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Executive Functioning and Behavior Issues

Executive functioning skills develop over time in most children, helping them to consciously control how they deal with their environment and new situations. Children with Down syndrome who have demonstrated greater challenges with executive functioning seem to capitalize on other strengths as teens and adults that help them manage their lives through dependence on routines and habits they develop as they learn their way around the world.

Some children go to great lengths to avoid what seems to them to be an unusual situation. Events or experiences that are new to them can cause them to feel uneasy, including minor changes in a daily schedule or activity that don't seem unusual to anyone else in the family.

Loud noises, commotion or other sensory events can also cause great discomfort or disorientation. Parents, teachers, or therapists may attempt to soothe the child; and to redirect or correct the behavior without much success. Overstimulation from unusual situations, sensory overload, or changes in what is expected can overwhelm the child's ability to predict how to manage their behavior or escape.

Parents have shared helpful advice online at the down-syn listserv about effective ways to help their children with Down syndrome deal with unexpected changes and uncomfortable situatioins, like providing visual cues or clues; giving a child a few seconds of silence to respond to a request or comply with a demand to allow them to process the meaning of the comment; using introductions with short, clear sentences; providing or promising small rewards; and adding a dash of good humor.

Children with executive functioning challenges often have no way to respond to their environment except through their behavior. It is up to their mainstream peers or adults in charge to provide a small accommodation, a substitute behavior, or a more pleasant way to communicate the need to avoid the uncomfortable situation - or just a little extra time.

Two professionals who seem to especially respect and admire their patients with Down syndrome, Dennis McGuire, Ph.D., and Brian Chicoine, M.D. of the Adult Down Syndrome Center of Lutheran General Hospital in Chicago, have explained how the executive functioning challenges of individuals with Down syndrome can cause behavior problems in a Q and A based on their excellent reference, Mental Wellness in Adults with Down Syndrome: A Guide to Emotional and Behavioral Strengths and Challenges.

9 Terms to Know If Your Child Struggles With Executive Functioning Issues
http://ncld.org/types-learning-disabilities/executive-function-disorders/terms-to-know-child-struggles-with-executive-functioning-issues

Q&A from Dennis McGuire, Ph.D., and Brian Chicoine, M.D.
http://www.woodbinehouse.com/mcguire_chicoine.asp
based on their book,
Mental Wellness in Individuals with Down Syndrome (Woodbine House, 2006)
http://tinyurl.com/MntlWllnssDwnSyn

Executive Function: Skills for Life and Learning
http://developingchild.harvard.edu/resources/multimedia/videos/inbrief_series/inbrief_executive_function/

Also by Dr. McGuire and Dr. Chicoine:
The Guide to Good Health for Teens & Adults With Down Syndrome

Get me started, but let me finish!
http://tinyurl.com/97jfew5

Andy's Behavior
One family's experience using Applied Behavioural Analysis
http://www.cdss.ca/information/personal-stories/andys-behaviour-answer.html

Help Me with My Toddler!
http://appliedbehavioralstrategies.wordpress.com/2012/02/13/help-me-with-my-toddler/

Please read this article before implementing ABA in your classroom or home:
Quiet Hands
http://juststimming.wordpress.com/2011/10/05/quiet-hands

America's Supernanny: The Fitzgerald Family - Season One Episode 6
"Childcare expert Deborah Tillman helps a family where Mom feels like a failure and Dad has on all his attention to his church congregation. ... Mom is left alone with four unruly kids. Garrett has Down Syndrome and his own set of special needs that require all of Mom's attention, leaving the three other children feeling neglected and abandoned. ..."
http://www.mylifetime.com/shows/americas-supernanny/video

Communication Strategies in Social Situations
http://www.handsandvoices.org/articles/SocEmot/V9-4_bluff.htm
"... Growing up hard of hearing, I bluffed my way through conversations ..."

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