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Saturday, July 13, 2013

Executive Dysfunction or Lack of Motivation?

From NCLD.org - The National Center for Learning Disabilities

By Annie Stuart
July 10, 2013

Lazy, apathetic, stubborn. Do you ever think of your child in this way?

If so, chances are your child has trouble getting started and procrastinates with homework or other projects. You may be asking yourself, “What kind of kid am I raising?”

Don’t be too quick to pin a lack of motivation on personality or a character defect. “Motivation is actually one component of executive function,” says Lisa A. Jacobson, Ph.D., NCSP (Nationally Certified School Psychologist), a pediatric neuropsychologist with the Kennedy Krieger Institute in Baltimore. So a lack of motivation may be one part of executive dysfunction, just as trouble planning or sequencing information are.

What follows may help lay some common misconceptions to rest.

Motivation Mashup

Different aspects of executive function—emotion, attention, behavior—are like a braid, says Dr. Jacobson. They develop together and impact each other. In a child with executive dysfunction, it may be difficult to tease these apart.

Pinpoint the Problem

You need to do a little detective work to figure out why your child or teen has trouble initiating tasks or falls apart before she even begins. There are some formal tests that can assess motivation, such as checking to see whether or not a child is internally or externally motivated, says Dr. Jacobson.

For example, does she work on problems to solve them out of personal curiosity (intrinsic motivation)? Or does she do so because she has to, or is worried about getting in trouble (extrinsic motivation)?

To get to the root of the problem, Dr. Jacobson recommends parents and teachers use a less formal approach instead—one that involves assessing skill levels.

Try these approaches to figure out what’s causing the problem:

Does your child simply not understand what you are asking him to do? You can check for comprehension by having him or her repeat instructions back to you.

Or does he know what to do, but not how to do itwhat to do first or second, and how these steps fit together, like in a division problem: Do I multiply first or add first? See what happens if you give a prompt such as, “First, you need to do this.”

Or is it a problem with motivation? Your child understands and can do it, but doesn’t care, or thinks there’s nothing in it for him. If you’ve ruled out problems of understanding or skill, then you’ll know that motivation is a more likely culprit.

Emotional issues can also factor into this equation. That’s because the regions of the brain serving cognitive executive functions also support emotional regulation, says Dr. Jacobson. If your child gets easily frustrated, that may not bode well for taking initiative and staying motivated.

Check and Adapt

Once you’ve pinpointed the main problem, you can adapt your approach to your child. But know that this is an ongoing process as your child continues to develop.

If it seems your child doesn’t understand what you’re asking, simplify or condense instructions or make them more concrete. Then try again. This is particularly important for children with working memory problems.

Make sure your child can actually do what you are asking him to do. If he has trouble getting started, try providing a cue or support or some kind of environmental structuring, such as a checklist. Then, if you ask, “Where’s your checklist?” see if he can pull it out and get started without additional prompts every step of the way.

“That ongoing interaction allows for some assessment of how well your child is integrating the system or cues into their process,” says Dr. Jacobson. And, with regular assessments like this, you can see if skill deficits are a major roadblock to motivation.

Building Bridges

“The bridge between skill and motivation is competence,” says Dr. Jacobson. It’s the experience of success that is critical, she explains. “Target the task or assignment to the child’s developmental or skill level, so the child will be able to accomplish it. Then you will be facilitating that development of intrinsic motivation.”

Keep it Simple

“If something is doable, we’re much more likely to get going on it,” says Dr. Jacobson. If it’s a simple and achievable goal, you can check it off your list. “But if something is too hard, the experience of working on it won’t be intrinsically motivating,” she adds.

For example, a child with dyslexia or another LD that affects language may not understand what is being asked of her. “The more times she tries to do it,” says Dr. Jacobson, “the more she gets it wrong, and now she has this sense of learned helplessness:No matter what I do, I’m not going to get it right, so why start?” Children with both LD and ADHD, she says, are especially quick to withdraw their effort because tasks can seem overwhelming to them.

Think about First Impressions

The perception of challenge also really impacts a child’s perception of his ability to accomplish the task. And that affects his ability to get going, even if he has the ability to do so. Take this example: You have two math worksheets—one contains 10 simple problems, the other has just a single hard problem. “To a child with executive dysfunction, the second one might actually look easier because it’s just one problem,” explains Dr. Jacobson.

Use Personal Rewards

If you’ve ruled out a problem of skill, and your child or teen is still truly not engaged, the trick is to use things that are personally motivating, says Dr. Jacobson. This could be video game time or access to the family car. As the parent of this child, you know your child best. So who knows better than you what the magic motivating ingredient will be?

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