Ep 152. Spotting the Signs of Executive Function Delays in Your Child’s Daily Life

Introduction and listener question 0:00

Hi everybody, it's Dr. Laura and welcome to Connect My Brain podcast. So excited to connect with you once again and I've got some things I'd like to chat about. I actually had a listener reach out to me and ask a question and so I want to framework today's podcast around the question. And I do encourage you that if there's ever a time that you feel like you didn't get what I was talking about, reach out and ask, say, can you go over that again? One of the things that I really pride myself on is connecting the dots.

That's why all these words connecting are surrounding me. So let's dive in. The listener wrote in and asked, I don't really understand what executive function means and where is it? And that is an excellent question because we are actually hosting a parental information webinar. Now, you'll probably hear this podcast after the webinar, because we're doing it May 14th, which for me right now is this coming week. So depending upon when this airs and you actually get to hear it, we will be posting the initial one on our website so you can actually go back and listen to it.

But if you are interested in doing a deeper dive, we're actually going to be hosting two more webinars on executive function. One at the end of May and the beginning of June and or I think it's the middle of june. It's on the website connectmybrain.com.

What executive function looks like across ages 2:00

What I'm trying to do is to really educate parents because this is a common thing that parents will come into the office or they write it down on the intake form that their child is struggling with. So let's identify the struggling with, what are these typical things that would then lead me to going, this has something to do with executive function. So we'll go from a variety of ages. I'm gonna go school age up to maybe teenage and then even to the early 20s. And then I'll even tie it back to anybody 30s, 40s 50s 60s So if you feel like your child has a hard time following through, you might give your child a three-step direction and your trial does not follow one, two, three.

They might do one and it's like they lose the other two. Uh, they may come back and ask you lots of questions like, now what, what did you tell me to do? And I want to also give some suggestions to some of these things as well. Let's move up the chronology a little bit and now let's think about what it might look like for an adolescence going into their teenage years. So this by now, the child may appear all over the place. It's just been a chronic situation. There's lack of follow through, there's a lack reasoning, lack organization, and lack putting together a plan and being able to execute.

and they may have their own little strategy of dealing with it, and really it might be more of the frustration they feel. They may laugh about everything, they maybe angry about every thing, They maybe just throw things down,they may hide them. they made hide papers. It can really look like anything. Now, if I jump into, let's say, college to early 20s, this might be somebody that maybe they couldn't complete the process of going to college. They couldn' make a schedule, they were not getting up, They were maybe involved in lots of recreational activities, but at the end of the day, they can't complete that season of time fully.

And then as we merge into our adult years, we may still be struggling and saying things like, I just really can pay attention. I really have a bad memory. they may be failing in their job, in the career. They may have never launched into a career, so I give you as many examples and we'll come back and weave in those examples so that we can tie it to a better understanding of what is the role of the brain in this equation. So the first thing, let me identify how the brain is broken up into lobes.

So all the way in the back, and for my podcast audience, I'm actually taking my hand and putting it behind my head.

Brain lobes and how circuits develop 6:00

And that's your occipital lobe. It's also where your visual cortex is. But vision, even though your eyes are the only piece of neurology on the outside of your skull, it completely influences your brain on so many different levels. Think of it more about how you see the action of how you see, not the visual acuity like reading glasses, but the actual action, of How You See, and then How you See Yourself in the World, And how You Think the world sees you. So, perceptions. Then as we move more to the top of the head but back, so I'm not smack dab in the middle, I more at the curve of my head, that's the parietal lobe.

That's where your body is mapped and we do a lot of sensory motor integration. Many things go on but those are some big ones. As I come down around my ears, that's my temporal lobe. That's your auditory cortex. your drive to have cognitive flexibility and wanting to learn something new. I love this area. This area is a highlight for me. Then as I come around towards my forehead, that's your frontal lobe. So we have all these different lobes. Now again, if you've listened to any of my podcasts, you know that what I try to offer is an understanding that there's a journey that we go through.

We don't just pop into one lobe out of the other. We literally are building our brain. We come into the world fully formed, and then we must go through the movement, the milestones, all the things that kids do. And then, we begin to activate, turn on, connect all these lobes to one another. and it is our experience that is then going to direct the way the circuits come together. This is what I mean by that, is you might say that You are a person that learns when there's a rhythm associated with whatever it is that you're learning.

You might say that, you go in to yourself and do personal reflection before you make your next step. You might say, I look at the room or all the people and that's what my initial step is. you might say I do better putting things together if I'm moving. So we can have a musical rhythm. We can also have kinesthetic rhythm, an actual body movement rhythm I would say, like if you ever get to see this on a video, I use my hands a lot when I talk, so I am a very kinestedic person, first step out of the gate.

