Help for executive function issues

Hi everyone,

My daughter is a Junior with what I am coming to realize are real executive function issues. She is bright, willing and enthusiastic. She is NOT lazy but incredibly distracted. She loses points for forgetting to turn in homework she has done…work that she might actually be holding in her hand. She can get lost staring at a shiny object for hours and not know she is doing it. She forgets when tests are coming up, when homework is assigned etc. She has high grades because I have been acting as executive secretary. I keep her schedule, keep on top of homework, make sure she meets deadlines etc. She has never had an official diagnosis. But the problems are evident.

Now, I am looking at one year before she goes off to college. Obviously, I won’t be there to handle all the back up I have been doing. I’m frankly, terrified. I am considering having her live at home and commute so that I can keep providing backup, but that is not optimal. She really wants the full college experience and the colleges in commuting distance are not perfect for her.

Do you have any advice on what I can do? She doesn’t need special support like extra time on tests. She needs a secretary and a coach! I would be willing to pay for services to help her through if something like that exists but I don’t know where to find it.

Thanks so much for any help you can give me!

Executive functioning coaching is a booming industry! Do a search in your area, and you’ll very likely find more than one coach. Be warned, it can be very expensive (in metro Boston I paid $150 for weekly hour-long sessions). The best coach will teach your daughter how to manage herself.

You may want to look in to becoming a coach yourself as a new career path! :wink:

Look for colleges with Spectrum Support…e.g. https://www.rit.edu/studentaffairs/ssp/

Or have her start at community college so you can help her manage her schedule

Unfortunately, the best thing would have been to take care of this years ago because you’ve really only enabled the issue and haven’t improved it. My son suffers from executive functioning issues as well, but he was given academic support from 6th - 10th grade to overcome it and learn how to organize his schoolwork. It takes years to learn that skill, at least it did at a middle school age. Hopefully, your high school D can pick it up faster because it will be extremely hard for her to compensate in college without a backup at this point.

You need to find some sort of coach or academic support IMMEDIATELY if she’s ever going to be able to function, not only in college, but in life. You may also want to have her evaluated by a psych because you’ll need that report in order to get any support or accommodations in college.

It may be necessary for her to go to community college for the next couple of years while she receives some sort of education on how to organize schoolwork, time, etc. and how to organize her thoughts for essays, projects, etc. But as she begins to learn the skills to manage her organization by herself, you MUST step back and let her do it. It’s the only way she can become competent in these skills. It could take a few years, but she’ll get there. And then when she does, she’ll feel much more confident in her own abilities to manage her life. Plus, then you can just relax and be a mom instead of a secretary. :slight_smile:

Thanks @madgemini4 for the suggestion of a coach. Do you have any suggestions for how to determine if someone is reputable and a good fit?

I’m not sure that community college is the right solution, but will give it thought.

@megan12 Gee, thanks for telling me what I should have done years ago. Great, that you were so knowledgeable and were able to do everything right. You may have good suggestions, but the implied criticism is unhelpful.

I don’t know where you live but I’ve heard that the support programs at Muskingum U. are excellent. https://www.muskingum.edu/plus/services. Kent State is also supposed to have good programs. (Can you tell I live in Ohio ; ).

I would start with either your pediatrician or the school guidance office.

This is your first experience with these issues. It won’t be theirs. Both should have the resources to get you started.

Is it possible she has ADHD? There is no definitive test for that: even our neuropsych. used a questionnaire which is easily accessed online. Executive function issues really should be evaluated by a neurpsych. Sometimes your school can do it. Bite the bullet and pay for an evaluation at this crucial time.

She may qualify for a 504 plan or an IEP. Since she has done well, with your help, the schools may not have recommended these.

She may also qualify for accommodations like extra time or extra breaks on standardized tests, but there has to be some history of accommodations at school and testing etc.

When she is accepted and decides on a college, oShe can meet with the disabilities office, where she will get letters for professors stating she is registered with them- and sometimes listing accommodations, not always. Your daughter would have to talk to the professor about it.

Sometimes a dean or advisor at school will be helpful in finding resources. Or a school will have personnel to help. More often, parents do hire coaches, and the coaching can happen online if needed. Call Landmark College and ask for a referral.

Some kids have learning disabilities that in turn result in executive functioning issues. You could try “taking care of it” until you are blue in the face, and the kid would not improve. I agree that having her assessed for an LD would be a good step. Even if there isn’t a treatment (or you choose not to pursue one or more that could be available), having a diagnosis can be quite helpful in getting a kid to accept that maybe they need to do things differently from their peers to compensate for a difference in how their brain works.

Hi – I was referred to a consultancy that specialized in EF coaching by a friend. I just liked what they were saying (we had an in-person consultation before starting), and the coach was a good fit with my kid. Do you live in a metro area or are you more remote? If the former you probably have practices that offer EF coaching.

Given where you are now, and the need to maintain good grades next year for college applications, I don’t think you can step back, which is the usual recommendation in the event of a diagnosis in middle school.

