Executive Functions: A Complete Guide for Speech Therapists
Executive functions are high-level cognitive processes that allow us to plan, organize, initiate, and control our actions. They play a crucial role in language, learning, and behavior. Executive function disorders are common in ADHD, DYS disorders, and many other conditions. This guide presents these functions and their place in speech therapy rehabilitation.
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What are Executive Functions?
Executive functions (EF) are the cognitive processes that regulate our thinking and behavior to achieve a goal. They are primarily supported by the prefrontal cortex and develop gradually from childhood to adulthood.
They can be compared to the "conductor" of the brain: they coordinate other cognitive functions to enable appropriate, flexible, and goal-oriented behavior.
The Main Components
🎯 Inhibition
The ability to stop an automatic response or inappropriate behavior. It allows resisting distractions, not acting impulsively, and suppressing irrelevant information.
Example: not shouting the answer in class, waiting for one's turn.
🔄 Cognitive Flexibility
The ability to change strategy, adapt to changes, and switch from one task to another. It prevents getting "stuck" on one way of doing things.
Example: changing methods when the first one doesn't work.
🧠 Working Memory
The ability to hold and manipulate information in memory for a short period. Essential for understanding, reasoning, and mental calculation.
Example: remembering a complex instruction long enough to execute it.
📋 Planning
The ability to organize the steps to achieve a goal, anticipate, and establish a strategy.
Example: organizing work to finish a project on time.
⏰ Time Management
The ability to estimate the time needed, meet deadlines, and perceive the passage of time.
Development of Executive Functions
| Age | Development of EF |
|---|---|
| 0-3 years | Emergence of inhibition, basic attention |
| 3-6 years | Rapid development, inhibition, emerging flexibility |
| 6-12 years | Gradual improvement, working memory, planning |
| 12-25 years | Continued maturation into adulthood |
The prefrontal cortex, the main seat of EF, is the last region of the brain to reach maturity, which explains why adolescents still have control difficulties.
Executive Function Disorders
Concerned Populations
- ADHD: central deficit in EF (inhibition, working memory)
- ASD: difficulties with flexibility, planning
- DYS Disorders: working memory, planning
- SLI: verbal working memory
- Post-brain injury: depending on the location
- Prematurity: often fragile EF
Daily Manifestations
- Difficulty with organization: loses belongings, forgets instructions
- Impulsivity: responds before thinking, does not wait for their turn
- Difficulty starting a task (initiation)
- Difficulty finishing a task (perseverance)
- Rigidity: difficulty adapting to changes
- Difficulty with time management
Link with Language
💡 Executive Functions and Language
EF are closely linked to language: verbal working memory is essential for understanding complex sentences and learning vocabulary. Inhibition allows selecting the right word among several. Planning is necessary to construct a coherent narrative.
Intervention
Principles
- Compensate: external supports (lists, timers, visuals)
- Train: targeted exercises (effectiveness debated)
- Adapt the environment
- Teach metacognitive strategies
Practical Strategies
- Visual Timer: to materialize time
- Checklists: for routines and complex tasks
- Break down tasks into small steps
- Stable and predictable routines
- Reduce distractions
- Regular breaks
Our Downloadable Tools
Frequently Asked Questions
The question is a debate in research. Training exercises (memory games, inhibition...) improve performance on trained tasks, but transfer to daily life is limited. Compensatory strategies (external supports, organizing the environment) and teaching metacognitive strategies seem more effective in real life.
Yes, EF develop naturally until adulthood (around 25 years). A child with executive difficulties can therefore progress with brain maturation, especially if the environment is adapted and strategies are taught. However, some difficulties may persist (ADHD).
Yes, indirectly. Speech therapy often engages EF (working memory for understanding, planning for narrative...). The speech therapist can also teach compensatory strategies and adapt their intervention to executive difficulties. For specific work, collaboration with a neuropsychologist can be helpful.
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