Now, all of those are ways and steps, and there's more, but all those ways that we come together inside of ourself. So think of the brain, each of these lobes having circuits inside of them, lots of then, and based on your experience is how they come together and what begins to wire you into the pattern that you approach your life. I mean, I hear all the time, my little one has been like this since they were a toddler. I can remember that I used to do that as a kid. These are learned patterns. We have them all, but they may have a different sequential order than your neighbor.

And that's why when we're looking at building relationships, we first internalize ourselves and go well this is my perspective and this the way i do things and it's sometimes we almost automatically think everybody else does that too and that's not it we all have a very unique. experience and this goes all the way back. So that's what I call the blueprint. The blueprint tells me what goes on for an individual and that is why I even tie in working with children. I go back to the mother and I ask about the pregnancy and any other pieces of information that I can gather.

Because there are pregnancies and let's even say conceptions.

Blueprints, stress, and early development 12:00

Let's say we're planning to have a baby. So there's a conception that is planned, ready, willing, able. There's lots of situations where it's not planned. What does it mean for that individual? What is it like? So in the past, I've done a couple of podcasts sharing with you stories of different situations that mothers were going through and what it looked like for their child. And I think one of the most interesting timeframes really had to do with COVID. we're starting to have a lot of little toddlers coming into the office and that is the time frame that goes back to when covid was just permeating the world and they had already realized that children conceived born at this time They were already demonstrating language delays, emotional dysregulation.

They figured that out within six months. It's the fastest research I think I've ever heard. But it is definitely something that has happened. So I referred to a story that I heard about a little boy that came, mother brought the child to me. And it was because his language was delayed. And unfortunately, what he was utilizing for the form of communication was just screaming and yelling and lots of emotional dysregulation. The story that was shared with me was mom was actually expecting twins. She lost one of the babies.

one of the number one things that they've identified leads to stress. in a pregnant mother is suffering a loss. And suffering the loss looks like many different things. We can lose a life, we can a partner, a job, lots of things, so that idea of loss has a great impact in the season of time that everybody was already in stress. And then on top of it, she actually lost a sibling at the same season. And so there's two losses. And consequently, the child that was born was already impacted by this high level of stress.

And you know, I know we've even talked about this in the past, but if there's anything that impacts the development of a child, it is stress, Unfortunately, I think we kind of use that word like a box of tissues. Let me just pull it out and say, hey, i'm stressed out. But there's an event that goes on with stress. it changes blood flow. It changes not only in the body, but in your brain. And if you're pregnant, that is the time that your baby's brain is forming, is growing. So whatever's going on in you is going to have an impact on that developing brain.

And it's not just you by yourself, but whatever environment you're in is going to have an impact. Now I'm going break some of this down because I want to give a few examples. So let's talk about autism for a moment or anything that's on the spectrum. One of the things that has become crystal clear through research is that these children All babies have a gazillion nerves, but you don't get to keep them all. And what is supposed to happen is you're supposed go through pruning, which means that whatever you use and practice is what you are going to get keep.

So whatever fires together, wires together. but what you don't use should be cleaved away, literally removed. And that's the way that the brain knows how to become efficient. Well, that process alone, pruning, is something that goes on until your 20s. Now, as a baby, it's bigger and bolder as far as the number of neurons that we are cleaving away and the efficiency that's being built. But this process continues and it just gets more efficient polishing those neurons? Which ones are we really going to put together in our circuits?

Now, back to autism. In autism, they're not demonstrating this. This is why I think one of the first things that came out is that it appears that these children have very large heads. Well, babies initially do have large head. Their heads are bigger than their body. But as they go through pruning, that is literally changing. In an autistic child, it doesn't because they're not going through that process efficiently.

Pruning, autism, and language delays 18:00

They do keep the long nerves that are able to connect to their bodies. But that, process of building circuits that it's supposed to go on for years is very inefficient. So those short neurons building the circuits are not coming together and therefore they have different symptoms or patterns that they show. Okay, let's talk about what does that really mean? One of the most common things in autism that people talk is language delay. So language is a process. Language starts in the first couple of months with the baby babbling and then the babies putting more sounds together and toddlers know more words than they actually speak because they're listening, they are building and eventually that comes out as communication.

But if I don't have my circuits coming together, it's delayed. Same thing with socialization. You need your mirror neurons to function. Those are there right at birth. That's why babies look when they're being breastfed. They're looking right into their mother's eyes and they are building facial expression. But again, that takes seasons to go through before it is efficient, before its really being controlled by the higher brain. So what we're talking about is we are building a brain. And that doesn't happen overnight.