Instead I’d suggest a gap year after getting the college acceptance. Have her work for a year while living at home. She’ll have to do it on her own, but the consequences for failure won’t be that great, compared to failing in college. If she succeeds she will be ready for college, if she doesn’t then you can recalibrate and reconsider local options. But do look into getting an assessment by an educational psychologist ASAP, followed by EF coaching and support over the next year.

First.

Breathe.

Second.

Be proud of yourself for being willing to look at what is going on and realize that it may be beyond you and your D is not going to just grow out of it on her own.

While hindsight may be 20/20, it’s not remotely productive in this case. And frankly, kids grow and change and what might have seemed normal or manageable, or a maturity issue at 12 or 14 can all of a sudden become a bit scary at 17.

There really are a number of ways you can tackle this. They may or may not get her ready for college for a fall 2019 start. But knowledge is power and the more you know, they more you dig in, the more steps forward you both will take.
I, personally, would not suggest you start with your pediatrician or your schools GC. If they saw an issue on their own, they’d have called it to your attention. Granted, much of it may have been hidden from them but based on personal experience you will have better, deeper and more holistic results if you leapfrog that step. You’ll come back to them, but with information.

I would suggest a full work up and testing by a psychiatrist. Asap. While you see executive functioning issues, it’s a layman’s diagnosis. That may be all there is to it, but there may be other things and the treatments vary quite a bit. I would start looking into this tomorrow, it can take a long time to get in, a long time on the phone figuring out who your insurance may cover, a long time till results and reports come back. By way of example, my S17 who had a diagnosis of ADHD has experienced a severe increase in his Executive Functioning issues this year. His workload, always heavy, also increased. I elevated the situation last October. The pediatrician just kept changing meds, therapists tried different ways to help him get organized and the HS couldn’t meet with us to discuss a possible 504 until Feb. I couldn’t get him in for testing until March, we got verbal results in April and are STILL waiting for the actual report. But he doesn’t have ADHD and now we can work on a better treatment plan now that we have a more accurate diagnosis.

And that’s with relatively awesome providers, great pediatrician, a therapist we adore and a supportive school and GC. It is just SLOW. HS’s are not set up to help the bright kid with executive functioning issues, they just see smart but lazy (if they even see it). My kid flew under the radar and I was a terrible executive secretary!

Depending on the diagnosis I would really suggest getting a 504 in place if you can. You may not be able to regardless of the diagnosis depending on your schools policy as her disability isn’t effecting her academics from the schools side of things. While you don’t want to let your child fail…to some degree it is needed. It lets your child realize what they aren’t managing on their own in a much more impactful way (which lets them admit they need help) and it lets the school see the real issues. Having a plan in HS seems to make getting one in college easier but I’ve not done it yet so that’s just a hypothesis. A 504 can be fairly minimal, in our case it’s just preferential seating so he interacts with others and allowing him to to the calc homework n reverse order to make it more interesting. More importantly though it documents that he has some issues that teachers need to be aware of even if the accommodations themselves seem silly.

You do need to step back and away, but it can’t be cold turkey. You can start educational coaching for executive function issues now. You can find centers that specialize in it, it will often be at places that also offer coaching linked autistm/apsergers/adhd. Some centers that specialize only in ADHD. This will generally not be covered by insurance. Once you have test results and can show a medical need (if test results show it), it is a qualified HSA/FSA expense. However. Educational coaching really only works if there is something the student is working on, it’s not a summer camp. It’s a 1-3 times a week session where they take over the coaching and you give up your secretary role. As others have suggested, just start googling. It is not always easily found. So, now (based on timing with school) may or may not work. What are her summer plans? Some of these centers have parent support groups which can help too (haven’t been but have heard).

We plan to start this with S17 in August. He will have plenty of summer homework with his AP classes for senior year and he will have college apps. He will also be juggling an internship though I don’t expect that to be a ton of hours.
We feel it’s a soft rollout before classes start. We will be going to a place recommended by the psychiatrist that did the testing. You could also consider therapy, we have found it very beneficial and have seen progress in his Executive Functioning with just that (and finding the right one). We will continue with therapy as well.

As for college, it’s impossible to say as you don’t really know her issues, you just suspect. Different issues will have different treatments and time frames. Distractibility can be ADHD. Medication can make an amazing difference if that is what it is, as can maturity and the right kind of training support. But if the staring at a shiny object is because they are so overwhelmed they can’t parse the data to know where to start and the shiny object is really avoidance, well that’s a different issue entirely. It took my S a year, and therapy to tell me he couldn’t do homework at home because being home was distracting (home should be home and not work in his mind). It could be more than one thing.

There are colleges that offer certain kinds of accommodation support services that require a diagnosis, and paperwork. There are colleges that have paid support programs that do not require an official diagnosis (likely because you are paying extra). The paid programs we are looking at provide the kind of coaching/check in’s that traditional accommodations will not provide. As with your D my S does not need extra time or assistive devices but he does need someone to help him keep on track and help facilitate him taking that over on his own. These programs specialize in just that. I am hoping the internship, the summer coaching, and then coaching and therapy through all of senior year, will have him in an improved pace as we look at whether we allow him to go away…or not.

