Attention and Executive Function

Attention is the ability to focus on a stimulus long enough for it to reach consciousness. Focused attention is essential to all learning. Students with attentional difficulties pay attention but often to too many things simultaneously. Their working memory becomes overwhelmed, making it difficult for them to sustain goal-oriented behavior and self-monitor for progress.

Students with attention difficulties are often diagnosed with one of three subtypes of attention deficit hyperactivity disorder (ADHD):

• The hyperactive/impulsive subtype includes difficulty inhibiting motor activity, including talking.
• The inattentive type includes difficulty initiating and sustaining focus.
• The combined type includes significant difficulties with hyperactivity/impulsivity and inattention.
• None of these diagnoses is a language-based difficulty, but all affect the acquisition and fluent use of language. All interfere with academic progress.

Executive function is the management system of the brain. Because attention is a central element in executive function, executive function disorder is increasingly cited in diagnostic evaluations, even though it is not an official diagnostic category. Research in neuroscience is offering persuasive evidence for expanding existing definitions of ADD/ADHD to include executive function. Thomas E. Brown of Yale University proposes a model of ADD as primarily a problem with executive function. He writes: “Although ADD/ADHD has been recognized for over 100 years, it has usually been seen as essentially a behavior problem. Yet many with ADD/ADHD suffer not from behavior problems so much as from chronic problems with focusing their attention, organizing their work, sustaining their effort, and utilizing short-term memory. (n.d., para. 1)” Unlike language difficulties, which are fairly consistent in how they manifest in each student, attention and executive function difficulties are variable. Educators often misinterpret this variability as evidence that a student is lazy. A student might spend hours building a LEGO castle, designing a website, or writing a play but fail to finish their homework. Laziness is simply an inaccurate explanation. Individuals with ADHD or weak executive function can often focus and sustain effort on tasks of intense interest but struggle to marshal these skills for school or other life activities. In fact, “The single most consistent finding across children who exhibit executive function difficulties of one type or another is the inconsistent nature of their behavior and/or academic production” (McCloskey, Perkins, & Van Divner, 2008, p. 249).

Motor Skills

Gross motor skills involve large, generalized movements such as running, kicking a ball, jumping rope, and riding a bike. Fine motor skills, on the other hand, involve small, precise movements such as beading, manipulating small blocks, using scissors, drawing, and writing.

Motor disorders are not language-based, but many students with LBLD experience them. Difficulties with gross motor skills can profoundly affect a student’s social experience in school but generally do not interfere with academics. Difficulties with fine motor skills, however, can affect both.

Fine motor skills are essential to many aspects of classroom learning. They impact handwriting and, at times, keyboarding. Students need fluency in one or both to write assignments, take notes, and answer questions on quizzes and tests. They may also struggle with building projects and other hands-on activities. Younger students are often expected to construct bridges from toothpicks, create dioramas, make posters, and illustrate stories. Older students may need to perform dissections, measure and mix chemicals, construct models, and use mathematical instruments.

Outside the classroom, weak fine motor skills can make everyday tasks more difficult, such as tying shoes on the fly, using a game controller, whittling a stick, making a friendship bracelet, or peeling an orange. These difficulties can create feelings of inadequacy and lead to teasing from peers.

Social and Emotional Adjustment

All students experience social and emotional difficulties at some point in their school careers. For some, these challenges are themselves disabling. Social and emotional adjustment is one of the most complex topics addressed in this chapter, partly due to the breadth and depth of these difficulties and partly because sorting out their causes and effects can be challenging. Struggles with social and emotional adjustment can either cause academic difficulties or result from them. Some students’ academic struggles stem from poor social skills, behavioral issues, or emotional disturbances. For example, students who are verbally combative may spend so much time in the hall, in detention, or suspended that their academic progress suffers. As they fall behind, they lose motivation, fail, and eventually give up.

Students who are severely depressed may struggle to find the energy to attend class, let alone complete homework or participate in a group project. They may not have a language-based learning disability, but their academic progress is impeded nonetheless, making intervention necessary.

Other students exhibit poor social skills, behavioral issues, or emotional disturbances as a result of their academic struggles. Students with mixed receptive-expressive language disorder may have poor social skills because they lack the language abilities needed to understand and respond appropriately in social interactions. Students with a reading disorder may disrupt class with inappropriate comments or actions to avoid reading in front of others or may become overwhelmed by an in-class reading assignment.

Finally, students with all types of learning disabilities and differences commonly struggle with anxiety and depression resulting from their school difficulties. Poor academic performance can destroy their sense of self-efficacy. They are often accused of being lazy, unintelligent, dependent, stubborn, or troublesome—and may begin to believe these accusations themselves. When this happens, it compounds the difficulties caused by their learning disability.

Student Profiles

Students have unique learning profiles shaped by their educational experiences, learning and thinking styles, personality traits, and specific needs related to language acquisition and use. All students who struggle in school—particularly those with LBLD—benefit from structured, multisensory, skills-based instruction. Each requires individualized instruction tailored to their specific needs.

The following student profiles highlight different aspects of five students: Lan, Carlos, Ayanna, Elijah, and Jason. Each faces challenges in school that teachers must analyze and address. These profiles are composites of several real students, with names changed for privacy.

Interventions for Other Difficulties

As you read about interventions for each student, keep in mind the following questions:

• What issues lie at the core of the student’s difficulties?
• Do the interventions seem sufficient?
• What role would you play in supporting each student? 

LAN GRADE 2: Lan struggles with social and emotional adjustment. Because of her reading disorder, she often feels unintelligent and believes that her teachers and parents are disappointed in her despite her efforts to improve. These feelings lead to anger and frustration, causing her to respond negatively to instruction or suggestions or to refuse tasks altogether. Her expressive language disorder further complicates her ability to demonstrate knowledge and skills. Although she has the vocabulary, she struggles to use it efficiently. As a result, she is often misunderstood by both peers and adults, who may perceive her as talking too much, making little sense, or suddenly exploding in frustration. However, none of these interpretations of Lan’s behavior are accurate

CARLOS GRADE 4: Carlos’s poor academic performance stems from ADHD and executive function weaknesses. With medication and environmental adjustments, he is better able to sustain focus on academic tasks. Through teacher modeling and explicit instruction, he can identify a goal, follow a plan to achieve it, and monitor his progress along the way. An added benefit is his growing confidence that he can succeed in school just as he excels at building robots. He simply needs to learn the right strategies.

AYANNA GRADE 6: In addition to Ayanna’s challenges with receptive and expressive language, she has a fine motor disorder and receives occupational therapy once a week. Her handwriting is legible but labored and unevenly spaced on the page. She also struggles with tasks requiring fine motor precision, such as folding, using scissors, handling tweezers, and working with small parts. These difficulties can be embarrassing for her when collaborating with other students. Ayanna is currently practicing her handwriting skills while also learning keyboarding, which she missed at her previous school due to pull-outs for reading tutoring.

ELIJAH GRADE 8: In addition to Elijah’s challenges with expressive language, he has ADHD and struggles with various social and emotional issues. Academically, a trial of ADHD medication has been successful, especially when combined with participation in the school’s language-based program and daily check-ins with his advisor to help him stay organized and focused on short-term goals. However, Elijah’s social and emotional difficulties stem from a complex background, and academic interventions alone are not enough to support him. He meets weekly with a licensed social worker to develop strategies for expressing his feelings and needs, monitoring his behavior, and managing his anger. In addition, Elijah and his foster parents attend counseling outside of school.

JASON GRADE 10: While Jason faces academic difficulties, his school and home environments do not present any unusual challenges. He is well-connected with his neighborhood and church communities, and he and his older brother have built a successful landscaping business. According to his mother and guidance counselor, the biggest challenge is convincing him to delay full-time landscaping work in order to finish high school.

Checklists for Other Difficulties:

The checklists below focus on specific concerns about difficulties commonly coexisting with students’ LBLD. Specifying students’ areas of difficulty (e.g., difficulty remaining focused during class discussion rather than distractible) gives us language to use with parents, evaluators, counselors, and students and helps guide interventions. The checklists linked in the “Strategies to Download” section below can be used with other informal diagnostic instruments to guide instructional decision-making. They should not take the place of formal educational or psychological evaluations.

References:

Brown, T. E. (n.d.). Welcome to DrThomasEBrown.com: A website that offers a new understanding of attention deficit disorder. Retrieved December 11, 2011, from http://www.drthomasebrown.com

McCloskey, G., Perkins, L. A., & Van Divner, B. (2008). Assessment and intervention for executive function difficulties. New York: Routledge.