The same thing is true when we talk about executive function. That is not something you just pop into. You just don't pop in to the ability to reason, to make good choices. To be able to follow a direction. All of these things have to be practiced. We want to go all the way back to the beginning and think about how did you teach your child to pick up toys? How did your teach you child how to eat? creating that regulation in the space. Sometimes in these situations, I see a lot of families where a child that is delayed kind of has a free rein of the house and they just kind go.

I think a of it has to do with that people are tired and I really understand that. But if we don't teach habits They're not going to just pop in. So if I have a child that is struggling with eating and you're just trying to get a piece of food in their hand, even when they're walking around, they are never going pick up that pattern of we sit down at the table, we eat as a family. We have to practice this. Even if it means that they sit up there in a high chair, for maybe two minutes and they try something, then if it goes into an emotional breakdown, sure, you can take them out, but then later on, try it again.

We have to keep dripping in. the correct behavior and expectation. That's probably a bigger word, expectation, and the expectation needs to meet the age of the child. So what are we practicing? What kind of blueprint does that really set up for us? And what kind expectation can we really have in order to think that my child should be able to work in the higher brain function? for reading, for writing, executive function, reasoning, planning, making good decisions. What does the blueprint look like?

How long have you been practicing this blueprint? And then that's going to put us into an arena of is it new or is chronic? when you've been practicing something for a very long time, that becomes chronic. You've actually surrendered real estate in your brain in order to perpetuate whatever that chronic pattern is. Okay, so let's break that down. So the child that just walks around and eats, That is a pattern. How long has that been going on? Two, three years. That's chronic, okay? A child that doesn't learn how to pick up toys and do their part at an early age, how long is that being going?

Well, they're eight years old now and that went on when they were a toddler. that is definitely chronic. And so in that situation, we have to do something different. And you can only imagine if we're going into adolescence and teenage years, how many repetitions is this going to take?

Practice, chronic patterns, and expectations 24:00

It's going take a lot. As you get over the age of 14, which goes into our teenagers, our 20-year-olds, and any adult listening to this, Over the age of 14, it's going to take thousands of repetition, practicing another pattern for a period of time in order to change the old chronic pattern to the new chronic patterns. Something that will give you a positive outcome, take you into the direction that you would want to go in. So that's a very important part of trying to understand when we start with a problem, the very first thing you must look at is how old is that child?

What is the blueprint? And then you got to break it down. What are the compensations, The adaptations that this child has gone through where they've kind of settled into? Little ones, the strategies that they typically use when they don't want to do something, they just sit down, cry, have an emotional breakdown. They might even go into rougher behaviors. when you're more school age, like somewhere between seven and nine, you kind of probably have some different brainwaves going on dominating inside of your brain.

And you may be the kid that somebody's saying, I think your kid can't pay attention. If I were you, i'd put him on medication. I drastic response without looking at the blueprint. You're putting just a mask over something, but you're not getting to the root of the problem. Now, don't take that as judgment. Some people prefer and believe that their child has done much better. Well, depending again, when you are listening to this, we're going into the summer. we could do a summer intensive program that could make that child's beginning of the next school year be completely different.

I've done it for over, well, just about 30 years. i'm going to go probably about 29 and three quarters. You can make these changes. Nobody is stuck But our current way of approaching things has truly, most of the time, only been going in a traditional model, no offense, but it's been typically medication and let's talk about it. And talking about something over and over again also becomes chronic and you are truly just burrowing this issue deeper into your brain. Now, you may benefit from talk therapy, and that is absolutely something that somebody can use.

But it's not enough if you are told, this is what I want you to work on this week. You go out there, your child goes out and tries to figure out, okay, am I doing it? If you don't get the feedback, you brain does not know that you're doing something different and you are doing with the engagement that need. Okay, let's break that down. The brain has got to be reinforced. It needs intensity and it needs frequency. That's one of the reasons why I love doing intensives. You really move the needle. If we do a typical two-week intensive, on four days, off the weekend.

That's eight days in a two-week period, but it's 16 sessions because we do two a day. Now, remember what I said just a moment ago. Over the age of 14, we need thousands of stimulations, okay? Under 14 we're looking somewhere between a period of daily change somewhere between six and nine months. But if I jump in with intensity and frequency and create the retraining momentum, chugga, work with the parent, help the parents realize the changes that we are laying down and how I want you to work that, especially after we get done with that initial intensive.