For our college search we are doing a mix of schools that offer paid support and are strong in my S’s area of interest, schools where he could either live at home and commute or on campus but continue with his current therapist and the educational coach (assuming it’s helpful) and ones that have small classes and appear more nurturing with support services…albeit at a lower level. CC and a gap year are also real options. Right now it’s an open book without a page written. So much can change, even in the span of a month. I have days I am sure he will not be ready and days I think…you know, he might pull this off.

OP, my student was dx in college w ADHD that manifested as serious executive function deficits…insert long story with good outcome. Feel free to PM me if you’d like.

As far as college – living at home to start is a fine idea, you aren’t wrong. Another reality is that a 4-year finish is unlikely. Often it is more successful to take a smaller class load, even p/t, to help keep things manageable. A coach or helper is a great concept but getting her to participate reliably can be a problem, so it’s no magic wand and lots of money, and not available everywhere. A coach cannot make her get up, go to class, hand in a paper, keep a schedule.

A smaller school, where professors know her, will help. IEP at a college level are not always helpful or address the problem, but some schools have support groups of peers with similar issues can be great. Does your daughter see a problem? Kids like ours have a big, big, gulf between their intentions and their execution. Be watchful for discouragement and disengagement as college exerts pressure and highlights deficiencies.

I strongly push back against the whole “stand away and let her learn” idea. Students like this need the help, and they need your support, and they need a long, long, long learning curve as adults to acquire skills. There will be trial and error until she finds things that work for her. You go right ahead and be the training wheels, be the lighthouse for her little boat, and as a team you can get there.

@mommafox999 Hmmm, sorry you took that the wrong way since I’m not really that knowledgeable about it. Thought my experience could help you.

Are the EF issues evident outside of school? Has she held a summer job, or other home chores which require attention and responsibility? Managed herself at an away camp or trip without You? Acquired her drivers license? EF has many non-academic overlaps, maybe you can use the summer to address.

I recommend a thorough evaluation with a neuropsychologist. That specific combination of good ability to focus with severe EF struggles, and losing track of time staring at shiny objects is actually very typical of autism spectrum disorder, though often confused with ADHD. ASD with no intellectual impairment manifests very differently in girls than in boys and is often overlooked until problems crop up in the late teen and early adult years. You might want to consider ruling it out at least.

I don’t think kids with severe EF difficulties can easily overcome them without help. And I reject the idea of sink or swim. That could very well trigger depression and anxiety and you would have much more serious issues to deal with. Give all the support you can to safeguard emotional health and academic success. It’s a hard road but girls like this can be successful with support and once they’ve found their niche. I’ve seen it happen.

Getting a diagnosis is important. Lots of things can cause EF struggles, and they may be treated in very different ways. ADHD is often used as a catch-all when people don’t understand specific causes. Auditory and sensory process disorders can often be confounded with attention disorders.

Generally, the earlier these things are picked up and treated the better the outcome, but hindsight is always 20-20. Don’t beat yourself up or feel guilty. Parenting is the hardest job in the world.

Sorry, didn’t read all the responses, so please forgive me if I’m repeating. My son is ASD, and struggles with Executive Functioning. He will be attending UCONN in the fall that has a program for kids like him, but in my research for college, most schools have some sort of study skills support. The hurdle you might have if she is not used to having services (my son started in 1st grade, so it isn’t an issue for him to get support) is resistance to avail herself of that in college. I have a friend whose daughter is struggling at RIT because she will not seek out the help and/or is resistant to take their advice.

That said, my mother and I both struggle with executive function, though to a lesser extent (I do not remember ever missing assignments). We misplace things easily, forget things if they are not written down. Even with years and years of training and knowing intellectually, he has not typically been able to do it on his own. I do see glimmers however. In the last 6 months since he turned 18, he is very aware of where his phone and his wallet are or realizes quickly and retraces his steps. I don’t think a diagnosis would be a bad thing and if she’s going to go on medication, better to do it now. We are just getting around to getting him evaluated for ADHD because I was recently diagnosed, but I worry about putting him on meds (hoping low dose like me) and then shipping him off across the country.

Most schools (if not all) will not give any support unless there is an IEP or 504 in place in high school. Once one is in place then you can get a transition plan from the high school which clearly states what services are need. Then you can take the transition plan to the colleges and ask if they can meet her needs.

There is no IEP for college. The letters provided by the disabilities office are sometimes the only thing provided by that office. That said, deans, psychiatrists and other professionals can advocate. You just need to know that the level of accommodations is lower at college.

I had one go to college for a year and then come home and now does p/t school while working. Work really helps organize her for some reason.

Every kid is different and just want to say things can/do work out, even if the path isn’t exactly straight :slight_smile: