executive function (EF). When I was in graduate school, we certainly talked about executive function. I knew that the frontal lobe was in charge of it. I knew that EF handled all of the organization and planning and inhibition for the brain. I knew that brain injury patients often had huge impacts in their EF, which could lead to massive dysfunction in their daily lives. I heard stories (and met patients) who after traumatic brain injury struggled with violent outbursts because they lost their ability to regulate their bodies and their emotions, or who lost the ability to complete basic daily living tasks because creating a following a plan was no longer possible for their brains.
However! I never really understood executive function’s role as the basis of learning, and of communication. This last winter I joined Tera Sumpter’s Seeds of Learning Online Education Community, and it has blown my mind. Tera has taken multidisciplinary research from the fields of cognitive science, psychology, education, speech therapy, and probably many more fields as well as many years of her own clinical experience (and her brilliant clinical problem solving brain) to create a model of how EF underlies everything that we do. Did you know babies are using EF from the very beginning? It’s true. Even at birth, infants immediately use the most basic elements of EF, attention and perception, to orient themselves to the world around them and begin their lifelong learning journey. Neurodiverse kiddos are likely taking in different information than neurotypical kiddos from the very beginning depending on how their sensory systems are perceiving the world. These differences might lead to them attending to entirely different stimuli than neurotypical babies!
Based on the information we are able to perceive and pay attention to, we then start building up our working memory. Working memory includes the information that we are able to take in, hold, manipulate, and retrieve in our brains. It’s basically how we think. Our nonverbal working memory includes our entire internal representation of the world. When we think about an apple, our verbal working memory gives us the sounds of its name, and our nonverbal working memory gives us all of the things we have experienced about an apple—its shape, the sound it makes when we bite into it, the way the skin feels on the outside and then how there is a different texture on the inside, the range of tastes an apple might have, what we know about how apples grow, if we’ve ever had a chance to pick an apple and what that feels like, etc. Depending on our experience, our schema, or internal representation, of “apple” might be huge. For children who are struggling with language development, typically they are also struggling with their nonverbal working memory. There has been a problem with the process of internalizing and being able to recall those internal representations of their experiences.
Not to worry, though, speech therapy can help tremendously with building up that nonverbal working memory! Just like if we want to have better upper body strength we need to have a workout routine and stick to it at least several days a week over time, all of our executive function skills can be strengthened with targeted practice that starts at the child’s level and builds over time. Similarly, sometimes children need help building up the strength of their verbal working memory. Children with difficulty in this area may have a hard time with their speech sounds, phonological processing (skills manipulating sounds), and literacy development (although literacy difficulty can come from many different causes!). Again, these skills absolutely can be strengthened with targeted exercises over time.
The last foundational EF skill is inhibition. Inhibition, essentially, is the ability to hit “pause” before taking action on an impulse. Kids who need support with inhibition often struggle when they get into a classroom and need to follow a whole list of rules that involve a lot of waiting and keeping hands to oneself. They might struggle socially with activities like turn taking on the playground or in games. Again, inhibition is a skill that practice and structured support can help immensely.
These four areas, attention, perception, working memory, and inhibition, are the basis of all of the other higher level executive function skills that we need to be successful, like planning, self-monitoring, self-correcting, and self-modulating. Without these baseline skills it would be impossible to have robust skills in these higher levels of EF. If you suspect that your child struggles in any of these areas, don’t hesitate to reach out to a speech therapist and ask for support!