Then you're able to see, okay, what kind of progress did I make and where do I need to shift and create the next step? And that's something we do. Like, for example, we may need to really look at the fuel. And I think that is very important.

Intensity, frequency, and retraining the brain 30:00

If you're really trying to make a change, think about how many stimulations you would be creating if you actually change the body chemistry. Wow, that would be all day long, feeding the body the fuel that it needs so there isn't a strain on the Body Chemistry. That part is really important because most of the time when I'm looking at that blueprint, I am actually finding lots of things with food, vitamin deficiencies, etc. And that is a drain on the system. So if we bring that back into harmony, that's a constant intensity and frequency going on in the body.

Let me make another example. I work with babies too, and when a child is delayed, this is a very difficult place sometimes for parents because think about what a typical developing baby would do all day long. Okay, we'll have some sleep. We're gonna be held, but we're going to have floor time and we are going play with our toys and there's going be interactions with people all day long. A child that is delayed and not doing those things in order for you to move the needle you have to do it with them until they are able to it for themselves.

I was brought into a case on a little boy who has some things going on, but definitely delayed. And this child was really only laying around. We've been together now for, I think it's three months and the child is sitting up for himself. He is babbling. And even when he went to the traditional checkup, they were very excited with the progress because that's the way I coach. I teach you how you have to do this. And yes, it's got to be done all day long, every single day, because they would be doing it for themselves.

All of the work that we do here at Connect My Brain is focused on that premise. Let me kind of wrap this up with the bow. So when you're in coming into the world. The brain, I explain the lobes of the brain. But it's more of a back of brain that gets everything going. And that is your occipital lobe, your visual cortex and your cerebellum. And that's just the name of parts of the brain. Cerebellum is about proprioception, it's about balance, its about coordination. And of course, all these areas do other things, but to really complete the connection, that is what I want you to focus on.

What is the first thing that we get babies doing? we get them laying on their belly then they go to prone on elbows then, they get fully extended arms they're always moving their heads around because the vestibular system which is inside your ear number one thing that it's known for is communicating to the brain where you are in space balance many other things but that's why babies roll their heads around. That's why it's so important for them to roll. So the back of the brain, based on that child's early development, is starting to come on.

Now in a perfect world, if everything goes as expected, now for my podcast audience, I'm kind of using my hand like a cogwheel. So I want you to think of a Cogwheel, a wheel, gear, and it's moving and moving, it moves kinesthetic. And it's checking out the environment, it is checking the internal environment the external environment all of these things and it becomes the role model then for the midbrain. So now I'm bringing my other hand in and they are in rhythm and mirror imaging each other. Now, as I get older, this becomes the role model, then for the frontal lobe.

And now I've brought my back hand in front of my other hand, and they're in perfect rhythm with one another. It's been the roll model. The progression of activation, the sequentialness of the brain coming together coming online, learning patterns, building circuits. But what happens if my gear just doesn't have the rhythm, the smoothness?

Back of brain to frontal lobe integration 36:00

Well, that becomes the role model for the rest of the brain. So the big picture idea When we're talking about higher brain function, executive function. Think of an executive. An executive has been put into that position because they can function with all the things that are expected of them. Reasoning, planning, making good choices, doing what they need to do. but you don't just pop into this in order to truly evaluate what is going on for an individual, especially for children and adults too. I don' ever want to take it away from adults, but my primary focus is kids.

When I look at a child, I have to know their story. That's what I mean by the word blueprint. I just love the work blueprint because it's like the graphics that are made in the building on the architect paper. And it is what i see when I looked at the child. How did you come together? So when executive function is working like it's meant to or being developed in the right direction, the child is engaging. The child, is willing to help pick up their toys. the Child is able to engage with the family at the dinner table.

The child is turning in their homework. The Child is able to stand in front of a group of people and present their PowerPoint. the child aspires to go to college.

Executive function in daily life and closing resources 38:00

And even if the direction changes, because I think we put, you know, declare a major on an 18 year old, I Think that's just crazy. Because did you Know what you really wanted to do at 18? There's a world to learn and that should be what we're trying to get kids to go towards. And that's the reward pathway of the brain. Now I hope you'll take the time and go check out the video that we created from the parental information webinar and maybe even decide to join us. But if you're getting into this and, maybe it's a totally different time of the year, Connect My Brain has so many resources.

We have an incredible parent membership. Would love for you to know more about that. We want to tie you in no matter where you are. We have private podcasts for you. We a private Facebook group where we really encourage our parents to engage, ask questions. we truly believe in the community, our world. Thanks for listening today and be blessed.